Characterization of a Biomechanical Animal Model for Intact Knee Kinematics and ACL Function Using 6-DOF Robotic Technology

2011 ◽  
Author(s):  
Daniel V. Boguszewski ◽  
Safa T. Herfat ◽  
Christopher T. Wagner ◽  
David L. Butler ◽  
Jason T. Shearn
Keyword(s):  
Animal Model ◽  
Degrees Of Freedom ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Biomechanical Model ◽  
Ligament Injury ◽  
Joint Stability ◽  
Robotic Technology ◽  
Anterior Cruciate ◽  
Intact Knee

Anterior cruciate ligament injury (ACL) affects an estimated 250,000 people annually [1]. Unfortunately, even with ACL reconstruction, the likely prognosis is long-term osteoarthritis (OA) [2]. Many strides have been made in attempting to understand and improve this outcome. The use of robotic technology has provided an avenue for researchers to examine the ACL’s role in knee joint stability in all six anatomical degrees of freedom (DOF) [3]. The overall goal of our lab robotics research is to use this technology to understand ACL function during activities of daily living (ADLs) in hopes of developing a biomechanical animal model which can be used as a preclinical tool to design new repair methods and materials. We have examined three species (ovine, porcine, and human), measuring all forces and moments produced from displacement control motion paths developed for cyclic testing in a robotic system (KUKA; KR210). This information will provide a basis for comparing intact knee biomechanics and ACL function across species. With these robotic inputs, we have performed a series of studies to aid in the development of a biomechanical model of the human knee.

scholarly journals Different anterolateral procedures have variable impact on knee kinematics and stability when performed in combination with anterior cruciate ligament reconstruction

2020 ◽  
pp. jisakos-2019-000360
Author(s):  
Thomas Neri ◽  
Danè Dabirrahmani ◽  
Aaron Beach ◽  
Samuel Grasso ◽  
Sven Putnis ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Rotational Laxity ◽  
Level Of Evidence ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Deficient Knee ◽  
Intact Knee

ObjectiveThe optimal anterolateral procedure to control anterolateral rotational laxity of the knee is still unknown. The objective was to compare the ability of five anterolateral procedures performed in combination with anterior cruciate ligament reconstruction (ACLR) to restore native knee kinematics in the setting of a deficient anterior cruciate ligament (ACL) and anterolateral structures.MethodsA controlled laboratory study was performed using 10 fresh-frozen cadaveric whole lower limbs with intact iliotibial band. Kinematics from 0° to 90° of flexion were recorded using a motion analysis three-dimensional (3D) optoelectronic system, allowing assessment of internal rotation (IR) and anteroposterior (AP) tibial translation at 30° and 90° of flexion. Joint centres and bony landmarks were calculated from 3D bone models obtained from CT scans. Intact knee kinematics were assessed initially, followed by sequential section of the ACL and anterolateral structures (anterolateral ligament, anterolateral capsule and Kaplan fibres). After ACLR, five anterolateral procedures were performed consecutively on the same knee: ALLR, modified Ellison, deep Lemaire, superficial Lemaire and modified MacIntosh. The last three procedures were randomised. For each procedure, the graft was fixed in neutral rotation at 30° of flexion and with a tension of 20 N.ResultsIsolated ACLR did not restore normal overall knee kinematics in a combined ACL plus anterolateral-deficient knee, leaving a residual tibial rotational laxity (p=0.034). Only the ALLR (p=0.661) and modified Ellison procedure (p=0.641) restored overall IR kinematics to the normal intact state. Superficial and deep Lemaire and modified MacIntosh tenodeses overconstrained IR, leading to shifted and different kinematics compared with the intact condition (p=0.004, p=0.001 and p=0.045, respectively). Compared with ACLR state, addition of an anterolateral procedure did not induce any additional control on AP translation at 30° and 90° of flexion (all p>0.05), except for the superficial Lemaire procedure at 90° (p=0.032).ConclusionIn biomechanical in vitro setting, a comparison of five anterolateral procedures revealed that addition of either ALLR or modified Ellison procedure restored overall native knee kinematics in a combined ACL plus anterolateral-deficient knee. Superficial and deep Lemaire and modified MacIntosh tenodeses achieved excellent rotational control but overconstrained IR, leading to a change from intact knee kinematics.Level of evidenceThe level-of-evidence statement does not apply for this laboratory experiments study.

The Position of the Tibia during Graft Fixation Affects Knee Kinematics and Graft Forces for Anterior Cruciate Ligament Reconstruction

2001 ◽  
Vol 29 (6) ◽  
pp. 771-776 ◽  
Author(s):  
Jürgen Höher ◽  
Akihiro Kanamori ◽  
Jennifer Zeminski ◽  
Freddie H. Fu ◽  
Savio L-Y. Woo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Anterior Tibial Translation ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Intact Knee

Ten cadaveric knees (donor ages, 36 to 66 years) were tested at full extension, 15°, 30°, and 90° of flexion under a 134-N anterior tibial load. In each knee, the kinematics as well as in situ force in the graft were compared when the graft was fixed with the tibia in four different positions: full knee extension while the surgeon applied a posterior tibial load (Position 1), 30° of flexion with the tibia at the neutral position of the intact knee (Position 2), 30° of flexion with a 67-N posterior tibial load (Position 3), and 30° of flexion with a 134-N posterior tibial load (Position 4). For Positions 1 and 2, the anterior tibial translation and the in situ forces were up to 60% greater and 36% smaller, respectively, than that of the intact knee. For Position 3, knee kinematics and in situ forces were closest to those observed in the intact knee. For Position 4, anterior tibial translation was significantly decreased by up to 2 mm and the in situ force increased up to 31 N. These results suggest that the position of the tibia during graft fixation is an important consideration for the biomechanical performance of an anterior cruciate ligament-reconstructed knee.

Estimation of ACL Forces Utilizing a Novel Non-Invasive Methodology That Reproduces Knee Kinematics Between Sets of Knees

2003 ◽  
Author(s):  
Shon P. Darcy ◽  
Robert H. P. Kilger ◽  
Savio L.-Y. Woo ◽  
Richard E. Debski
Keyword(s):  
Degrees Of Freedom ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Acl Injuries ◽  
Non Invasive ◽  
Rehabilitation Protocols ◽  
Anterior Cruciate ◽  
6 Degrees Of Freedom ◽  
Rehabilitation Exercises

A non-invasive, non-contact methodology to estimate forces in the anterior cruciate ligament (ACL) in response to in vivo knee kinematics will allow surgical procedures and rehabilitation protocols for ACL injuries to be improved. During the last decade, intensive efforts have been made to quantify the forces in the ACL in vivo (Holden, 1994; Lundberg, 1997; Zacharias, 2001). With the use of these methods, valuable information on the forces experienced by the ACL has been obtained, however many of these methods were invasive, and involved direct contact with the ACL, which may affect the force measurements. It has been proposed at our research center that the forces in the ACL during activities of daily living and rehabilitation exercises can be estimated in a non-contact, non-invasive manner by reproducing in vivo kinematics in 6-degrees of freedom (DOF) on a cadaveric knee. Therefore, the specific aim of this study was to evaluate the feasibility of a non-invasive, non-contact methodology for estimating force in the ACL by reproducing average kinematics in 6-DOF degrees of freedom from one set of porcine knees (source) onto a separate set of porcine knees (target).

Effect of Meniscal Ramp Lesion Repair on Knee Kinematics, Bony Contact Forces, and In Situ Forces in the Anterior Cruciate Ligament

2019 ◽  
Vol 47 (13) ◽  
pp. 3195-3202 ◽  
Author(s):  
Jan-Hendrik Naendrup ◽  
Thomas R. Pfeiffer ◽  
Calvin Chan ◽  
Kanto Nagai ◽  
João V. Novaretti ◽  
...  
Keyword(s):  
External Rotation ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Contact Forces ◽  
Full Extension ◽  
Compression Load ◽  
Ramp Lesion ◽  
Anterior Cruciate ◽  
Intact Knee

Background: Meniscal ramp lesions are possible concomitant injuries in cases of anterior cruciate ligament (ACL) deficiency. Although recent studies have investigated the influence of ramp lesions on knee kinematics, the effect on the ACL reconstruction graft remains unknown. Purpose/Hypothesis: The purpose was to determine the effects of ramp lesion and ramp lesion repair on knee kinematics, the in situ forces in the ACL, and bony contact forces. It was hypothesized that ramp lesions will significantly increase in situ forces in the native ACL and bony contact forces and that ramp lesion repair will restore these conditions comparably with those forces of the intact knee. Study Design: Controlled laboratory study. Methods: Investigators tested 9 human cadaveric knee specimens using a 6 degrees of freedom robotic testing system. The knee was continuously flexed from full extension to 90° while the following loads were applied: (1) 90-N anterior load, (2) 5 N·m of external-rotation torque, (3) 134-N anterior load + 200-N compression load, (4) 4 N·m of external-rotation torque + 200-N compression load, and (5) 4 N·m of internal-rotation torque + 200-N compression load. Loading conditions were applied to the intact knee, a knee with an arthroscopically induced 25-mm ramp lesion, and a knee with an all-inside repaired ramp lesion. In situ forces in the ACL, bony contact forces in the medial compartment, and bony contact forces in the lateral compartment were quantified. Results: In response to all loading conditions, no differences were found with respect to kinematics, in situ forces in the ACL, and bony contact forces between intact knees and knees with a ramp lesion. However, compared with intact knees, knees with a ramp lesion repair had significantly reduced anterior translation at flexion angles from full extension to 40° in response to a 90-N anterior load ( P < .05). In addition, a significant decrease in the in situ forces in the ACL after ramp repair was detected only for higher flexion angles when 4 N·m of external-rotation torque combined with a 200-N compression load ( P < .05) and 4 N·m of internal-rotation torque combined with a 200-N compression load were applied ( P < .05). Conclusion: In this biomechanical study, ramp lesions did not significantly affect knee biomechanics at the time of surgery. Clinical Relevance: From a biomechanical time-zero perspective, the indications for ramp lesion repair may be limited.

scholarly journals The Contralateral Knee Joint in Cruciate Ligament Deficiency

2008 ◽  
Vol 36 (11) ◽  
pp. 2151-2157 ◽  
Author(s):  
Michal Kozanek ◽  
Samuel K. Van de Velde ◽  
Thomas J. Gill ◽  
Guoan Li
Keyword(s):  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Ligament Injury ◽  
Joint Injury ◽  
Kinematic Control ◽  
Contralateral Knee ◽  
Anterior Cruciate

Background Patients with unilateral ligament deficiency are believed to have altered kinematics of the contralateral knee, increasing the risk of contralateral joint injury. Therefore, the contralateral knees might not be a reliable normal kinematic control. Purpose To compare the in vivo kinematics of the uninjured contralateral knees of patients with anterior or posterior cruciate ligament deficiency with knee kinematics of age-matched patients without joint injury. Study Design Controlled laboratory study. Methods Ten subjects with bilateral healthy knees, 10 patients with acute unilateral anterior cruciate ligament injury, and 10 with acute unilateral posterior cruciate ligament injury participated in this study. Kinematics were measured from 0° to 90° of flexion using imaging and 3-dimensional modeling. Results No significant differences were found across the groups in all rotations and translations during weightbearing flexion (P > .9). Conclusion Patients with unilateral cruciate ligament deficiency did not alter kinematics of the contralateral uninjured knee during weightbearing flexion. In addition, these findings suggest that the included patients with anterior cruciate ligament or posterior cruciate ligament deficiency did not have preexisting abnormal kinematics of the knee. Clinical Relevance As the contralateral joint kinematics of the injured patients were not affected by the ipsilateral ligament injury in the short term, physicians and researchers might use the contralateral knee as a reliable normal kinematic control.

A Method for the Kinematic Evaluation of the Knee following Anterior Cruciate Ligament Injury and Reconstruction

1993 ◽  
Vol 207 (2) ◽  
pp. 73-77 ◽  
Author(s):  
A J Long ◽  
F P Monsell ◽  
M L Porter ◽  
P Bowker ◽  
D W L Hukins
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Knee Kinematics ◽  
Ligament Injury ◽  
Anterior Cruciate ◽  
Centre Of Rotation ◽  
Kinematic Evaluation

A quantitative method for assessing the kinematics of the knee in the sagittal plane has been developed in order to evaluate the role of the anterior cruciate ligament following injury and reconstruction. Measurements were made on a series of lateral radiographs obtained at different angles of flexion with the limb weight-bearing and the foot and ankle rotated so that the condyles of the femur overlapped. The kinematics of the joint were then defined by recording the path of the tip of the medial tibial spine as flexion proceeded, using a coordinate system based on the femur. This method overcomes the problems inherent in quantifying knee kinematics by using the pathway of the centre of rotation. In an amputated knee, tibial positions could be specified to within approximately 1.2 mm. There were no significant differences between results obtained at the beginning and end of a six month period for the normal knees of two patients; the standard deviation of the measured tibial positions was approximately 1.6 mm.

scholarly journals Risk Factors for Anterior Cruciate Ligament Injury: literature Review: مخاطر الإصابة بالرباط الصليبي الأمامي: مراجعة أدبية

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Suleiman Ali Mansi
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Joint Stability ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Anterior Cruciate

  The Anterior cruciate ligament (ACL) plays an important role in maintaining knee-joint stability. Most ACL injures (approximately 65%) are due to a non-contact mechanism during physical activities, particularly in sports involving a landing from a jump, pivoting on the leg, rapid deceleration and cutting maneuvers. The average injury of ACL rates is still high for both professional and recreational athletes in particular between the group ages of 15 to 25 year old. The purpose of this article was to review and analysis the causes and potential risk factors for the ACL injury. Several anatomic and neuromuscular risk factors are associated with increased risk of suffering ACL injury, such as shoe-surface interaction, quadriceps angle, knee-joint laxity, genu varum of knee, and body composition. These risk factors most likely act in combination to influence the risk of ACL injury. Therefore, these factors should be considered when designing training programs, competitions, and implementing ACL injury prevention programs.

Comparison of Knee Mechanics Among Risky Athletic Motions for Noncontact Anterior Cruciate Ligament Injury

2013 ◽  
Vol 29 (6) ◽  
pp. 749-755 ◽  
Author(s):  
Hidenori Tanikawa ◽  
Hideo Matsumoto ◽  
Ikki Komiyama ◽  
Yoshimori Kiriyama ◽  
Yoshiaki Toyama ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Ligament Injury ◽  
Male And Female ◽  
Recreational Athletes ◽  
Athletic Activities ◽  
Anterior Cruciate ◽  
Kinematics And Kinetics

It has been suggested that noncontact anterior cruciate ligament injury commonly occurs during sports requiring acute deceleration or landing motion and that female athletes are more likely to sustain the injury than male athletes. The purpose of this study was to make task-to-task and male-female comparisons of knee kinematics and kinetics in several athletic activities. Three-dimensional knee kinematics and kinetics were investigated in 20 recreational athletes (10 males, 10 females) while performing hopping, cutting, turning, and sidestep and running (sharp deceleration associated with a change of direction). Knee kinematics and kinetics were compared among the four athletic tasks and between sexes. Subjects exhibited significantly lower peak flexion angle and higher peak extension moment in hopping compared with other activities (P< .05). In the frontal plane, peak abduction angle and peak adduction moment in cutting, turning, and sidestep and running were significantly greater compared with hopping (P< .05). No differences in knee kinematics and kinetics were apparent between male and female subjects. Recreational athletes exhibited different knee kinematics and kinetics in the four athletic motions, particularly in the sagittal and frontal planes. Male and female subjects demonstrated similar knee motions during the four athletic activities.

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