Aim: The purpose of this study was to develop Injury Risk Functions (IRFs) for the Anterior- and Posterior Cruciate Ligament (ACL and PCL, respectively) and the Medial- and Lateral Collateral Ligament (MCL and LCL, respectively) in the knee joint and address two injury mechanisms of the ligaments, mid-substance failure and ligament insertion detachment.
Method: The IRFs were developed from Post-Mortem Human Subject (PMHS) tensile failure strains of Bone-Ligament-Bone (BLB) or dissected Ligament (LIG) preparations. To compensate for insufficient sample size of experimental datapoints, virtual failure strains were as well generated based on mean- and standard deviation from experiments that did not provide specimen-specific results. All virtual and specimen-specific values were then categorised into groups of static and dynamic rates and tested for the best fitting theoretical distribution to formulate the ligament IRF.
Results: Nine IRFs were derived (3 for ACL, 2 for PCL, 1 for MCL and 3 for LCL).
Conclusion: These IRFs are, to the best of the authors' knowledge, the first knee ligament injury predicting tool based on PMHS data. The IRFs of BLB address both failure modes of mid-ligament and attachment failure, while the IRFs of LIG address mid-ligament failures only. The proposed risk functions can be used to determine the effectiveness of injury prevention measures.
Keywords: Injury risk functions, knee ligaments, anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, lateral collateral ligament.
Treatment and outcomes of lateral collateral ligament injury associated with anterior and posterior cruciate ligament injury at 2-year follow-up
