Knee Joint Motion and Ligament Forces Before and After ACL Reconstruction

1989 ◽  
Vol 111 (2) ◽  
pp. 97-106 ◽  
Author(s):  
J. L. Lewis ◽  
W. D. Lew ◽  
J. A. Hill ◽  
P. Hanley ◽  
K. Ohland ◽  
...  
Keyword(s):  
Knee Joint ◽  
Cruciate Ligament ◽  
In Vitro Study ◽  
Test Series ◽  
Poor Correlation ◽  
Consistent Difference ◽  
Joint Motion ◽  
Mechanical State ◽  
Control Series

The goal of this in vitro study was to investigate the initial postoperative mechanical state of the knee with various types of anterior cruciate ligament (ACL) reconstructions. An experimental knee testing system was developed for the in vitro measurement of ligament forces and three-dimensional joint motion as external loads were applied to fresh knee specimens. Two groups of knee specimens were tested. In test series #1, two intraarticular reconstructions were performed in each of five specimens using semifree and free patellar tendon grafts with bone blocks. In test series #2, a more carefully controlled intraarticular reconstruction was performed in five specimens using a semifree composite graft consisting of the semitendinosus and gracilis tendons augmented with the Ligament Augmentation Device. Ligament force and joint motion data were collected as anteriorly directed tibial loads were applied to the normal joint, the joint with a cut ACL and the reconstructed joint. These knee joint states were compared on the basis of ACL or graft forces, joint motion and load sharing by the collateral ligaments. The dominate result of the study was that the forces and motions defining the mechanical state of the knee after the ACL reconstructions in both test series were highly variable and abnormal when compared to the normal knee state. The higher level of surgical control series #2 did not decrease this variability. There was a poor correlation between motion of the reconstructed knee relative to normal, and the ACL graft force. There was little consistent difference in force and motion results between the surgical procedures tested.

Lateral Extra-articular Tenodesis Alters Lateral Compartment Contact Mechanics under Simulated Pivoting Maneuvers: An In Vitro Study

2021 ◽  
pp. 036354652110282
Author(s):  
Niv Marom ◽  
Hamidreza Jahandar ◽  
Thomas J. Fraychineaud ◽  
Zaid A. Zayyad ◽  
Hervé Ouanezar ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Contact Force ◽  
Contact Stress ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
In Vitro Study ◽  
Lateral Compartment ◽  
Lateral Tibial Plateau ◽  
Intact Knee

Background: There is concern that utilization of lateral extra-articular tenodesis (LET) in conjunction with anterior cruciate ligament (ACL) reconstruction (ACLR) may disturb lateral compartment contact mechanics and contribute to joint degeneration. Hypothesis: ACLR augmented with LET will alter lateral compartment contact mechanics in response to simulated pivoting maneuvers. Study Design: Controlled laboratory study. Methods: Loads simulating a pivot shift were applied to 7 cadaveric knees (4 male; mean age, 39 ± 12 years; range, 28-54 years) using a robotic manipulator. Each knee was tested with the ACL intact, sectioned, reconstructed (via patellar tendon autograft), and, finally, after augmenting ACLR with LET (using a modified Lemaire technique) in the presence of a sectioned anterolateral ligament and Kaplan fibers. Lateral compartment contact mechanics were measured using a contact stress transducer. Outcome measures were anteroposterior location of the center of contact stress (CCS), contact force from anterior to posterior, and peak and mean contact stress. Results: On average, augmenting ACLR with LET shifted the lateral compartment CCS anteriorly compared with the intact knee and compared with ACLR in isolation by a maximum of 5.4 ± 2.3 mm ( P < .001) and 6.0 ± 2.6 mm ( P < .001), respectively. ACLR augmented with LET also increased contact force anteriorly on the lateral tibial plateau compared with the intact knee and compared with isolated ACLR by a maximum of 12 ± 6 N ( P = .001) and 17 ± 10 N ( P = .002), respectively. Compared with ACLR in isolation, ACLR augmented with LET increased peak and mean lateral compartment contact stress by 0.7 ± 0.5 MPa ( P = .005) and by 0.17 ± 0.12 ( P = .006), respectively, at 15° of flexion. Conclusion: Under simulated pivoting loads, adding LET to ACLR anteriorized the CCS on the lateral tibial plateau, thereby increasing contact force anteriorly. Compared with ACLR in isolation, ACLR augmented with LET increased peak and mean lateral compartment contact stress at 15° of flexion. Clinical Relevance: The clinical and biological effect of increased anterior loading of the lateral compartment after LET merits further investigation. The ability of LET to anteriorize contact stress on the lateral compartment may be useful in knees with passive anterior subluxation of the lateral tibia.

THE EFFECT OF INTERCARPAL JOINT MOTION ON WRIST MOTION: ARE THERE KEY JOINTS? AN IN VITRO STUDY

Orthopedics ◽  
1995 ◽  
Vol 18 (8) ◽  
pp. 727-732
Author(s):  
Houshang Seradge ◽  
Willis Owens ◽  
Espanta Seradge
Keyword(s):  
In Vitro Study ◽  
Vitro Study ◽  
Joint Motion ◽  
Wrist Motion

scholarly journals Biomechanical Effects of Tibial Plateau Levelling Osteotomy on Joint Instability in Normal Canine Stifles: An In Vitro Study

2020 ◽  
Vol 33 (05) ◽  
pp. 301-307
Author(s):  
Masakazu Shimada ◽  
Tetsuya Takagi ◽  
Nobuo Kanno ◽  
Satoshi Yamakawa ◽  
Hiromichi Fujie ◽  
...  
Keyword(s):  
Joint Instability ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Biomechanical Testing ◽  
In Vitro Study ◽  
Axial Rotation ◽  
Testing System ◽  
Compression Tests ◽  
Cranial Cruciate Ligament

Abstract Objective The aim of the study was to determine the changes in biomechanical characteristics following tibial plateau levelling osteotomy (TPLO) using simulated manual tests. Study Design Twenty-one stifles from healthy Beagle dogs that had undergone TPLO or had not (control) were first tested in the intact form, and then the cranial cruciate ligament (CrCL) was transected in each to provide four test situations: control-intact, control-CrCL-transected, TPLO-intact and TPLO-CrCL-transected. The stifles were then analysed using a robotic joint biomechanical testing system. The craniocaudal drawer, axial rotation and proximal compression tests were applied. Results The craniocaudal displacement during the drawer test was not significantly different between the control-intact and TPLO-intact. However, the displacement was significantly greater in the TPLO-CrCL-transected than in the control-intact. In the axial rotation test, the internal–external (IE) rotation was significantly greater in the TPLO-intact than in the control-intact. Similarly, the IE rotation was significantly greater in the TPLO-CrCL-transected than in the control-CrCL-transected. In the proximal compression test, craniocaudal displacement was not significantly different among the control-intact, TPLO-intact and TPLO-CrCL-transected. Conclusion These findings suggest that TPLO influences the tension of the collateral ligaments and might generate laxity of the tibiofemoral joint. Instability after the osteotomy might be associated with the progression of osteoarthritis.

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