Effects of ruptured anterior cruciate ligament and medial meniscectomy on stress distribution of human knee joint at full extension

Author(s):  
Aleksandra Vulovic ◽  
Nenad Filipovic ◽  
Branko Ristic
2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
M. Marieswaran ◽  
Ishita Jain ◽  
Bhavuk Garg ◽  
Vijay Sharma ◽  
Dinesh Kalyanasundaram

The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial. An abridged summary of the prominent literature with a focus on key topics on kinematics and kinetics of the knee joint and various loads acting on the anterior cruciate ligament as a function of flexion angle is presented here with an emphasis on the gaps. Briefly, we also review mechanical characterization composition and anatomy of the anterior cruciate ligament as well as graft materials used for replacement/reconstruction surgeries. The key conclusions of this review are as follows: (a) the highest shear forces on the anterior cruciate ligament occur during hyperextension/low flexion angles of the knee joint; (b) the characterization of the anterior cruciate ligament at variable strain rates is critical to model a viscoelastic behavior; however, studies on human anterior cruciate ligament on variable strain rates are yet to be reported; (c) a significant disparity on maximum stress/strain pattern of the anterior cruciate ligament was observed in the earlier works; (d) nearly all synthetic grafts have been recalled from the market; and (e) bridge-enhanced repair developed by Murray is a promising technique for anterior cruciate ligament reconstruction, currently in clinical trials. It is important to note that full extension of the knee is not feasible in the case of most animals and hence the loading pattern of human ACL is different from animal models. Many of the published reviews on the ACL focus largely on animal ACL than human ACL. Further, this review article summarizes the issues with autografts and synthetic grafts used so far. Autografts (patellar tendon and hamstring tendon) remains the gold standard as nearly all synthetic grafts introduced for clinical use have been withdrawn from the market. The mechanical strength during the ligamentization of autografts is also highlighted in this work.


2012 ◽  
Vol 64 (3) ◽  
pp. 696-704 ◽  
Author(s):  
Akihiko Hasegawa ◽  
Shuhei Otsuki ◽  
Chantal Pauli ◽  
Shigeru Miyaki ◽  
Shantanu Patil ◽  
...  

Author(s):  
Ariful I. Bhuiyan ◽  
Nabila Shamim ◽  
Stephen Ekwaro-Osire

Abstract A three-dimensional (3D) finite element (FE) human knee joint model developed from magnetic resonance images (MRIs) has been validated with the sets of experimental results in a normalized scale. The performance of the 3D FE knee joint model has been tested, simulating a physical experiment. The experiment provided the direct measurement of anterior cruciate ligament (ACL) strains due to the forces of quadriceps muscle force (QMF) followed by ground reaction force (GRF) at low knee flexion. Accurate and precise anatomy has been obtained from segmented MRI images. The ACL strain subject to the loading was calculated and analyzed compared with the measured data from the experimental tests. The study shows that the pre-activated ACL strain, which is measured before the application of GRF, increased nonlinearly with increasing QMF before landing. However, the total ACL strain, which is measured after both QMF and GRF applied, reaches out to the limited constant value (6%) instead of crossing the ACL failure value. These results suggest that the forces generated from QMF and GRF at low flexion may not bring ACL to a failure level as presented in the experimental tests. The results of the FE model fall into the standard deviations of the 22 cadaveric knees testing results, which represents the successful mechanical modeling of ACL and the surrounding structures of the human knee joint. The model may further be used to investigate the risks of the ACL injury.


2017 ◽  
Vol 22 (3) ◽  
pp. 488-494 ◽  
Author(s):  
Kazunori Tanaka ◽  
Munehiro Ogawa ◽  
Yusuke Inagaki ◽  
Yasuhito Tanaka ◽  
Hitoshi Nishikawa ◽  
...  

Author(s):  
P N Grimshaw ◽  
P Bowker

The Salford static knee instrument (SSKI) was developed to determine the quantitative assessment of the human knee joint in vivo by utilizing the technique of applied displacement and measurement of resistive load as proposed by Butler et al. (1). The instrument was used in parallel with the device developed by Al-Turaiki (2) which utilized the opposite method of assessment. The objective of the research was to examine which of the two techniques provided the more reliable and accurate method of knee assessment. Fourteen patients with suspected isolated rupture of the anterior cruciate ligament (ACL) were subjected to anterior-posterior drawer testing on both devices. The results showed that each instrument produced results which confirmed the clinical diagnosis by indicating a significant decrease in anterior stiffness when comparing the injured and uninjured knees. [SSKI device ( p = 0.000) and Al-Turaiki (2) device ( p = 0.002) statistical significant difference testing with Bonferonni Alpha correction p = 0.0125]. The results showed the Salford static knee instrument indicated a 58 per cent decrease in anterior stiffness and the Al-Turaiki (2) device a 35 per cent decrease when comparing the injured and uninjured knees. In conclusion it is suggested that the application of displacement and measurement of load as proposed by Butler et al. (1) may be the most appropriate technique for precise clinical diagnosis of pathological human knee joint instability. load, displacement, knee, anterior, stiffness


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