Tibial Rotation Affects Anterior Displacement of the Knee

1994 ◽  
Vol 3 (4) ◽  
pp. 275-281 ◽  
Author(s):  
David E. Martin ◽  
Kevin M. Guskiewicz ◽  
David H. Perrin ◽  
David M. Kahler ◽  
Frank C. McCue
Keyword(s):  
Repeated Measures ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Position Effect ◽  
Tibial Rotation ◽  
Repeated Measures Anova ◽  
Anterior Displacement ◽  
Kt 1000 ◽  
Tibiofemoral Alignment ◽  
Anterior Cruciate

The purpose of this study was to assess anterior translation of the tibia using the Tibial Fixator Device (a mechanical leg stabilizer that controls tibial alignment) with the leg in three positions: neutral (N), internal rotation of 15° (IR), and external rotation of 15° (ER). Displacement was measured using a modified KT-1000 arthrometer. Eleven subjects with anterior cruciate ligament lesions were examined bilaterally in the three positions at 45, 67, and 89 newtons of anterior force. Three-factor repeated-measures ANOVA revealed a significant position effect regardless of force (p < .001). This effect was significant in the injured and noninjured legs. Displacement was greatest in ER and least in IR. These data indicate that the position of the tibia, maintained with an external leg restraint, has a significant effect on anterior displacement of the knee. Control of tibiofemoral alignment and modifications to the KT-1000 provide new potentials for instrumented arthrometry.

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 The Effect of Tibial Rotation on the Presence of Instability in the Anterior Cruciate Ligament Deficient Knee

2007 ◽  
Vol 16 (1) ◽  
pp. 2-17 ◽  
Author(s):  
Mina Samukawa ◽  
David Magee ◽  
Masaki Katayose
Keyword(s):  
Outcome Measures ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Normal Subjects ◽  
Group Differences ◽  
Tibial Rotation ◽  
Anterior Cruciate ◽  
The Relationship ◽  
Acl Deficient ◽  
Control Study

Context:The effects of tibial rotation after ACL injury have not yet been well determined.Objective:To show whether clinical outcomes such as the amount of tibial rotation can affect functional outcomes in normal and ACL deficient knees.Design:Case control study.Setting:Research laboratory.Participants:Twenty normal subjects (Control) and 20 subjects with ACL deficient knees (ACL).Main Outcome Measures:Tibial rotation at 30 and 90 degrees of knee flexion was measured using an inclinometer. One-legged hop, crossover hop, figure-of-eight running and 10-m running tests were used and determined the effect(s) of tibial rotation on the outcome of the functional tests.Results:There were significant between-group differences in internal and external rotation. The relationship between external tibial rotation and the figure-of-eight index was significantly negatively correlated.Conclusions:The amount of tibial rotation is greater in ACL ruptured knees than in uninjured knees, and these greater amounts of tibial rotation affected the figure-of-eight running index.

Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women’s Collegiate Soccer

2021 ◽  
pp. 1-8
Author(s):  
Elena M. D’Argenio ◽  
Timothy G. Eckard ◽  
Barnett S. Frank ◽  
William E. Prentice ◽  
Darin A. Padua
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Range Of Motion ◽  
Injury Risk ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Dynamic Risk Factors ◽  
Dynamic Risk ◽  
Anterior Cruciate

Context: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women’s soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Design: Prospective cohort study. Methods: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women’s soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. Results: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Conclusions: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women’s collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.

scholarly journals Effects of a Prophylactic Knee Sleeve on Anterior Cruciate Ligament Loading During Sport-Specific Movements

2019 ◽  
Vol 28 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Jonathan Sinclair ◽  
Paul J. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Repeated Measures ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Musculoskeletal Modeling ◽  
Acl Injuries ◽  
Recreational Athletes ◽  
Load Rate ◽  
Anterior Cruciate ◽  
3D Motion Capture

Context: Prophylactic knee bracing is extensively utilized in athletic populations to reduce the high risk from knee injuries, but its role in the attenuation of anterior cruciate ligament (ACL) pathologies is not well understood. Objective: The aim of this investigation was to explore the effects of a prophylactic knee sleeve on ACL loading parameters linked to the etiology of injury in recreational athletes. Setting: Laboratory. Design: Repeated measures. Participants: Thirteen healthy male recreational athletes. Intervention: Participants performed run, cut, and single-leg hop movements under 2 conditions; prophylactic knee sleeve and no sleeve. Main Outcome Measures: Biomechanical data were captured using an 8-camera 3D motion capture system and a force platform. Peak ACL force, average ACL load rate, and instantaneous ACL load rate were quantified using a musculoskeletal modeling approach. Results: The results showed that both average and instantaneous ACL load rates were significantly reduced when wearing the knee sleeve in the hop (sleeve = 612.45/1286.39 N/kg/s and no sleeve = 743.91/1471.42 N/kg/s) and cut (sleeve = 222.55/1058.02 N/kg/s and no sleeve = 377.38/1183.01 N/kg/s) movements. Conclusions: Given the biomechanical association between ACL loading and the etiology of ACL injuries, it is proposed that athletes may be able to attenuate their risk from injury during cut and hop movements through utilization of a prophylactic knee sleeve.

Assessment of Knee Laxity Following Anterior Cruciate Ligament Reconstruction

1993 ◽  
Vol 2 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Kelly R. Holcomb ◽  
Cheryl A. Skaggs ◽  
Teddy W. Worrell ◽  
Mark DeCarlo ◽  
K. Donald Shelbourne
Keyword(s):  
Anterior Cruciate Ligament ◽  
Standard Error ◽  
Cruciate Ligament ◽  
Intraclass Correlation ◽  
Knee Laxity ◽  
Testing Procedures ◽  
Kt 1000 ◽  
Anterior Cruciate ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

A paucity of information exists concerning reliability of the KT-1000 knee arthrometer (MEDmetric Corp., San Diego, CA) when used by different clinicians to assess the same anterior cruciate ligament-deficient patient. The purpose of this study was to determine the reliability and standard error of measurement of four clinicians who routinely report KT-1000 arthrometer values to referring orthopedic surgeons. Two physical therapists and two athletic trainers performed anterior laxity tests using the KT-1000 on 19 subjects. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were used to determine reliability. Intratester ICC ranged from .98 to 1.0 and intratesterSEMranged from 0.0 to .28 mm. Intertester ICC andSEMfor all four testers were .53 and 1.2 mm, respectively. A 95% confidence interval (M ± 1.96 ×SEM) of the intertester variability ranged from −0.18 to 4.52 mm. Therefore, large intertester variation existed in KT-1000 values. Each facility should standardize testing procedures and establish intratester and intertester reliability for all clinicians reporting KT-1000 values.

Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction Using Patellar Tendon Autograft

1998 ◽  
Vol 26 (1) ◽  
pp. 20-29 ◽  
Author(s):  
Bernard R. Bach ◽  
Steven Tradonsky ◽  
John Bojchuk ◽  
Matthew E. Levy ◽  
Charles A. Bush-Joseph ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Examination ◽  
Cruciate Ligament ◽  
Activity Level ◽  
Functional Testing ◽  
Symptomatic Knee ◽  
Kt 1000 ◽  
Arthroscopically Assisted ◽  
The Mean ◽  
Anterior Cruciate

We retrospectively reviewed the results of 97 patients with anterior cruciate ligament reconstructions using an arthroscopically assisted two-incision technique without extraarticular augmentation at an intermediate followup of 5 to 9 years postoperatively. Evaluation included detailed history, physical examination, functional testing, KT-1000 arthrometer measurements, multiple scoring systems, and radiographs. The results were compared with those from a previous study that evaluated a smaller patient cohort using the identical surgical technique at a 2- to 4-year followup. The post-operative physical examination and KT-1000 arthrometer results were statistically improved when compared with preoperative findings. A negative pivot shift result was noted in 83% of patients, and a 1 result in 17% of patients. Seventy percent of patients had 3 mm difference on manual maximum side-to-side testing. Functional testing averaged less than 2% asymmetry for vertical jump, single-legged hop, or timed 6-meter hop. The Tegner activity level was significantly improved from prereconstruction ratings and similar to preinjury ratings. The mean Lysholm score was 87. The modified Hospital for Special Surgery scores resulted in good or excellent results in 82% of the patients (mean, 87 points). The mean Noyes sports function score was 89, and the reoperation rate for a symptomatic knee flexion contracture was 12%. Ninety-seven percent of patients indicated that they would undergo the procedure again. When compared with this same population at 2 to 4 years, we saw no deterioration in scoring scale results.

scholarly journals Passive Hip Range-of-Motion Values Across Sex and Sport

2018 ◽  
Vol 53 (6) ◽  
pp. 560-567 ◽  
Author(s):  
Jennifer A. Hogg ◽  
Randy J. Schmitz ◽  
Anh-Dung Nguyen ◽  
Sandra J. Shultz
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
National Collegiate Athletic Association ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Knee Valgus ◽  
Cross Sectional ◽  
Increased Risk ◽  
Hip Range Of Motion ◽  
Cross Country

Context:  Greater passive hip range of motion (ROM) has been associated with greater dynamic knee valgus and thus the potential for increased risk of anterior cruciate ligament injuries. Normative data for passive hip ROM by sex are lacking. Objective:  To establish and compare passive hip ROM values by sex and sport and to quantify side-to-side differences in internal-rotation ROM (ROMIR), external-rotation ROM (ROMER), and total ROM (ROMTOT). Design:  Cross-sectional study. Setting:  Station-based, preparticipation screening. Patients or Other Participants:  A total of 339 National Collegiate Athletic Association Division I athletes, consisting of 168 women (age = 19.2 ± 1.2 years, height = 169.0 ± 7.2 cm, mass = 65.3 ± 10.2 kg) and 171 men (age = 19.4 ± 1.3 years, height = 200.0 ± 8.6 cm, mass = 78.4 ± 12.0 kg) in 6 sports screened over 3 years: soccer (58 women, 67 men), tennis (20 women, 22 men), basketball (28 women, 22 men), softball or baseball (38 women, 31 men), cross-country (18 women, 19 men), and golf (6 women, 10 men). Main Outcome Measure(s):  Passive hip ROM was measured with the athlete lying prone with the hip abducted to 20° to 30° and knee flexed to 90°. The leg was passively internally and externally rotated until the point of sacral movement. Three measures were averaged for each direction and leg and used for analysis. We compared ROMIR, ROMER, ROMTOT (ROMTOT = ROMIR + ROMER), and relative ROM (ROMREL = ROMIR − ROMER) between sexes and among sports using separate 2 × 6 repeated-measures analyses of variance. Results:  Women had greater ROMIR (38.1° ± 8.2° versus 28.6° ± 8.4°; F1,327 = 91.74, P &lt; .001), ROMTOT (72.1° ± 10.6° versus 64.4° ± 10.1°; F1,327 = 33.47, P &lt; .001), and ROMREL (1.5° ± 16.0° versus −7.6° ± 16.5°; F1,327 = 37.05, P &lt; .001) than men but similar ROMER (34.0° ± 12.2° versus 35.8° ± 11.5°; F1,327 = 1.65, P = .20) to men. Cross-country athletes exhibited greater ROMIR (37.0° ± 9.3° versus 30.9° ± 9.4° to 33.3° ± 9.5°; P = .001) and ROMREL (5.9° ± 18.3° versus −9.6° ± 16.9° to −2.7° ± 17.3°; P = .001) and less ROMER (25.7° ± 7.5° versus 35.0° ± 13.0° to 40.2° ± 12.0°; P &lt; .001) than basketball, soccer, softball or baseball, and tennis athletes. They also displayed less ROMTOT (62.7° ± 8.1° versus 70.0° ± 9.1° to 72.9° ± 11.9°; P &lt; .001) than basketball, softball or baseball, and tennis athletes. Conclusions:  Women had greater ROMIR than men, resulting in greater ROMTOT and ROMREL. Researchers should examine the extent to which this greater bias toward ROMIR may explain women's greater tendency for dynamic knee valgus. With the exception of cross-country, ROM values were similar across sports. The clinical implications of these aberrant cross-country values require further study.

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