scholarly journals Dynamic Trunk Control Influence on Run-to-Cut Maneuver: A Risk Factor for ACL Rupture

2011 ◽  
Author(s):  
Steve T. Jamison ◽  
Xueliang Pan ◽  
Ajit M. W. Chaudhari
Keyword(s):  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Rupture ◽  
Activity Levels ◽  
Trunk Control ◽  
Increased Risk ◽  
Knee Abduction ◽  
Short And Long Term ◽  
Anterior Cruciate

Anterior Cruciate Ligament (ACL) rupture is one of the most common serious knee injuries in field and court sports, with an estimated 70% of these injuries being non-contact in nature, often from sudden changes in direction or pivoting [3]. ACL injury results in both short- and long-term consequences for the athlete, which may include surgery, decreased activity levels, elevated pain levels during activities and increased risk of osteoarthritis. Previous studies have shown that knee abduction and tibial internal rotation moments independently strain the ACL, and that these moments have an interaction effect at physiologic load levels, creating strains approaching the reported range of ACL rupture [2, 6–8].

Deconstructing the Anterior Cruciate Ligament: What We Know and Do Not Know About Function, Material Properties, and Injury Mechanics

2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Scott G. McLean ◽  
Kaitlyn F. Mallett ◽  
Ellen M. Arruda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Mechanical Response ◽  
Cruciate Ligament ◽  
Complex Structure ◽  
Acute Injury ◽  
Research Attention ◽  
Increased Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury is a common and potentially catastrophic knee joint injury, afflicting a large number of males and particularly females annually. Apart from the obvious acute injury events, it also presents with significant long-term morbidities, in which osteoarthritis (OA) is a frequent and debilitative outcome. With these facts in mind, a vast amount of research has been undertaken over the past five decades geared toward characterizing the structural and mechanical behaviors of the native ACL tissue under various external load applications. While these efforts have afforded important insights, both in terms of understanding treating and rehabilitating ACL injuries; injury rates, their well-established sex-based disparity, and long-term sequelae have endured. In reviewing the expanse of literature conducted to date in this area, this paper identifies important knowledge gaps that contribute directly to this long-standing clinical dilemma. In particular, the following limitations remain. First, minimal data exist that accurately describe native ACL mechanics under the extreme loading rates synonymous with actual injury. Second, current ACL mechanical data are typically derived from isolated and oversimplified strain estimates that fail to adequately capture the true 3D mechanical response of this anatomically complex structure. Third, graft tissues commonly chosen to reconstruct the ruptured ACL are mechanically suboptimal, being overdesigned for stiffness compared to the native tissue. The net result is an increased risk of rerupture and a modified and potentially hazardous habitual joint contact profile. These major limitations appear to warrant explicit research attention moving forward in order to successfully maintain/restore optimal knee joint function and long-term life quality in a large number of otherwise healthy individuals.

Evaluating Different Criteria to Diagnose ACL Rupture Using a Knee Arthrometer

2009 ◽  
Author(s):  
Damoon Soudbakhsh ◽  
Mohammad-Naghi Tahmasebi ◽  
Mohamad Parnianpour
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Rupture ◽  
Ligament Injuries ◽  
Acl Injuries ◽  
Anterior Laxity ◽  
Anterior Cruciate

Every year many people suffer from knee injuries. Previous studies on patients with knee injuries has shown that about 40% percent of knee injuries are ligament injuries, and about 50% of the ligament injuries are the Anterior Cruciate Ligament (ACL) injuries [1–2]. Knee arthrometers are widely used to diagnose ACL injuries, along with other methods [3–4]. In the current research, a knee arthrometer which was developed to provide an accurate measurement of AP displacement of the knee [5] was used to measure anterior laxity of the knees of 20 subjects, and the results were analyzed to find better criteria to diagnose ACL rupture using knee arthrometers.

Long-term Effect of a Single Subcritical Knee Injury: Increasing the Risk of Anterior Cruciate Ligament Rupture and Osteoarthritis

2020 ◽  
pp. 036354652097750
Author(s):  
Carina L. Blaker ◽  
Sanaa Zaki ◽  
Christopher B. Little ◽  
Elizabeth C. Clarke
Keyword(s):  
Anterior Cruciate Ligament ◽  
Structural Change ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Acl Rupture ◽  
Osteochondral Lesions ◽  
Joint Mechanics ◽  
Pain Behaviors ◽  
Increased Risk ◽  
Anterior Cruciate

Background: Rupture of the anterior cruciate ligament (ACL) is a well-known risk factor for the development of posttraumatic osteoarthritis (PTOA), but patients with the “same injury” can have vastly different trajectories for the onset and progression of disease. Minor subcritical injuries preceding the critical injury event may drive this disparity through preexisting tissue pathologies and sensory changes. Purpose: To investigate the role of subcritical injury on ACL rupture risk and PTOA through the evaluation of pain behaviors, joint mechanics, and tissue structural change in a mouse model of knee injury. Study Design: Controlled laboratory study. Methods: Ten-week-old male C57BL/6J mice were allocated to naïve control and subcritical knee injury groups. Injury was induced by a single mechanical compression to the right hindlimb, and mice were evaluated using joint histopathology, anteroposterior joint biomechanics, pain behaviors (mechanical allodynia and hindlimb weightbearing), and isolated ACL tensile testing to failure at 1, 2, 4, or 8 weeks after injury. Results: Subcritical knee injury produced focal osteochondral lesions in the patellofemoral and lateral tibiofemoral compartments with no resolution for the duration of the study (8 weeks). These lesions were characterized by focal loss of proteoglycan staining, cartilage structural change, chondrocyte pathology, microcracks, and osteocyte cell loss. Injury also resulted in the rapid onset of allodynia (at 1 week), which persisted over time and reduced ACL failure load ( P = .006; mean ± SD, 7.91 ± 2.01 N vs 9.37 ± 1.01 N in naïve controls at 8 weeks after injury), accompanied by evidence of ACL remodeling at the femoral enthesis. Conclusion: The present study in mice establishes a direct effect of a single subcritical knee injury on the development of specific joint tissue pathologies (osteochondral lesions and progressive weakening of the ACL) and allodynic sensitization. These findings demonstrate a predisposition for secondary critical injuries (eg, ACL rupture) and an increased risk of PTOA onset and progression (structurally and symptomatically). Clinical Relevance: Subcritical knee injuries are a common occurrence and, based on this study, can cause persistent sensory and structural change. These findings have important implications for the understanding of risk factors of ACL injury and subsequent PTOA, particularly with regard to prevention and management strategies following an often underreported event.

scholarly journals EVALUATION OF SERUM RELAXIN CONCENTRATIONS AND KNEE VALGUS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0013
Author(s):  
Gabrielle G. Gilmer ◽  
Michael D. Roberts ◽  
Gretchen Oliver
Keyword(s):  
Anterior Cruciate Ligament ◽  
Health Outcomes ◽  
Luteal Phase ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Knee Valgus ◽  
Increased Risk ◽  
Anterior Cruciate

Background: Athletes who sustain an anterior cruciate ligament (ACL) injury are more likely to develop adverse health outcomes, such as knee osteoarthritis, knee pain, and obesity. It is assumed that the long-term consequences of ACL reconstruction are caused by the reconstruction itself. Studies have observed that relaxin, a peptide hormone similar in structure to insulin, interferes with the structural integrity of the ACL and elicits long term effects on bone, joint, muscle, and tendon health. Given the known effects of relaxin, it is reasonable to wonder if relaxin contributes to the development of these long-term health outcomes, independently of the ACL injury. Hypothesis/Purpose: The purpose of this study was to evaluate knee valgus and serum relaxin concentrations (SRC) in athletes who have and have not sustained an ACL injury. It was hypothesized that athletes who previously tore their ACL would have higher SRC and more knee valgus than those who were injury free. Methods: Twenty-two female athletes participated. Participants were assigned to one of two groups: ACL injury (6.0 ± 3.3 years after surgery, N = 4) and injury free (N = 18). Kinematic data were collected at 100 Hz using The MotionMonitor. Participants performed a single leg squat (SLS), single leg crossover dropdown (SCD), and drop vertical jump (DVJ) at two different time points in their menstrual period: pre-ovulatory phase and mid-luteal phase. Blood samples were collected when SRC are measurable (mid-luteal phase), and SRC were determined using a Quantikine Human Relaxin-2 Immunoassay. Results: Independent samples t-tests revealed significant differences between those who tore their ACL and those who were injury free in SRC and knee valgus during the SLS in the mid luteal phase, DVJ in both phases, and SCD in both phases. Specifically, the participants who tore their ACL had significantly higher SRC and more knee valgus than those who did not tear their ACL. Conclusion: These findings suggest that a previous ACL injury could place one at an increased risk of re-tear and other adverse effects on their joints, muscles, and tendons. Thus, further investigating hormonal risk factors during long term monitoring of recovery is needed.

scholarly journals Multiplanar Loading of the Knee and Its Influence on Anterior Cruciate Ligament and Medial Collateral Ligament Strain During Simulated Landings and Noncontact Tears

2019 ◽  
Vol 47 (8) ◽  
pp. 1844-1853 ◽  
Author(s):  
Nathaniel A. Bates ◽  
Nathan D. Schilaty ◽  
Christopher V. Nagelli ◽  
Aaron J. Krych ◽  
Timothy E. Hewett
Keyword(s):  
Cruciate Ligament ◽  
Frontal Plane ◽  
Tibial Rotation ◽  
Increased Risk ◽  
Acl Failure ◽  
Anterior Tibial ◽  
Knee Abduction ◽  
Internal Tibial Rotation ◽  
Risk Magnitude ◽  
Anterior Cruciate

Background:Anterior cruciate ligament (ACL) tears and concomitant medial collateral ligament (MCL) injuries are known to occur during dynamic athletic tasks that place combinatorial frontal and transverse plane loads on the knee. A mechanical impact simulator that produces clinical presentation of ACL injury allows for the quantification of individual loading contributors leading to ACL failure.Purpose/Hypothesis:The objective was to delineate the relationship between knee abduction moment, anterior tibial shear, and internal tibial rotation applied at the knee and ACL strain during physiologically defined simulations of impact at a knee flexion angle representative of initial contact landing from a jump. The hypothesis tested was that before ACL failure, abduction moment would induce greater change in ACL strain during landing than either anterior shear or internal rotation.Study Design:Controlled laboratory study.Methods:Nineteen cadaveric specimens were subjected to simulated landings in the mechanical impact simulator. During simulations, external knee abduction moment, internal tibial rotation moment, and anterior tibial shear loads were derived from a previously analyzed in vivo cohort and applied to the knee in varying magnitudes with respect to injury risk classification. Implanted strain gauges were used to track knee ligament displacement throughout simulation. Kruskal-Wallis tests were used to assess strain differences among loading factors, with Wilcoxon each pair post hoc tests used to assess differences of magnitude within each loading.Results:Each loading factor significantly increased ACL strain ( P < .005). Within factors, the high-risk magnitude of each factor significantly increased ACL strain relative to the baseline condition ( P≤ .002). However, relative to knee abduction moment specifically, ACL strain increased with each increased risk magnitude ( P≤ .015).Conclusion:Increased risk levels of each load factor contributed to increased levels of ACL strain during a simulated jump landing. The behavior of increased strain between levels of increased risk loading was most prevalent for changes in knee abduction moment. This behavior was observed in the ACL and MCL.Clinical Relevance:Knee abduction moment may be the predominant precursor to ACL injury and concomitant MCL injury. As knee abduction occurs within the frontal plane, primary preventative focus should incorporate reduction of frontal plane knee loading in landing and cutting tasks, but secondary reduction of transverse plane loading could further increase intervention efficacy. Constraint of motion in these planes should restrict peak ACL strain magnitudes during athletic performance.

Correlating Knee Characteristics and Dynamic Load to Customize Gait Simulation In Vitro

2013 ◽  
Author(s):  
Rebecca J. Nesbitt ◽  
Nathaniel A. Bates ◽  
Grant Schaffner ◽  
Timothy Hewett ◽  
Jason T. Shearn
Keyword(s):  
Cruciate Ligament ◽  
Knee Injuries ◽  
Surgical Reconstruction ◽  
Acl Repair ◽  
Gait Simulation ◽  
Increased Risk ◽  
The Us ◽  
Anterior Cruciate ◽  
Repair Techniques

Anterior cruciate ligament (ACL) tears are one of the most common knee injuries, with estimates reaching approximately 250,000 cases in the US per year [1]. In addition, patients treated with surgical reconstruction, or conservatively through rehabilitation and activity modification, have still been shown to be at increased risk of developing osteoarthritis (OA) earlier in life [2]. Researchers suspect that the failure of current ACL repair techniques is their inability to restore native functionality to the knee after injury.

Anterior Cruciate Ligament Rupture Associated with Cardiomyopathy in Three Cats

1991 ◽  
Vol 4 (01) ◽  
pp. 35-37 ◽  
Author(s):  
G. O. Janssens ◽  
D. L. Janssens ◽  
L. A. A. Janssens
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Anterior Cruciate Ligament Rupture ◽  
Acl Rupture ◽  
Thoracic Radiography ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Previous Trauma ◽  
History Of ◽  
Anterior Cruciate

SummaryOver a period of 14 years, three cats with anterior cruciate ligament (ACL) rupture were seen in our practice. In all, the rupture had occurred without a history of previous trauma. All were treated surgically. All died within a period of 14 days. The reason of death was in all cases cardiomyopathy. We now suggest that cats with rupture of the anterior cruciate ligament undergo an electrocardiographic recording and eventually an thoracic radiography before surgery is considered. We also suggest that cats with ACL rupture should preferably be treated conservatively.

The Femoral Footprint Position of the Anterior Cruciate Ligament Might Be a Predisposing Factor to a Noncontact Anterior Cruciate Ligament Rupture

2019 ◽  
Vol 47 (14) ◽  
pp. 3365-3372 ◽  
Author(s):  
Dimitris Dimitriou ◽  
Zhongzheng Wang ◽  
Diyang Zou ◽  
Tsung-Yuan Tsai ◽  
Naeder Helmy
Keyword(s):  
Anterior Cruciate Ligament ◽  
Matched Control ◽  
Cruciate Ligament ◽  
Magnetic Resonance Images ◽  
Small Sample ◽  
Transverse Plane ◽  
Acl Rupture ◽  
Coronal Plane ◽  
Predisposing Factor ◽  
Anterior Cruciate

Background: Although the femoral tunnel position is crucial to anatomic single-bundle anterior cruciate ligament (ACL) reconstruction, the recommendations for the ideal femoral footprint position are mostly based on cadaveric studies with small sample sizes, elderly patients with unknown ACL status, and 2-dimensional techniques. Furthermore, a potential difference in the femoral ACL footprint position and ACL orientation between ACL-ruptured and ACL-intact knees has not been reported in the literature. Hypothesis: The femoral ACL footprint position and ACL orientation vary significantly between ACL-ruptured and matched control ACL-intact knees. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Magnetic resonance images of the knees of 90 patients with an ACL rupture and 90 matched control participants who had a noncontact knee injury without an ACL rupture were used to create 3-dimensional models of the femur and tibia. The ACL footprints were outlined on each model, and their positions (normalized to the lateral condyle width) as well as ACL orientations were measured with an anatomic coordinate system. Results: The femoral ACL footprint in patients with an ACL rupture was located at 36.6% posterior and 11.2% distal to the flexion-extension axis (FEA). The ACL orientation was 46.9° in the sagittal plane, 70.3° in the coronal plane, and 20.8° in the transverse plane. The ACL-ruptured group demonstrated a femoral ACL footprint position that was 11.0% more posterior and 7.7% more proximal than that of the control group (all P < .01). The same patients also exhibited 5.7° lower sagittal elevation, 3.1° higher coronal plane elevation, and 7.9° lower transverse plane deviation (all P < .01). The optimal cutoff value of the femoral ACL footprint position to prevent an ACL rupture was at 30% posterior and 12% distal to the FEA. Conclusion: The ACL femoral footprint position might be a predisposing factor to an ACL rupture. Patients with a >30% posterior and <12% distal position of the femoral ACL footprint from the FEA might have a 51.2-times increased risk of an ACL rupture.

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