The Effects of Knee Motion and External Loading on the Length of the Anterior Cruciate Ligament (ACL): A Kinematic Study

1991 ◽  
Vol 113 (2) ◽  
pp. 208-214 ◽  
Author(s):  
J. M. Hollis ◽  
S. Takai ◽  
D. J. Adams ◽  
S. Horibe ◽  
S. L.-Y. Woo
Keyword(s):  
Knee Flexion ◽  
Degrees Of Freedom ◽  
Cruciate Ligament ◽  
External Loading ◽  
Tibial Rotation ◽  
Knee Motion ◽  
Six Degrees Of Freedom ◽  
Kinematic Study ◽  
Insertion Sites ◽  
Anterior Cruciate

A six-degrees-of-freedom mechanical linkage device was designed and used to study the unconstrained motion of ten intact human cadaver knees. The knees were subjected to externally applied varus and valgus (V-V) moments up to 14 N-m as well as anterior and posterior (A-P) loads up to 100 N. Tests were done at four knee flexion angles; 0, 30, 45, and 90 deg. Significant coupled axial tibial rotation was found, up to 21.0 deg for V-V loading (at 90 deg of flexion) and 14.2 deg for A-P loading (at 45 deg of flexion). Subsequently, the knees were dissected and the locations of the insertion sites to the femur and tibia for the anteromedial (AM), posterolateral (PL), and intermediate (IM) portions of the ACL were identified. The distances between the insertion sites for all external loading conditions were calculated. In the case when the external load was zero, the AM portion of the ACL lengthened with knee flexion, while the PL portion shortened and the intermediate (IM) portion did not change in length. With the application of 14 N-m valgus moment, the PL and IM portions of the ACL lengthened significantly more than the AM portion (p<0.001). With the application of 100 N anterior load, the AM portion lengthened slightly less than the PL portion, which lengthened slightly less than the IM portion (p<0.005). In general, the amount of lengthening of the three portions of the ACL during valgus and anterior loading was observed to increase with knee flexion angle (p< 0.001).

External Loading at the Knee Joint for Landing Movements in Alpine Skiing

1992 ◽  
Vol 8 (1) ◽  
pp. 62-80 ◽  
Author(s):  
Lynda Read ◽  
Walter Herzog
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Inverse Dynamics ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
External Loading ◽  
Alpine Skiing ◽  
Joint Forces ◽  
Anterior Cruciate ◽  
Resultant Forces

The purpose of this study was to determine resultant knee joint forces and moments during a specific movement in Alpine ski racers. The movement analyzed consisted of a landing from a bump and the initiation of recovery (if necessary). Resultant loads were obtained using an inverse dynamics approach. Results of two specific skiers are contrasted, one skier landing in good form, the second skier landing in poor form. The skier landing in poor form exhibited larger knee flexion, and larger knee joint resultant forces and moments than the skier landing in good form. The movement of the skier landing in poor form has been associated with isolated anterior cruciate ligament (ACL) injury. However, the data obtained in this study do not indicate that either skier was in danger of ACL injury.

The Effects of Removal and Reconstruction of the Anterior Cruciate Ligament on Patellofemoral Kinematics

1998 ◽  
Vol 26 (2) ◽  
pp. 201-209 ◽  
Author(s):  
Yeou-Fang Hsieh ◽  
Louis F. Draganich ◽  
Sherwin H. Ho ◽  
Bruce Reider
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Anterior Tibial Translation ◽  
Tibial Rotation ◽  
Patellar Tilt ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Intact Knee

Patellofemoral pain may be associated with anterior cruciate ligament deficiency or may occur after anterior cruciate ligament reconstruction. We investigated the effects of the removal and reconstruction of the anterior cruciate ligament on the kinematics of the tibiofemoral and patellofemoral joints during physiologic levels of quadriceps muscle loads in seven cadaveric knees. A bone-patellar tendon-bone graft was used for intraarticular reconstruction of the anterior cruciate ligament. The spatial positions of the tibiofemoral and patellofemoral joints were measured between 0° and 90° of knee flexion in 15° increments with a six degree-of-freedom digitizing system. Excision of the anterior cruciate ligament resulted in statistically significant increases in anterior tibial translation between 0° and 90° and valgus tibial rotation between 30° and 90°; intraarticular reconstruction returned these to levels not significantly different from those of the intact knee. Excision of the anterior cruciate ligament resulted in significant increases in lateral patellar tilt, ranging from 6.3° to 9.0° between full extension and 90° of knee flexion, and in lateral patellar shift, ranging from 2.9 mm at 15° of knee flexion to 5.9 mm at 90°; intraarticular reconstruction returned these to levels not significantly different from those of the intact knee. Neither removal nor reconstruction of the anterior cruciate ligament significantly affected tibial internal-external rotation, patellar flexion, patellar mediolateral rotation, patellar anteroposterior translation, or patellar proximodistal translation.

scholarly journals Frontal Plane Loading Characteristics of Medial Collateral Ligament Strain Concurrent With Anterior Cruciate Ligament Failure

2019 ◽  
Vol 47 (9) ◽  
pp. 2143-2150 ◽  
Author(s):  
Nathan D. Schilaty ◽  
Nathaniel A. Bates ◽  
Aaron J. Krych ◽  
Timothy E. Hewett
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Moment Condition ◽  
Tibial Rotation ◽  
Collateral Ligament ◽  
Knee Abduction ◽  
Anterior Cruciate

Background: Both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) bear load during athletic tasks of landing, cutting, pivoting, and twisting. As dynamic knee valgus is a purported mechanism for ACL injury, the MCL should bear significant strain load with valgus force. Hypothesis: The intact MCL will demonstrate a significant increase in strain upon failure of the ACL at 25° of knee flexion. Study Design: Controlled laboratory study. Methods: In vivo kinetics/kinematics of 44 healthy athletic participants were measured to determine stratification of injury risk (ie, low, medium, and high) in 3 degrees of knee forces/moments (knee abduction moment, anterior tibial shear, and internal tibial rotation). These stratified kinetic values were input into a cadaveric impact simulator to assess ligamentous strain during a simulated landing task. Uniaxial and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect mechanical data for analysis. Conditions of external loads applied to the cadaveric limbs were varied and randomized. Results: ACL strain increased with increased dynamic knee abduction moment (χ2[5] = 14.123, P = .0148). The most extreme dynamic knee abduction moment condition demonstrated significantly higher ACL strain compared with lower loaded trials ( P≤ .0203). Similarly, MCL strain increased with dynamic knee abduction moment (χ2[5] = 36.578, P < .0001). Matched-pairs analysis compared ACL strain with MCL strain (maximum ACL strain – maximum MCL strain) and demonstrated high strain for the ACL versus the MCL ( S177 = 6223.5, P < .0001). Conclusion: Although significant, MCL strain had minimal increase with increased dynamic knee abduction moment, and the event of ACL failure did not significantly increase MCL strain when compared with high dynamic knee abduction moment conditions in the cadaveric model. The ACL bears more strain than the MCL at increasing amounts of dynamic knee abduction moment at 25° of knee flexion, which may explain the limited concomitant MCL injury rate that can occur during a dynamic valgus collapse of the knee. Clinical Relevance: These characteristics of ACL and MCL strain are important to understand the mechanisms that drive these injuries at the knee and will improve rehabilitation and injury prevention techniques.

scholarly journals Gender differences in knee kinematics during weight-bearing knee flexion for patients with arthrofibrosis after anterior cruciate ligament reconstruction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ling Zhang ◽  
Shuai Fan ◽  
Jiling Ye ◽  
Xin Jiang ◽  
Bin Cai
Keyword(s):  
Gender Differences ◽  
Acl Reconstruction ◽  
Knee Flexion ◽  
Patellofemoral Joint ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Knee Kinematics ◽  
Tibial Rotation ◽  
Anterior Cruciate ◽  
Tibiofemoral Kinematics

Abstract Background Knowledge of tibiofemoral and patellofemoral joint kinematics is important for understanding gender-related dimorphism in developing knee arthrofibrosis and advancement of related treatments. The objective of our study was to investigate gender differences existing in tibiofemoral kinematics and patellar tracking in patients with arthrofibrosis after anterior cruciate ligament (ACL) reconstruction during weight-bearing knee flexion. Methods The tibiofemoral and patellofemoral joint kinematics were measured in 30 patients (15 male and 15 female) with arthrofibrosis after ACL reconstruction during a lunge task, using computed tomography and dual fluoroscopic imaging system. These data were analyzed for gender differences. Results The range of tibial rotation, patellar inferior shift, tilt, and flexion were significantly decreased in the affected knee compared to the contralateral knee from 15° to 75° of knee flexion (P ≤ 0.04). Statistically significant difference was detected for medial tibial translation between male and female patients at 60° (P = 0.04) and 75° of knee flexion (P = 0.02). The tibial rotation was significantly decreased at 60° (P = 0.03) and 75° of knee flexion (P < 0.01) in females. The inferior patellar shift in females was significantly lower than that in males at 15° (P = 0.04) and 30° of knee flexion (P = 0.01). The patellar tilt was significantly lower at 60° (P = 0.02) and 75° of knee flexion (P < 0.01) in females compared to males. Conclusions The results indicated a significant effect of gender on knee kinematics in patients with arthrofibrosis after ACL reconstruction during weight-bearing knee flexion. These gender differences in tibiofemoral kinematics and patellar tracking may warrant further investigations to determine implications for making gender-specific surgical treatments and rehabilitation programs.

scholarly journals Single-Leg Landings Following a Volleyball Spike May Increase the Risk of Anterior Cruciate Ligament Injury More Than Landing on Both-Legs

2020 ◽  
Vol 11 (1) ◽  
pp. 130
Author(s):  
Datao Xu ◽  
Xinyan Jiang ◽  
Xuanzhen Cen ◽  
Julien S. Baker ◽  
Yaodong Gu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Flexion Angle ◽  
Ligament Injury ◽  
Time Range ◽  
Acl Injuries ◽  
Volleyball Players ◽  
Anterior Cruciate

Volleyball players often land on a single leg following a spike shot due to a shift in the center of gravity and loss of balance. Landing on a single leg following a spike may increase the probability of non-contact anterior cruciate ligament (ACL) injuries. The purpose of this study was to compare and analyze the kinematics and kinetics differences during the landing phase of volleyball players using a single leg (SL) and double-leg landing (DL) following a spike shot. The data for vertical ground reaction forces (VGRF) and sagittal plane were collected. SPM analysis revealed that SL depicted a smaller knee flexion angle (about 13.8°) and hip flexion angle (about 10.8°) during the whole landing phase, a greater knee and hip power during the 16.83–20.45% (p = 0.006) and 13.01–16.26% (p = 0.008) landing phase, a greater ankle plantarflexion angle and moment during the 0–41.07% (p < 0.001) and 2.76–79.45% (p < 0.001) landing phase, a greater VGRF during the 5.87–8.25% (p = 0.029), 19.75–24.14% (p = 0.003) landing phase when compared to DL. Most of these differences fall within the time range of ACL injury (30–50 milliseconds after landing). To reduce non-contact ACL injuries, a landing strategy of consciously increasing the hip and knee flexion, and plantarflexion of the ankle should be considered by volleyball players.

scholarly journals Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 18 (14) ◽  
pp. 7492
Author(s):  
Tishya L. Wren ◽  
Veronica Beltran ◽  
Mia J. Katzel ◽  
Adriana S. Conrad-Forrest ◽  
Curtis D. VandenBerg
Keyword(s):  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Extensor Mechanism ◽  
Iliotibial Band ◽  
Cruciate Ligament Reconstruction ◽  
Mechanism Function ◽  
Anterior Cruciate ◽  
Knee Extensor Mechanism

Iliotibial band autograft is an increasingly popular option for pediatric anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare recovery of knee extensor mechanism function among pediatric patients who underwent ACLR using iliotibial band (IT), hamstring tendon (HT), quadriceps tendon (QT), and patellar tendon (PT) autografts. One hundred forty-five pediatric athletes (76 female; age 15.0, range 7–21 years) with recent (3–18 months) unilateral ACLR performed drop-jump landing and 45° cutting with 3D motion capture. Knee extensor mechanism function (maximum knee flexion angle, maximum internal knee extensor moment, energy absorption at knee) during the loading phase (foot contact to peak knee flexion) was compared among graft types (20 IT, 29 HT, 39 QT, 57 PT) and sides (ACLR or contralateral) using linear mixed models with sex, age, and time since surgery as covariates. Overall, knee flexion was significantly lower on the operated vs. contralateral side for HT, QT, and PT during both tasks (p < 0.03). All graft types exhibited lower knee extensor moments and energy absorption on the operated side during both movements (p ≤ 0.001). Kinetic asymmetry was significantly lower for IT compared with QT and PT during both movements (p ≤ 0.005), and similar patterns were observed for HT vs. QT and PT (p ≤ 0.07). Asymmetry was similar between IT and HT and between QT and PT. This study found that knee extensor mechanism function recovers fastest in pediatric ACLR patients with IT autografts, followed by HT, in comparison to QT and PT, suggesting that IT is a viable option for returning young athletes to play after ACLR.

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