Vibration Excitation and Suppression of a Composite Laminate Plate Using Piezoelectric Actuators.

Piezoelectric (PZT) actuators bonded on a structure can be used to generate deformation and excite vibration for the shape control and vibration suppression, respectively. This article proposes a theoretical model for predicting vibrational response of a composite laminate plate with PZT actuators. The bending moment induced by the PZT actuator was obtained and applied on the composite laminate plate. Utilizing composite mechanics and plate theory, an analytical solution of the vibrational response of a composite laminate plate excited by the PZT actuator with oscillating voltage was derived. Furthermore, the finite element analysis using ANSYS software (2019 version) was carried out to compare with the proposed model with a good agreement. A parametric study was performed to investigate the influences of PZT location and frequency on the vibration. Numerical results illustrate that mode can be selectively excited provided the PZT actuator is placed in an appropriate location. Moreover, the proposed model was employed to predict the effectiveness of vibration suppression by distributed PZT actuators. The novelty of this work is that a complicated coupling problem between the composite plate and bonded PZT actuator is resolved into two simple problems, leading to a simple analytical solution for the vibrational response of a composite plate induced by PZT actuators. The proposed model has been successfully demonstrated its applications on the vibration excitation and suppression of a composite laminate plate.

Deformation of Composite Laminates Induced by Surface Bonded and Embedded Piezoelectric Actuators.

In this work, piezoelectric (PZT) actuators were surface bonded on or embedded in a composite laminate and subjected to an electric voltage across the thickness, resulting in a bending effect on the composite laminate. An analytical expression of the deflection of a simply supported cross-ply composite laminate induced by distributed piezoelectric actuators was derived on the basis of classical plate theory and composite mechanics. The theoretical solution can be used to predict the deformation of the composite laminate. Series of parametric studies were performed to investigate the effects of location, size, and embedded depth of PZT actuators on the composite laminate deformation. The analytical predictions were verified with finite element results. A close agreement was achieved. It demonstrated that the present approach provided a simple solution to predict and control the deformed shape of a composite laminate induced by distributed PZT actuators.

Awareness And Belief Regarding Breast Cancer Among Women Living In Selangor, Malaysia

@#Breast cancer is one of the leading causes of mortality among women. The aim of the current study was to assess the factors affecting awareness and beliefs regarding breast cancer, among women living in the state of Selangor, Malaysia. A cross-sectional study was conducted among women living in Selangor aged 18 to 65 years old, with a total of 483 participants. A validated questionnaire regarding awareness and belief was used. The questionnaires consist of 25 questions comprising of socio-demographic, history of other diseases, awareness and belief. The prevalence of poor awareness among women was 63.4%. while the poor level of belief was 84.7%. There was a significant association between awareness and educational background, family history of breast cancer (P=0.001, P=0.032) respectively. The association between awareness and belief was significant (P=0.02). As a conclusion: There is a high level of poor belief and poor awareness among women in Selangor, Malaysia regarding breast cancer. Source of information such as the internet plays a major role in breast cancer prevention, and the majority of them do not know the technique of breast self-examination. More health promotion is needed to target general population through big campaign of awareness.

Superior Capsular Release After Failed Combined Superior Labral Repair And Biceps Tenodesis For Slap Tear.

INTRODUCTION: Optimal treatment of type II superior labrum anterior and posterior (SLAP) tears is controversial. There has been a recent trend towards biceps tenodesis over SLAP repair in older patients. Few surgeons have performed combined biceps tenodesis and SLAP repair with inferior results. CASE REPORT: This case describes a 46-year-old patient who had persistent pain and stiffness after combined biceps tenodesis and SLAP repair for a type II SLAP tear. His pain and motion improved after arthroscopic superior capsular release. CONCLUSION: Failed SLAP repair is often multifactorial and a thorough workup is needed. Combined biceps tenodesis and SLAP repair can cause pain, stiffness, and dysfunction which can be successfully treated with arthroscopic superior capsular release.

Stress analysis of sandwich composite beam induced by piezoelectric layer.

INTRODUCTION: Smart structures equipped with piezoelectric devices to sense and actuate the structure could be used in many engineering applications. To explore the smart structure further and apply it to more complex structures, some problems are critical to be concerned. Among them, delamination due to the high stress is an important issue since its serious effect on the strength and stiffness of the composite structure. METHOD: In this investigation, a piezoelectric layer is embedded into the host structure to form a sandwich composite structure. The piezoelectric layer is subjected to an electric voltage, yielding the bending effect on the sandwich composite structure. A theoretical model based on the Euler beam theory and interfacial continuity is presented to determine the stresses of the sandwich composite beam caused by the piezoelectric layer. RESULTS: The influences of the embedded depth and Young's modulus of the piezoelectric layer on the stress distribution of the sandwich composite beam are investigated through a parametric study. The analytical solutions are verified by the finite element method. Good agreement is achieved between the present approach and the finite element method. CONCLUSIONS: Numerical analysis indicates that the maximum tensile stresses in the top and bottom layers are decreasing with the increase of the embedded depth, while the maximum compressive stress in the lead zirconate titanate layer is increasing with the increase of the embedded depth. Both the top and bottom layers are subjected to tensile stress and increasing with the increase of the Young's modulus ratio, while the piezoelectric layer is subjected to compressive stress and increasing with the increase of the Young's modulus ratio.

The efficacy and tolerability of paliperidone in mania of bipolar disorder: A preliminary meta-analysis.

Paliperidone may be effective for the treatment of bipolar disorder (BD); however, the evidence has been mixed. This is the first meta-analysis to evaluate the efficacy, safety, and tolerability of paliperidone for the treatment of BD. We performed a systematic search of the literature using major electronic databases from inception to January 27, 2017. Randomized control trials (RCTs) investigating paliperidone treatment among patients with BD versus a placebo or other second-generation antipsychotics were included. We then performed exploratory random-effects meta-analysis. The 3 included RCTs compared paliperidone with placebo (667 patients received paliperidone and 369 received a placebo). The dose of paliperidone in the included studies ranged from 3 to 12 mg/day. Paliperidone did not significantly improve manic symptoms (Hedges' g = -0.221, p = .067, k = 5) compared with a placebo; however, it was superior to a placebo in improving psychosocial function (Hedges' g = -0.156, p = .042, k = 3) and general severity (Hedges' g = -0.205, p = .001, k = 5). Paliperidone was associated with a greater use of anticholinergic medications (p = .002), increased body weight (p < .001), and higher serum prolactin level (p < .001) compared with a placebo. Our preliminary results suggest that paliperidone does not offer significant benefits for the treatment of mania symptoms in BD compared with a placebo. In addition, treatment with paliperidone was associated with a higher incidence of adverse effects. Because of the limited number of studies, further well-designed RCTs are warranted. (PsycINFO Database Record

Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials.

Numerous studies have investigated aripiprazole as a treatment for bipolar disorder (BD). therefore we conducted this comprehensive meta-analysis to investigate the efficacy and safety profile of aripiprazole in treating BD. Two authors conducted systematic searches of PubMed and ScienceDirect from inception until May 14th, 2017. Randomized controlled trials (RCTs) of people with BD who received aripiprazole were included. A total of 20 RCTs met the eligibility criteria, including two which investigated the efficacy of aripiprazole versus haloperidol (aripiprazole=340; haloperidol=337), three which compared aripiprazole versus lithium (aripiprazole=208; lithium=212), and 15 with multiple comparisons of aripiprazole versus a placebo (aripiprazole=1923; placebo=1499). Compared to a placebo, aripiprazole improved acute mania (Hedges' g: -0.299, p=0.001) and psychosis (Hedges' g: -0.296, p<0.001) in the acute mania state, but did not improve depressive symptoms (Hedges' g: -0.127, p=0.054) in the acute depressive state. Aripiprazole was associated with lower relapse rates in bipolar mania when used in combination versus a placebo in maintenance therapy (odds ratio: 0.522, p<0.029). Aripiprazole was also associated with higher levels of high density lipoprotein, lower dropout rates, but no difference in extrapyramidal symptoms in the maintenance phase versus a placebo or in comparison with other medications (haloperidol or lithium). Our results suggest that aripiprazole is effective and safe in treating bipolar mania. Further trials are necessary to evaluate the efficacy and tolerability versus other medications.

Integrated Flexible Electronic Devices Based on Passive Alignment for Physiological Measurement.

This study proposes a simple method of fabricating flexible electronic devices using a metal template for passive alignment between chip components and an interconnect layer, which enabled efficient alignment with high accuracy. An electrocardiogram (ECG) sensor was fabricated using 20 µm thick polyimide (PI) film as a flexible substrate to demonstrate the feasibility of the proposed method. The interconnect layer was fabricated by a two-step photolithography process and evaporation. After applying solder paste, the metal template was placed on top of the interconnect layer. The metal template had rectangular holes at the same position as the chip components on the interconnect layer. Rectangular hole sizes were designed to account for alignment tolerance of the chips. Passive alignment was performed by simply inserting the components in the holes of the template, which resulted in accurate alignment with positional tolerance of less than 10 µm based on the structural design, suggesting that our method can efficiently perform chip mounting with precision. Furthermore, a fabricated flexible ECG sensor was easily attachable to the curved skin surface and able to measure ECG signals from a human subject. These results suggest that the proposed method can be used to fabricate epidermal sensors, which are mounted on the skin to measure various physiological signals.

Linguistic and psychometric validation of the Malaysian version of Diabetes Quality of Life-Brief Clinical Inventory (DQoL-BCI).

BACKGROUND: Quality of life (QoL) assessment provides valuable outcome to support clinical decision-making, particularly for patients with chronic diseases that are incurable. A brief, 15-item diabetes-specific tool [i.e. Diabetes Quality of Life-Brief Clinical Inventory (DQoL-BCI)] is known to be developed in English and validated for use in clinical practice. This simplified tool, however, is not readily available for use in the Malaysian setting. OBJECTIVE: To translate the DQoL-BCI into a Malaysian version and to assess its construct validity (factorial validity, convergent validity and discriminant validity), reliability (internal consistency) and floor and ceiling effects among the Malaysian diabetic population. MATERIAL AND METHODS: A forward-backward translation, involving professional translators and experts with vast experience in translation of patient reported outcome measures, was conducted. A total of 202 patients with Type 2 diabetes mellitus (T2DM) who fulfilled the inclusion criteria were invited to complete the translated DQoL-BCI. Data were analysed using SPSS for exploratory factor analysis (EFA), convergent and discriminant validity, reliability and test-retest, and AMOS software for confirmatory factor analysis (CFA). RESULTS: Findings from EFA indicated that the 4-factor structure of the Malaysian version of DQoL-BCI was optimal and explained 50.9% of the variance; CFA confirmed the 4-factor model fit. There was negative, moderate correlation between the scores of DQoL-BCI (Malaysian version) and EQ-5D-3L utility score (r = -0.329, p = 0.003). Patients with higher glycated haemoglobin levels (p = 0.008), diabetes macrovascular (p = 0.017) and microvascular (p = 0.013) complications reported poorer QoL. Cronbach's alpha coefficient and intraclass coefficient correlations (range) obtained were 0.703 and 0.86 (0.734-0.934), indicating good reliability and stability of the translated DQoL-BCI. CONCLUSION: This study had validated the linguistic and psychometric properties of DQoL-BCI (Malaysian version), thus providing a valid and reliable brief tool for assessing the QoL of Malaysian T2DM patients.

The Apex of the Deep Cartilage: A Landmark and New Technique to Help Identify Femoral Tunnel Placement in Anterior Cruciate Ligament Reconstruction.

PURPOSE: The purpose of this study was to evaluate the apex of the deep cartilage (ADC) as a landmark to help guide femoral tunnel placement during anatomic single-bundle anterior cruciate ligament (ACL) reconstruction. Our secondary purpose was to assess whether or not the endoscopic transtibial femoral offset drill guide could reach the center of the ACL's femoral footprint. METHODS: Eight formalin-injected cadaveric knees were dissected and the center of the ACL femoral footprints identified. The ADC was selected as an easily identifiable landmark during arthroscopy and was used to reference the position of the ACL femoral footprint with the knee flexed at 90°. Next, a 7-mm transtibial femoral ACL drill guide was used to engage the posterior aspect of the lateral condyle at the level of the femoral footprint. This position was marked, and the distance from the center of the femoral footprint was recorded for each specimen. Descriptive statistics were used to report our measurements. RESULTS: The median high and shallow measurements were 3 mm (range, 1 to 4 mm) and 12 mm (range, 11 to 17 mm), respectively. The femoral offset guide never reached the center of the femoral footprint in all specimens; the median distance between the 2 measurements was 4.5 mm (range, 2 to 9 mm). CONCLUSIONS: If the anatomy is difficult to delineate at the time of reconstruction, our study suggests using the ADC as a landmark to guide anatomic placement. The dissection of 8 cadavers showed that the center of the ACL femoral footprint had a median position of 3 mm high and 12 mm shallow to the ADC. We also showed that the transtibial femoral offset guide did not reach the center of the ACL footprint on all specimens and should therefore not be used for anatomic ACL reconstruction. CLINICAL RELEVANCE: Current commercially available transtibial femoral offset guides cannot reach the center of the ACL's femoral footprint and therefore should not be used. Alternative techniques, such as referencing from the ADC through an anteromedial (AM) portal, are recommended.

A Case of Klippel-Trenaunay Syndrome with Acute Submassive Pulmonary Thromboembolism Treated with Thrombolytic Therapy.

Klippel-Trenaunay syndrome is a rare congenital mesodermal abnormality characterized by varicose veins, cutaneous hemangiomas, soft tissue and bony hypertrophy of limb. Potential complications such as deep venous thrombosis and pulmonary thromboembolism have not been reported in Korea to date. We demonstrate the case of a 48-year-old woman with Klippel-Trenaunay syndrome with extensive varicose veins on right lower limb, hypertrophy of left big toe and basilar artery tip aneurysm, complicated with acute submassive pulmonary thromboembolism treated successfully with intravenous thrombolytic therapy.

Effectiveness of a brief physician counselling session on improving smoking behaviour in the workplace.

BACKGROUND: Brief physician counselling has been shown to be effective in improving smokers' behaviour. If the counselling sessions can be given at the workplace, this would benefit a larger number of smokers. This study aimed to determine the effectiveness of a ten-minute physician counseling session at the workplace in improving smoking behaviour. MATERIALS AND METHODS: This prospective randomised control trial was conducted on smokers in a factory. A total of 163 participants were recruited and randomised into control and intervention groups using a table of random numbers. The intervention group received a ten-minute brief physician counselling session to quit smoking. Stages of smoking behaviour were measured in both groups using a translated and validated questionnaire at baseline, one month and three months post intervention. RESULTS: There was a significant improvement in smoking behaviour at one-month post intervention (p=0.024, intention to treat analysis; OR=2.525; CI=1.109-5.747). This was not significant at three-month post intervention (p=0.946, intention to treat analysis; OR=1.026; 95% CI=0.486-2.168). CONCLUSIONS: A session of brief physician counselling was effective in improving smokers' behaviour at workplace, but the effect was not sustained.

Is the clock face an accurate, precise, and reliable measuring tool for anterior cruciate ligament reconstruction?

PURPOSE: (1) To assess the use and practice of the clock face among surgeons who routinely perform anterior cruciate ligament (ACL) reconstructions, and (2) to assess the accuracy, precision, and reliability of 3 commonly used clock-face schemes in ACL reconstruction. METHODS: First, 9 surgeons completed a questionnaire assessing the use and definition of the clock-face technique. Next, to assess the accuracy, precision, and reliability of the clock face, each surgeon estimated the "time" of 8 artificial femur models with a black dot located on the posterior aspect of the lateral condylar wall. The estimates were performed using 3 different clock-face schemes and were repeated 10 months later. Solutions for each specimen were obtained by use of a computer graphical interface. RESULTS: More than half of the respondents (55%) use the clock face in ACL reconstructions, with the reported mean ideal "time" for a femoral tunnel in a right knee of 10:05 (SD, 31 minutes). When we accounted for the different clock definitions, this ideal position was found along the entire lateral condylar wall. In the assessment of the performance of the clock face, the mean error was 32 to 40 minutes (which translates to 3 to 4 mm) among the 3 clock schemes. The maximum error was 4 hours 0 minutes, and the range of responses was 1 hour 0 minutes to 4 hours 0 minutes depending on the specimen and clock scheme. Regardless of the clock scheme used, the intrarater and inter-rater reliabilities were similar-measuring, on average, 0.78 and 0.68, respectively. CONCLUSIONS: The clock face continues to be commonly used in ACL reconstruction. Different clock-face definitions affect the position for the same "time." When the clock-face parameters were strictly defined, there was good reliability with borderline accuracy and poor precision. CLINICAL RELEVANCE: Considering the borderline performance of the clock face in accuracy and poor precision, we recommend against using the clock face in ACL reconstruction.

Is posterior delamination in arthroscopic rotator cuff repair hidden to the posterior viewing portal?

PURPOSE: The purposes of this study were (1) to examine whether posterior delamination is hidden to the most commonly used posterior viewing portal compared with differential rotator cuff portals and (2) to observe posterior delamination patterns so that a treatment-based classification system may be proposed. METHODS: One-hundred thirty consecutive patients undergoing arthroscopic rotator cuff repair by 4 different surgeons were evaluated for the presence of posterior delamination viewable through the posterior, posterolateral, and lateral portals. Randomized arthroscopic pictures were viewed by 2 independent blinded observers, and the Fleiss κ was used to assess inter-reliability agreement. In addition, patterns of posterior delamination and surgical treatment were assessed. RESULTS: The incidence of posterior delamination was 88%. Only 11% of cases were visualized through the posterior portal, whereas 70% and 100% were visualized through the posterolateral and lateral portals, respectively. The Fleiss κ was 0.78 (95% confidence interval, 0.73 to 0.83), indicating substantial agreement. Three general patterns of posterior delamination with specific surgical repair strategies were identified and subclassified into 5 types: type A1, full-thickness tears with extensive posterior delamination separating the rotator cuff into 2 layers and sometimes with dissociation of the rotator cable; type A2, bursal-sided partial-thickness tears with posterior delamination; type B1, delamination with an L-shaped bursal layer tear and crescent-shaped articular layer tear; type B2, a partial-thickness articular-sided tear with extensive posterior delamination; and type C, extensive degeneration with multiple longitudinal bursal-sided tears. CONCLUSIONS: The incidence of posterior delamination is extremely high, and most of these lesions are missed if one is viewing from just the posterior portal. Differential rotator cuff portals are needed to appreciate and treat posterior delamination. Patterns of delamination can be classified according to surgical repair strategy. It is important to recognize that the rotator cable may delaminate from the cuff and not to mistake it for a "retracted" articular layer, as previously described. LEVEL OF EVIDENCE: Level II, prospective comparative study.

Can surgeons predict what makes a good hemiarthroplasty for fracture?

BACKGROUND: The purposes of this study were (1) to identify the risk factors for tuberosity complications and poor functional outcomes and (2) to compare a standard humeral stem with a fracture-specific humeral stem in hemiarthroplasty for the treatment of 3- and 4-part proximal humeral fractures. METHODS: We retrospectively reviewed the cases of 60 consecutively operated patients (61 shoulders) using radiographs and computed tomography scans. There were 56 displaced four-part and 5 three-part fractures. The technique was standardized for prosthesis positioning in height and retroversion and for tuberosity fixation. A conventional standard stem was implanted in the first 31 shoulders (group A), and a specific fracture stem was implanted in the next 30 shoulders (group B). The sample size needed for comparison was predetermined with an a priori power analysis. The mean follow-up period was 64 months (range, 24 to 150 months). RESULTS: At the last follow-up, the greater tuberosity was healed in an adequate (anatomic) position in 45% of the patients in group A (14 of 31) and 87% of those in group B (26 of 30) (P = .0001). Active forward elevation, active external rotation, and the Constant score were significantly better with fracture stems (136°, 34°, and 68 points, respectively) than with conventional stems (113°, 23°, and 58 points, respectively) (P < .0001). Regardless of the type of implant used, patients aged 75 years or older and women had significantly lower functional results and higher rates of tuberosity complications (P < .0001). CONCLUSION: Good functional outcomes can be anticipated after hemiarthroplasty for proximal humeral fractures if the greater tuberosity is anatomically positioned (ie, lateral to the stem) and healed around the prosthesis. The use of a specific fracture stem allows to double the rate of tuberosity healing compared to a conventional stem (87% vs. 45%), decreases complications and improves shoulder function. Risk factors associated with poor functional results and anatomic failures are (1) patient age (≥75 years), (2) patient gender (women), and (3) use of a conventional (bulky) stem.

Risk of glove perforation with arthroscopic knot tying using different surgical gloves and high-tensile strength sutures.

PURPOSE: To examine the risk of glove tears associated with arthroscopic knot tying using 4 commonly used high-tensile strength sutures and 2 different types of gloves. METHODS: We analyzed 2 different surgical latex glove types (0.24-mm-thick powder-free and 0.32-mm-thick powdered) for perforation after arthroscopic knot tying with 4 different high-tensile strength sutures: Hi-Fi (ConMed Linvatec, Largo, FL), Ultrabraid (Smith & Nephew, Memphis, TN), FiberWire (Arthrex, Naples, FL), and Orthocord (DePuy Mitek, Raynham, MA). All knots were tied by a double-gloved single surgeon. Twelve trials of 4 knots each were performed for every glove-suture combination. All gloves were analyzed for perforation by a blinded evaluator using visual inspection, hydro-insufflation, and electroconductivity. RESULTS: The overall incidence of glove perforation was 3.4% and was detectable only by the electroconductivity method; the other 2 methods did not detect any perforations. There was a statistically significantly higher rate (P < .001) of perforations in the 0.32-mm powdered gloves (6.8%) compared with the 0.24-mm powder-free gloves (0%). Perforation of the inner glove occurred 5.7 times more frequently than perforation of the outer glove. However, simultaneous perforation of both the inner and outer gloves did not occur in any set. The Hi-Fi suture was involved in 6 perforations compared with 4 for FiberWire, 3 for Ultrabraid, and 0 for Orthocord. CONCLUSIONS: Double gloving provides an adequate surgical barrier between the surgeon and the patient during arthroscopic knot tying with high-tensile strength sutures as indicated by the low incidence of glove perforations in our study in an in vitro biomechanical evaluation. There were no instances of simultaneous perforation of both the inner and outer gloves. All perforations occurred only in the thicker (0.32-mm) powdered gloves. CLINICAL RELEVANCE: Glove tears and finger lacerations have been reported with the use of high-tensile strength sutures during arthroscopic shoulder surgery, thereby raising a concern for safety and disease transmission. This study addresses these concerns by evaluating the risk of glove tears during arthroscopic knot tying.

Revision surgery of reverse shoulder arthroplasty.

BACKGROUND: There is limited knowledge regarding revision of reverse shoulder arthroplasty (RSA). This study assesses reasons for failure in RSA and evaluates the outcomes of revision RSA. MATERIALS AND METHODS: Between 1997 and 2009, 37 patients with RSA had revision surgery. Clinical and radiologic examinations performed preoperatively and at 3 months, at 6 months, and then annually postoperatively were analyzed retrospectively. Patients were reviewed with a minimum 2-year follow-up. RESULTS: The most common causes for RSA revision were prosthetic instability (48%); humeral loosening, derotation, or fracture (21%); and infection (19%). Only 2 patients (3%) had to be reoperated on for glenoid loosening. More than 1 re-intervention was performed in 11 patients (30%) because of recurrence of the same complication or appearance of a new complication. Underestimation of humeral shortening and excessive medialization were common causes of recurrent prosthetic instability. Proximal humeral bone loss was found to be a cause for humeral loosening or derotation. Previous surgery was found as a potential cause of low-grade infection. At a mean follow-up of 34 months, 32 patients (86%) had retained the RSA whereas 2 patients (6%) had undergone conversion to humeral hemiarthroplasty and 3 (8%) to a resection arthroplasty. The mean Constant score in patients who retained the RSA increased from 19 points before revision to 47 points at last follow-up (P < .001). CONCLUSIONS: Even if revision may lead to several procedures in the same patient, preservation or replacement of the RSA is largely possible, allowing for a functional shoulder. Full-length scaled radiographs of both humeri are recommended to properly assess humeral shortening and excessive medialization before revision.

Measuring the anterior cruciate ligament's footprints by three-dimensional magnetic resonance imaging.

PURPOSE: The purpose of this study was to compare 3D MR imaging and open cadaveric measurements of the ACL's footprints to see whether 3D MR imaging measurements are accurate enough to be used for preoperative templating in anatomic ACL reconstruction. METHODS: Eight formalin-injected cadaveric knees were scanned by rapid acquisition isotropic 3D MR imaging. The femoral and tibial footprints were measured on MR imaging and compared with cadaveric dissection. Bland-Altman plots were used to assess the level of agreement. RESULTS: The AM and PL bundles were clearly appreciated in each specimen by 3D MR imaging and cadaveric dissection. The average paired difference in the femoral and tibial footprint measurements was 2, 1, 2, and 2 mm for the femoral footprint length, femoral footprint width, tibial footprint length, and tibial footprint width, respectively. The individual paired measurements were all within the mean difference ± two standard deviations of the difference in the Bland-Altman plot showing strong agreement. CONCLUSION: Measuring the ACL's footprint by 3D MR imaging or open cadaveric dissection has strong agreement and can be used interchangeably. 3D MR imaging has the potential to allow surgeons to: (1) tailor ACL reconstruction technique or graft choice based on ACL footprint size, (2) plan for selective bundle ACL reconstruction for partial tears, and (3) preoperatively template tunnel position according to the patient's individual anatomy.