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.

Anterior Cruciate Ligament Forces in Alpine Skiing

1993 ◽  
Vol 9 (4) ◽  
pp. 260-278 ◽  
Author(s):  
Walter Herzog ◽  
Lynda Read
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Inverse Dynamics ◽  
Cruciate Ligament ◽  
Symmetric System ◽  
Alpine Skiing ◽  
Loading Conditions ◽  
World Cup ◽  
Joint Forces ◽  
Anterior Cruciate

The purpose of this study was to estimate cruciate ligament forces in Alpine skiing during a movement that has been associated with anterior cruciate ligament (ACL) tears. Resultant knee joint forces and moments were obtained from two skiers during a World Cup Downhill race using an inverse dynamics approach and a 2-D bilaterally symmetric system model. It was found that ACL forces were typically small for both skiers throughout the movement analyzed because quadriceps forces prevented anterior displacement of the tibia relative to the femur at the knee joint angles observed. However, for about 10 ms, loading conditions in the knee joint of Subject 2 (who displayed poor form) were such that large ACL forces may have been present. These particular loading conditions were never observed in Subject 1, who displayed good form. Since neither of the skiers was injured, it is not possible to draw firm conclusions about isolated ACL tears in Alpine skiing from the data at hand.

Torsion and Bending Imposed on a New Anterior Cruciate Ligament Prosthesis During Knee Flexion: An Evaluation Method

1984 ◽  
Vol 106 (4) ◽  
pp. 285-294 ◽  
Author(s):  
P. Gely ◽  
G. Drouin ◽  
P. S. Thiry ◽  
G. R. Tremblay
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Knee Flexion ◽  
Input Data ◽  
Evaluation Method ◽  
Cruciate Ligament ◽  
Geometric Model ◽  
Kinematic Model ◽  
Full Extension ◽  
Anterior Cruciate

A new composite prosthesis was recently proposed for the anterior cruciate ligament. It is implanted in the femur and the tibia through two anchoring channels. Its intra-articular portion, composed of a fiber mesh sheath wrapped around a silicons rubber cylindrical core, reproduces satisfactorily the ligament response in tension. However, the prosthesis does not only undergo elongation. In addition, it is submitted to torsion in its intra-articular portion and bending at its ends. This paper presents a new method to evaluate these two types of deformations throughout a knee flexion by means of a geometric model of the implanted prosthesis. Input data originate from two sources: (i) a three-dimensional anatomic topology of the knee joint in full extension, providing the localization of the prosthesis anchoring channels, and ii) a kinematic model of the knee describing the motion of these anchoring channels during a physiological flexion of the knee joint. The evaluation method is independent of the way input data are obtained. This method, applied to a right cadaveric knee, shows that the orientation of the anchoring channels has a large effect on the extent of torsion and bending applied to the implanted prosthesis throughout a knee flexion, especially on the femoral side. The study suggests also the best choice for the anchoring channel axes orientation.

Influence of Modern Studded and Bladed Soccer Boots and Sidestep Cutting on Knee Loading during Match Play Conditions

2007 ◽  
Vol 35 (9) ◽  
pp. 1528-1536 ◽  
Author(s):  
Rajiv Kaila
Keyword(s):  
Inverse Dynamics ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Match Play ◽  
Joint Forces ◽  
Significant Difference ◽  
Knee Loading ◽  
Anterior Cruciate ◽  
Inverse Dynamics Analysis ◽  
Straight Ahead

Background The influence of modern studded and bladed soccer boots and sidestep cutting on noncontact knee loading during match play conditions is not fully understood. Hypothesis Modern soccer boot type and sidestep cutting compared with straight-ahead running do not significantly influence knee internal tibia axial and valgus moments, anterior joint forces, and flexion angles. Study Design Controlled laboratory study. Methods Fifteen professional male outfield soccer players undertook trials of straight-ahead running and sidestep cutting at 30° and 60° with a controlled approach velocity on a Fédération Internationale de Football Association (FIFA) approved soccer surface. Two bladed and 2 studded soccer boots from 2 manufacturers were investigated. Three-dimensional inverse dynamics analysis determined externally applied internal/external tibia axial and valgus/varus moments, anterior forces, and flexion angles throughout stance. Results The soccer boot type imparted no significant difference on knee loading for each maneuver. Internal tibia and valgus moments were significantly greater for sidestep cutting at 30° and 60° compared with straight-ahead running. Sidestep cutting at 60° compared with straight-ahead running significantly increased anterior joint forces. Conclusion Varying soccer boot type had no effect on knee loading for each maneuver, but sidestep cutting significantly increased internal tibia and valgus moments and anterior joint forces. Clinical Relevance Sidestep cutting, irrespective of the modern soccer boot type worn, may be implicated in the high incidence of noncontact soccer anterior cruciate ligament injuries by significantly altering knee loading.

scholarly journals Additional Anterior Cruciate Ligament MRI Examination Protocols: a Standard of Diagnosis or a Whim of Researchers? (Review)

2020 ◽  
pp. 26-34
Author(s):  
O.O. Kostrub ◽  
V.V. Kotiuk ◽  
V.A. Podik ◽  
V.B. Mazevych ◽  
R.A. Tretiakov ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Accurate Diagnosis ◽  
Acute Period ◽  
Mri Examination ◽  
Modern Methods ◽  
Anterior Cruciate ◽  
Methods Of Treatment

Summary. Standard MRI protocols of the knee joint in case of suspected anterior cruciate ligament (ACL) injury involve tomography in three mutually perpendicular planes – coronal, sagittal, and axial. Modern methods of treatment (especially refixation of the ACL and reconstruction of separate ACL bundles) and rehabilitation require more accurate diagnosis not only of the fact of injury, but also its clear location, degree and term. It is especially difficult to assess the nature and extent of ACL damage in the acute period and in cases of partial injury. Therefore, we propose to introduce into the standard of ACL MRI examination the additional use of oblique sagittal and oblique coronal sequences (images) oriented at an angle of ACL fibers with reduced to 0-2 mm interslice interval to improve the diagnosis of ACL injury. To reduce the duration of the study, it is possible to limit yourself to a small number of slices (images) in additional projections only in the area of the ACL.

scholarly journals Risk Factors for Anterior Cruciate Ligament Injury in Competitive Adolescent Alpine Skiers

2018 ◽  
Vol 6 (4) ◽  
pp. 232596711876683 ◽  
Author(s):  
Maria Westin ◽  
Marita L. Harringe ◽  
Björn Engström ◽  
Marie Alricsson ◽  
Suzanne Werner
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Left Knee ◽  
Alpine Skiing ◽  
Acl Injuries ◽  
Alpine Skiers ◽  
Anterior Cruciate ◽  
Reduced Risk

Background: There is a high risk for anterior cruciate ligament (ACL) injuries in alpine skiers. To reduce or try to prevent these injuries, intrinsic and extrinsic risk factors need to be identified. Purpose: To identify possible intrinsic and extrinsic ACL injury risk factors among competitive adolescent alpine skiers. Study Design: Case-control study; Level of evidence, 3. Methods: Between 2006 and 2009, a cohort of 339 alpine ski students (176 male, 163 female) from Swedish ski high schools were prospectively observed in terms of ACL injuries. First-time ACL injuries were recorded. In September, prior to each ski season, the skiers were clinically examined according to a specific knee protocol. Results: Overall, 11 male and 14 female skiers sustained a total of 25 first-episode ACL injuries. The majority of injuries occurred in the left knee ( P < .05). Skiers who had participated in alpine skiing for >13 years (hazard ratio, 0.83; 95% CI, 0.68-1.00; P < .05) had a reduced risk of sustaining an ACL injury. Eighteen ACL injuries occurred during training, 12 in the technical discipline of giant slalom, and 8 in slalom. Fourteen skiers reported not to be fatigued at all at the time of injury, and 8 skiers reported that they were somewhat fatigued. Conclusion: ACL injuries occurred more often in the left knee than the right. This should be taken into consideration in the design of ACL injury prevention programs. Those who reported a higher number of active years in alpine skiing showed a reduced risk of sustaining an ACL injury. No other factor among those studied could be identified as an independent risk factor for ACL injury.

Magnetic Resonance Image Based Computational Modeling for Anterior Cruciate Ligament Response at Low Knee Flexion Angle

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Ariful I. Bhuiyan ◽  
Nabila Shamim ◽  
Stephen Ekwaro-Osire
Keyword(s):  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Knee Joint ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Experimental Tests ◽  
Joint Model ◽  
Human Knee ◽  
Human Knee Joint ◽  
Anterior Cruciate

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.

Result of anterior cruciate ligament reconstruction with all-inside technique using button system tightrope in Viet Duc University Hospital

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Trường Thịnh Vũ ◽  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
University Hospital ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Abstract Background: Evaluating the treatment results of Anterior Cruciate Ligament (ACL) reconstruction with the all-inside technique using the TightRope system. Patients and methods: It was a longitudinal descriptive study to investigate 56 patients who underwent ACL reconstruction with an all-inside technique using the Tight-Rope system in Viet Duc University Hospital between June 2019 and March 2020. Result: 82% of patients were men, and mainly of working age. The primary cause of ACL injury was a sports injury. Six months after surgery, the outcomes were excellent. The patient's knee joint range of motion and stability (evaluated by the Lachman and Pivot-Shift test) has improved significantly. Conclusions: Arthrosopic ACL reconstruction with all-inside technique using TightRope system leads to significant improvement in range of motion of patient's knee joint. The result of this study helps surgeons choose more options for management of ACL injury. Key word: Knee arthroscopy, anterior cruciate ligament reconstruction, all-inside. Tóm tắt Mục tiêu: Nghiên cứu đánh giá kết quả điều trị của phẫu thuật tái tạo dây chằng chéo trước (DCCT) theo kĩ thuât tái tạo "all inside" (tất cả bên trong) sử dụng Tightrope (TGR) hai đầu. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả tiến cứu trên 56 người bệnh (NB) phẫu thuật nội soi tái tạo DCCT với kỹ thuật tất cả bên trong sử dụng Tightrope hai đầu tại bệnh viện Hữu Nghị Việt Đức từ tháng 6 năm 2019 đến tháng 3 năm 2020. Kết quả: NB chủ yếu là nam giới (82%), trong độ tuổi lao động, nguyên nhân chủ yếu do tai nạn thể thao. Kết quả sau mổ 6 tháng rất tốt, NB cải thiện biên độ vận động và độ vững của khớp gối rõ rệt qua đánh giá bằng dấu hiệu Lachman và nghiệm pháp Pivot-shift. Kết luận: Nội soi tái tạo DCCT bằng kỹ thuật "tất cả bên trong" sử dụng TGR hai đầu đạt kết quả cao về sự phục hồi biên độ vận động khớp gối của NB sau mổ, giúp cho phẫu thuật viên có thêm lựa chọn về phương pháp phẫu thuật trong điều trị tái tạo DCCT. Từ khóa: Nội soi khớp gối, tái tạo dây chằng chéo trước, tất cả bên trong.

Effect of Fatigue on Hip and Knee Joint Biomechanics in Anterior Cruciate Ligament Deficient Patients

2021 ◽  
pp. 1-8
Author(s):  
Komeil Dashti Rostami ◽  
Abbey Thomas
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Peak Knee ◽  
Flexion Moment ◽  
Protective Strategy ◽  
Joint Biomechanics ◽  
Anterior Cruciate ◽  
Anterior Cruciate Ligament Deficient

The influence of fatigue on landing biomechanics in anterior cruciate ligament deficient (ACLD) patients is poorly understood. The purpose of this study was to examine the effect of fatigue on hip and knee joint biomechanics in deficient patients. Twelve ACLD males and 12 healthy control subjects participated in the study. The ACLD patients landed with increased peak knee flexion angle (F = 15.71, p < .01) and decreased peak knee flexion moment (F = 9.13, p < .01) after fatigue. Furthermore, ACLD patients experienced lower vertical ground reaction forces compared with controls regardless of fatigue state (F = 9.75, p < .01). It seems that ACLD patients use protective strategy in response to fatigue in order to prevent further injury in knee point.

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).

scholarly journals Tibial slope in the posterolateral quadrant with and without ACL injury

2021 ◽  
Author(s):  
A. Korthaus ◽  
M. Krause ◽  
G. Pagenstert ◽  
M. Warncke ◽  
F. Brembach ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Knee Joint ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Mri Scans ◽  
The Mean ◽  
Anterior Cruciate

Abstract Introduction An increased tibial slope is a risk factor for rupture of the anterior cruciate ligament. In addition, a tibial bone bruise or posterior lateral impression associated with slope changes also poses chronic ligamentous instability of the knee joint associated with an anterior cruciate ligament (ACL) injury. In the majority of cases, the slope is measured in one plane X-ray in the lateral view. However, this does not sufficient represent the complex anatomy of the tibial plateau and especially for the posterolateral quadrant. Normal values from a “healthy” population are necessary to understand if stability of the knee joint is negatively affected by an increasing slope in the posterolateral area. Until now there are no data about the physiological slope in the posterolateral quadrant of the tibial plateau. Materials and methods In 116 MRI scans of patients without ligamentous lesions and 116 MRI scans with an ACL rupture, tibial slope was retrospectively determined using the method described by Hudek et al. Measurements were made in the postero-latero-lateral (PLL) and postero-latero-central (PLC) segments using the 10-segment classification. In both segments, the osseous as well as the cartilaginous slope was measured. Measurements were performed by two independent surgeons. Results In the group without ligamentous injury the mean bony PLL slope was 5.8° ± 4.8° and the cartilaginous PLL slope was 6.7° ± 4.8°. In the PLC segment the mean bony slope was 6.6° ± 5.0° and the cartilaginous slope was 9.4° ± 5.7°. In the cohort with ACL rupture, the bony and cartilaginous slope in both PLL and PCL were significantly higher (P < 0.001) than in the group without ACL injury (bony PLL 9.8° ± 4.8°, cartilage PLL 10.4° ± 4.7°, bony PLC 10.3° ± 4.8°, cartilage PLL 12.8° ± 4.3°). Measurements were performed independently by two experienced surgeons. There were good inter- (CI 87–98.7%) and good intraobserver (CI 85.8–99.6%) reliability. Conclusion The bony and the cartilaginous slope in the posterolateral quadrant of the tibial plateau are different but not independent. Patients with an anterior cruciate ligament injury have a significantly steeper slope in the posterolateral quadrant compared to a healthy group. Our data indicate that this anatomic feature might be a risk factor for a primary ACL injury which has not been described yet. Level of evidence III.

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