scholarly journals A Review on Biomechanics of Anterior Cruciate Ligament and Materials for Reconstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
M. Marieswaran ◽  
Ishita Jain ◽  
Bhavuk Garg ◽  
Vijay Sharma ◽  
Dinesh Kalyanasundaram
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Viscoelastic Behavior ◽  
Strain Rates ◽  
Self Healing ◽  
Full Extension ◽  
Human Knee Joint ◽  
Anterior Cruciate ◽  
Synthetic Grafts

The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial. An abridged summary of the prominent literature with a focus on key topics on kinematics and kinetics of the knee joint and various loads acting on the anterior cruciate ligament as a function of flexion angle is presented here with an emphasis on the gaps. Briefly, we also review mechanical characterization composition and anatomy of the anterior cruciate ligament as well as graft materials used for replacement/reconstruction surgeries. The key conclusions of this review are as follows: (a) the highest shear forces on the anterior cruciate ligament occur during hyperextension/low flexion angles of the knee joint; (b) the characterization of the anterior cruciate ligament at variable strain rates is critical to model a viscoelastic behavior; however, studies on human anterior cruciate ligament on variable strain rates are yet to be reported; (c) a significant disparity on maximum stress/strain pattern of the anterior cruciate ligament was observed in the earlier works; (d) nearly all synthetic grafts have been recalled from the market; and (e) bridge-enhanced repair developed by Murray is a promising technique for anterior cruciate ligament reconstruction, currently in clinical trials. It is important to note that full extension of the knee is not feasible in the case of most animals and hence the loading pattern of human ACL is different from animal models. Many of the published reviews on the ACL focus largely on animal ACL than human ACL. Further, this review article summarizes the issues with autografts and synthetic grafts used so far. Autografts (patellar tendon and hamstring tendon) remains the gold standard as nearly all synthetic grafts introduced for clinical use have been withdrawn from the market. The mechanical strength during the ligamentization of autografts is also highlighted in this work.

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.

scholarly journals Anterior cruciate ligament changes in the human knee joint in aging and osteoarthritis

2012 ◽  
Vol 64 (3) ◽  
pp. 696-704 ◽  
Author(s):  
Akihiko Hasegawa ◽  
Shuhei Otsuki ◽  
Chantal Pauli ◽  
Shigeru Miyaki ◽  
Shantanu Patil ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Human Knee ◽  
Human Knee Joint ◽  
Anterior Cruciate

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.

scholarly journals Human knee joint sound during the Lachman test: Comparison between healthy and anterior cruciate ligament-deficient knees

2017 ◽  
Vol 22 (3) ◽  
pp. 488-494 ◽  
Author(s):  
Kazunori Tanaka ◽  
Munehiro Ogawa ◽  
Yusuke Inagaki ◽  
Yasuhito Tanaka ◽  
Hitoshi Nishikawa ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Human Knee ◽  
Lachman Test ◽  
Human Knee Joint ◽  
Anterior Cruciate ◽  
Anterior Cruciate Ligament Deficient

scholarly journals Synthetic grafts in the treatment of ruptured anterior cruciate ligament of the knee joint

2017 ◽  
Vol 47 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Wojciech Satora ◽  
Aleksandra Królikowska ◽  
Andrzej Czamara ◽  
Paweł Reichert
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Anterior Cruciate ◽  
Synthetic Grafts

Quantitative assessment of anterior cruciate ligament deficiency: Applied load versus applied displacement

1997 ◽  
Vol 211 (6) ◽  
pp. 441-449
Author(s):  
P N Grimshaw ◽  
P Bowker
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Clinical Diagnosis ◽  
Quantitative Assessment ◽  
Cruciate Ligament ◽  
Human Knee ◽  
Human Knee Joint ◽  
Anterior Cruciate ◽  
Applied Displacement ◽  
Cent Decrease

The Salford static knee instrument (SSKI) was developed to determine the quantitative assessment of the human knee joint in vivo by utilizing the technique of applied displacement and measurement of resistive load as proposed by Butler et al. (1). The instrument was used in parallel with the device developed by Al-Turaiki (2) which utilized the opposite method of assessment. The objective of the research was to examine which of the two techniques provided the more reliable and accurate method of knee assessment. Fourteen patients with suspected isolated rupture of the anterior cruciate ligament (ACL) were subjected to anterior-posterior drawer testing on both devices. The results showed that each instrument produced results which confirmed the clinical diagnosis by indicating a significant decrease in anterior stiffness when comparing the injured and uninjured knees. [SSKI device ( p = 0.000) and Al-Turaiki (2) device ( p = 0.002) statistical significant difference testing with Bonferonni Alpha correction p = 0.0125]. The results showed the Salford static knee instrument indicated a 58 per cent decrease in anterior stiffness and the Al-Turaiki (2) device a 35 per cent decrease when comparing the injured and uninjured knees. In conclusion it is suggested that the application of displacement and measurement of load as proposed by Butler et al. (1) may be the most appropriate technique for precise clinical diagnosis of pathological human knee joint instability. load, displacement, knee, anterior, stiffness

scholarly journals CONSERVATIVE REHABILITATION OF PARTIAL ANTERIOR CRUCIATE LIGAMENT TEAR FOR BETTER FUNCTIONAL OUTCOME

2021 ◽  
Vol 10 (5) ◽  
pp. 3606-3609
Author(s):  
Ragini Dadgal
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Invasive Procedure ◽  
Joint Effusion ◽  
Posterolateral Bundle ◽  
Full Extension ◽  
Anterior Cruciate ◽  
The Right

To stabilize the knee joint, the anterior cruciate ligament (ACL) is one of the important ligaments. For normal movement and mechanics of the knee joint, ACL is important. If the ACL is torn, people notice problems in stability function of knee joint and there the feeling of ‘giving away’ while weight bearing. The function of anterior cruciate ligament is to restrain translation of the tibia on the femur. However, this role is divided by either anteromedial or the posterolateral bundle, depending on the knee flexion angle. The posterolateral bundle is stretched when the knee is close to full extension; as the knee flexes, the posterolateral bundle loosens and the anteromedial bundle becomes tight. In this report, a 32-year-old male who had a history of twisting of the leg while jogging, started by him since 40 days, lead to partial thickness tear of ACL, minimal joint effusion along the periarticular surface of the right knee and was diagnosed by radiological findings and MRI. As patient was not ready for surgery, he decided to opt for physiotherapy management. The aim of this study is to study effects on functional outcomes after physiotherapy rehabilitation of ACL injury without any invasive procedure.

Sign in / Sign up

Export Citation Format

Share Document