scholarly journals Injury risk functions for the four primary knee ligaments

2021 ◽  
Author(s):  
Jiota Nusia ◽  
Jia Cheng Xu ◽  
Reimert Sjöblom ◽  
Johan Knälmann ◽  
Astrid Linder ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Injury Risk ◽  
Failure Modes ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Knee Ligament ◽  
Knee Ligaments ◽  
Risk Functions

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.

scholarly journals Treatment and outcomes of lateral collateral ligament injury associated with anterior and posterior cruciate ligament injury at 2-year follow-up

2019 ◽  
Vol 16 (6) ◽  
pp. 489-492 ◽  
Author(s):  
Leonardo Adeo Ramos ◽  
Tiago Zogbi ◽  
Edilson Ferreira de Andrade ◽  
Gabriel Taniguti de Oliveira ◽  
Alexandre Pedro Nicolini ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Ligament Injury ◽  
Posterior Cruciate Ligament Injury ◽  
Collateral Ligament

Biomechanics and Microstructural Analysis of the Mouse Knee and Ligaments

2017 ◽  
Vol 31 (06) ◽  
pp. 520-527 ◽  
Author(s):  
Camila Carballo ◽  
Ian Hutchinson ◽  
Zoe Album ◽  
Michael Mosca ◽  
Arielle Hall ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Microstructural Analysis ◽  
Gross Anatomy ◽  
Ligament Injury ◽  
Murine Models ◽  
Knee Ligament ◽  
Knee Ligaments ◽  
Injury Repair ◽  
Load To Failure

AbstractThe purpose of this study is to determine the feasibility of using murine models for translational study of knee ligament injury, repair, and reconstruction. To achieve this aim, we provide objective, quantitative data detailing the gross anatomy, biomechanical characteristics, and microscopic structure of knee ligaments of 44 male mice (C57BL6, 12 weeks of age). Biomechanical testing determined the load-to-failure force, stiffness, and the site of ligament failure for the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and the medial and lateral collateral ligaments (MCL and LCL). These data are complemented by histological characterization of each of the knee ligaments. In addition, the osseous morphology of the mouse knee was examined using high-resolution nanofocus computed tomography (CT), while standard micro-CT was employed to measure bone morphometrics of the distal femur and proximal tibia. Collectively, our findings suggest that the gross anatomy of the mouse knee is similar to the human knee despite some minor differences and features unique to the murine knee. The ACL had the highest load to failure (5.60 ± 0.75 N), the MCL (3.33 ± 1.45 N), and the PCL (3.45 ± 0.84 N) were similar, and the LCL (1.44 ± 0.37 N) had the lowest load to failure and stiffness. Murine models provide a unique opportunity to focus on biological processes that impact ligament pathology and healing due to the availability of transgenic strains. Our data support their use as a translational platform for the in vivo study of ligament injury, repair, and reconstruction.

Design and Development of an Instrumented Knee Joint for Quantifying Ligament Displacements

2021 ◽  
Author(s):  
Lei Cui ◽  
Brody Dale ◽  
Garry Allison ◽  
Min Li
Keyword(s):  
Knee Joint ◽  
Rapid Prototyping ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Published Data ◽  
Collateral Ligament ◽  
Knee Ligaments ◽  
Leg Flexion ◽  
Anterior Cruciate ◽  
Four Bar Linkage

Abstract Recently robotic assistive leg exoskeletons have gained popularity because an increased number of people crave for powered devices to run faster and longer or carry heavier loads. However, these powered devices have the potential to impair knee ligaments. This work was aimed to develop an instrumented knee joint via rapid prototyping that measures the displacements of the four major knee ligaments\textemdash the anterior cruciate ligament (ACL), posterior crucial ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL)\textemdash to quantify the strain experienced by these ligaments. The knee model consists of a femur, lateral and medial menisci, and a tibia-fibula, which were printed from 3D imaging scans. Non-stretchable cords served as main fiber bundles of the ligaments with their desired stiffnesses provided by springs. The displacement of each cord was obtained via a rotary encoder mechanism, and the leg flexion angle was acquired via a closed-loop four-bar linkage of a diamond shape. The displacements were corroborated by published data, demonstrating the profiles of the displacement curves agreed with known results. The paper shows the feasibility of developing a subject-specific knee joint via rapid prototyping that is capable of quantifying the ligament strain via rapid prototyping.

How Well Do Anatomical Reconstructions of the Posterolateral Corner Restore Varus Stability to the Posterior Cruciate Ligament—Reconstructed Knee?

2007 ◽  
Vol 35 (7) ◽  
pp. 1117-1122 ◽  
Author(s):  
Keith L. Markolf ◽  
Benjamin R. Graves ◽  
Susan M. Sigward ◽  
Steven R. Jackson ◽  
David R. McAllister
Keyword(s):  
Posterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Posterolateral Corner ◽  
Popliteus Tendon ◽  
Tibial Rotation ◽  
Collateral Ligament ◽  
Popliteofibular Ligament ◽  
Grade 3

Background With grade 3 posterolateral injuries of the knee, reconstructions of the lateral collateral ligament, popliteus tendon, and popliteofibular ligament are commonly performed in conjunction with a posterior cruciate ligament reconstruction to restore knee stability. Hypothesis A lateral collateral ligament reconstruction, alone or with a popliteus tendon or popliteofibular ligament reconstruction, will produce normal varus rotation patterns and restore posterior cruciate ligament graft forces to normal levels in response to an applied varus moment. Study Design Controlled laboratory study. Methods Forces in the native posterior cruciate ligament were recorded for 15 intact knees during passive extension from 120° to 0° with an applied 5 N·m varus moment. The posterior cruciate ligament was removed and reconstructed with a single bundle inlay graft tensioned to restore intact knee laxity at 90°. Posterior cruciate ligament graft force, varus rotation, and tibial rotation were recorded before and after a grade 3 posterolateral corner injury. Testing was repeated with lateral collateral ligament, lateral collateral ligament plus popliteus tendon, and lateral collateral ligament plus popliteofibular ligament graft reconstructions; all grafts were tensioned to 30 N at 30° with the tibia locked in neutral rotation. Results All 3 posterolateral graft combinations rotated the tibia into slight valgus as the knee was taken through a passive range of motion. During the varus test, popliteus tendon and popliteofibular ligament reconstructions internally rotated the tibia from 1.5° (0° flexion) to approximately 12° (45° flexion). With an applied varus moment, mean varus rotations with a lateral collateral ligament graft were significantly less than those with the intact lateral collateral ligament beyond 0° flexion; mean decreases ranged from 0.8° (at 5° flexion) to 5.6° (at 120° flexion). Addition of a popliteus tendon or popliteofibular ligament graft further reduced varus rotation (compared with a lateral collateral ligament graft) beyond 25° of flexion; both grafts had equal effects. A lateral collateral ligament reconstruction alone restored posterior cruciate ligament graft forces to normal levels between 0° and 100° of flexion; lateral collateral ligament plus popliteus tendon and lateral collateral ligament plus popliteofibular ligament reconstructions reduced posterior cruciate ligament graft forces to below-normal levels—beyond 95° and 85° of flexion, respectively. Conclusions With a grade 3 posterolateral corner injury, popliteus tendon or popliteofibular ligament reconstructions are commonly performed to limit external tibial rotation; we found that they also limited varus rotation. With the graft tensioning protocols used in this study, all posterolateral graft combinations tested overconstrained varus rotation. Further studies with posterolateral reconstructions are required to better restore normal kinematics and provide more optimum load sharing between the PCL graft and posterolateral grafts. Clinical Relevance A lower level of posterolateral graft tension, perhaps applied at a different flexion angle, may be indicated to better restore normal varus stability. The clinical implications of overconstraining varus rotation are unknown.

scholarly journals Short-Term Outcome of Multi-Ligament Knee Injury among Sudanese Patients

2019 ◽  
Vol 7 (9) ◽  
pp. 1486-1493 ◽  
Author(s):  
Amin Ahmed Ali ◽  
Mohamed Babiker Abdelwahab
Keyword(s):  
Functional Outcome ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
The Body ◽  
University Hospital ◽  
Collateral Ligament ◽  
Term Outcome ◽  
Knee Ligaments ◽  
Excellent Outcome

BACKGROUND: Multi-ligament knee injury is the state of having two or more of the major knee ligaments, namely: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), the lateral collateral ligament (LCL), the posteromedial corner (PMC), and the posterolateral corner (PLC). The knee is a hinge joint; this dictates two direction movements on the y-axis plane. The knee joints carry the weight load of the body uniquely. The role of the knee ligaments is not conserved only to maintain knee in a rigid position while standing, but also orchestrates the biomechanics of knee motion in harmony. Multi-ligament knee injury is very rare (incidence < 10:10,000 of trauma cases). Patients with multiple ligaments injuries of the knee become disabled for a long period. This disability rises from the pain and stiffness of the knee joint. A disability that might be associated with increased frequencies of sick leave from work, or much more dire consequences, such as quitting a job or being relieved of duty. AIM: To assess the functional outcome of the knee of patients with a multi-ligament knee injury after treatment using a standard scoring system and to determine the recovery rates of each treatment option to a multi-ligament knee injury. METHODS: it is a cross-sectional study conducted from January 2018 to January 2019. All patients with multi-ligament knee injuries that were diagnosed by MRI, and underwent reconstruction surgeries or on the waiting list, at Ribat University Hospital and Alyaa Specialized Hospital, Alkuwiti specialised hospital, and Haj Alsafi Hospital for the past 2 years were included. Lyshlome knee scoring scale was used to assess the functional outcome of each patient. RESULTS: 24 patients were enrolled in this study (16 had reconstruction surgery, 8 did not). 3 had excellent outcome (LKSS = 95 – 100), 8 of them had good score (LKSS = 84-94), 5 had fair outcome (LKSS = 65-83). All those who did not have reconstruction had a poor score (LKSS < 64). CONCLUSION: Reconstruction of multi-ligament knee injury shows a good outcome than it was left alone. Post-operative physiotherapy increases the potential of reconstruction. While our data is limited because of the rare condition, we plan to expand our study area to include a larger sample size. We also recommend extending the post-operative physiotherapy to improve the outcome of a multi-ligament knee injury.

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