scholarly journals The Relationship Between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity

2009 ◽  
Vol 1 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Sandra J. Shultz ◽  
Anh-Dung Nguyen ◽  
Beverly J. Levine
Keyword(s):  
Lower Extremity ◽  
Pelvic Tilt ◽  
Knee Laxity ◽  
Tibiofemoral Angle ◽  
Navicular Drop ◽  
Lower Extremity Alignment ◽  
Anterior Knee Laxity ◽  
Genu Recurvatum ◽  
Anterior Pelvic Tilt ◽  
Anterior Knee

Background: Lower extremity alignment may influence the load distribution at the knee, potentially predisposing the anterior cruciate ligament to greater stress. We examined whether lower extremity alignment predicted the magnitude of anterior knee laxity in men and women. Hypothesis: Greater anterior pelvic angle, hip anteversion, tibiofemoral angle, genu recurvatum, and navicular drop will predict greater anterior knee laxity. Study Design: Descriptive laboratory study. Methods: Women (n = 122) and men (n = 97) were measured for anterior knee laxity and 7 lower extremity alignment variables on their dominant stance leg. Linear regression determined the extent to which the alignment variables predicted anterior knee laxity for each sex. Results: Lower anterior pelvic tilt and tibiofemoral angle, and greater genu recurvatum and navicular drop were related to greater anterior knee laxity in women, explaining 28.1% of the variance ( P < .001). Lower anterior pelvic tilt and greater hip anteversion, genu recurvatum and navicular drop were predictors of greater anterior knee laxity in men, explaining 26.5% of the variance ( P < .001). Conclusion: Lower anterior pelvic tilt, greater knee hyperextension, and foot pronation predicted greater anterior knee laxity in both men and women, with genu recurvatum and navicular drop having the greatest impact on anterior knee laxity. Greater hip anteversion was also a strong predictor in men, while a lower tibiofemoral angle was a significant predictor in women. Clinical Relevance: The associations between lower extremity alignment and anterior knee laxity suggest that alignment of the hip, knee, and ankle may be linked to or contribute to abnormal loading patterns at the knee, potentially stressing the capsuloligamentous structures and promoting greater joint laxity.

scholarly journals Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

2009 ◽  
Vol 44 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Jennifer M. Medina McKeon ◽  
Jay Hertel
Keyword(s):  
Lower Extremity ◽  
Pelvic Tilt ◽  
Cruciate Ligament ◽  
Femoral Anteversion ◽  
Injury Rates ◽  
Men And Women ◽  
Lower Extremity Alignment ◽  
Genu Recurvatum ◽  
Anterior Pelvic Tilt ◽  
Anterior Cruciate

Abstract Context: A discrepancy in anterior cruciate ligament (ACL) injury rates exists between men and women. Structural differences between the sexes often are implicated as a factor in this discrepancy. Researchers anecdotally assume that men and women tend to display different normative values for certain lower extremity alignments, but published information about these values is limited. Objective: To evaluate the effect of sex on 6 measures of lower extremity alignment and to report representative values of these measures from a sample of active adults and elite athletes. Design: Descriptive cohort design. Setting: University research laboratory. Patients or Other Participants: A total of 118 healthy adults (57 men: age  =  21.1 ± 3.0 years, height  =  179.1 ± 7.3 cm, mass  =  79.8 ± 13.0 kg; 61 women: age  =  20.0 ± 1.6 years, height  =  167.7 ± 6.7 cm, mass  =  62.7 ± 5.5 kg) volunteered. Main Outcome Measure(s): Six common measures of lower extremity posture (navicular drop, tibial varum, quadriceps angle, genu recurvatum, anterior pelvic tilt, femoral anteversion) were collected using established methods. One measurement was taken for each participant for each lower extremity alignment. We measured the right lower extremity only. Results: Compared with men, women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion. Conclusions: We observed differences between men and women for 4 of the 6 lower extremity alignments that we measured. Future researchers should focus on identifying how sex and skeletal alignment affect biomechanical performance of functional tasks and what these differences specifically mean regarding the discrepancy in anterior cruciate ligament injury rates between the sexes.

scholarly journals Identifying Relationships Among Lower Extremity Alignment Characteristics

2009 ◽  
Vol 44 (5) ◽  
pp. 511-518 ◽  
Author(s):  
Anh-Dung Nguyen ◽  
Sandra J. Shultz
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Femoral Anteversion ◽  
Tibial Torsion ◽  
Tibiofemoral Angle ◽  
Navicular Drop ◽  
Lower Extremity Alignment ◽  
Select Group ◽  
Genu Recurvatum ◽  
The Relationship

Abstract Context: The relationship between lower extremity alignment and lower extremity injury risk remains poorly understood, perhaps because most authors have examined only individual or a select group of alignment variables. Examining the relationships among alignment variables may allow us to more accurately describe lower extremity posture and clarify the relationship between lower extremity alignment and injury risk in future studies. Objective: To measure lower extremity alignment variables and examine whether relationships could be identified among these variables. Design: Observational study. Setting: Laboratory. Patients or Other Participants: Two hundred eighteen (102 males: age  =  23.1 ± 3.2 years, height  =  177.3 ± 8.4 cm, mass  =  80.8 ± 13.0 kg; 116 females: age  =  21.8 ± 2.7 years, height  =  163.5 ± 7.4 cm, mass  =  63.4 ± 12.4 kg) healthy, college-aged participants. Main Outcome Measure(s): We measured pelvic angle, femoral anteversion, quadriceps angle, tibiofemoral angle, genu recurvatum, and tibial torsion to the nearest degree and navicular drop to the nearest millimeter on the right and left lower extremities. Separate principal components factor analyses were performed for each sex and side (left, right). Results: A distinct lower extremity factor was identified, with relationships observed among increased pelvic angle, increased quadriceps angle, and increased tibiofemoral angle. A second distinct lower extremity factor was identified, with relationships observed among increased supine genu recurvatum, decreased tibial torsion, and increased navicular drop. Femoral anteversion loaded as an independent third factor. These distinct lower extremity alignment factors were consistent across side and sex. Conclusions: Factor analysis identified 3 distinct lower extremity alignment factors that describe the potential interactions among lower extremity alignment variables. Future authors should examine how these collective alignment variables, both independently and in combination, influence dynamic knee function and risk for lower extremity injuries.

The relationship of lower extremity alignments and anterior knee laxity to knee translations during a vertical drop landing

2011 ◽  
Vol 45 (4) ◽  
pp. 350-350
Author(s):  
C. A. Myers ◽  
J. E. Giphart ◽  
M. R. Torry ◽  
K. B. Shelburne ◽  
S. L. Y. Woo ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Knee Laxity ◽  
Anterior Knee Laxity ◽  
Drop Landing ◽  
Relationship Of ◽  
The Relationship ◽  
Anterior Knee

scholarly journals Comparison of anterior knee laxity, stiffness, genu recurvatum, and general joint laxity in the late follicular phase and the ovulatory phase of the menstrual cycle

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mayuu Shagawa ◽  
Sae Maruyama ◽  
Chie Sekine ◽  
Hirotake Yokota ◽  
Ryo Hirabayashi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Menstrual Cycle ◽  
Knee Laxity ◽  
Acl Injury ◽  
Follicular Phase ◽  
Joint Laxity ◽  
Anterior Knee Laxity ◽  
Genu Recurvatum ◽  
Anterior Knee ◽  
Late Follicular Phase

Abstract Background One risk factor for anterior cruciate ligament (ACL) injury may be fluctuations in female hormones. This study examined variability in joint laxity, as a risk factor for ACL injury, during the menstrual cycle. Methods Subjects were 15 female university students with regular menstrual cycles. We measured estradiol (E2) concentration, anterior knee laxity (AKL), stiffness, genu recurvatum (GR), and general joint laxity (GJL) during the late follicular and ovulatory phases. AKL was measured as anterior tibial displacement of the femur after application of 44-, 89-, and 133-N loads on the tibia. Stiffness was calculated as Δforce/Δdisplacement at loads of 44–89 N and between 89 and 133 N. GR was measured prone, with the base of the patella distal to the edge of the bed. The University of Tokyo joint laxity test was used to evaluate GJL. Results E2 concentration was significantly higher in the ovulatory phase than in the late follicular phase (p = 0.018), AKL and stiffness did not differ significantly between phases, and GR and GJL were significantly higher in the ovulatory phase than in the late follicular phase (p = 0.011, 0.031). Conclusion These findings suggest that E2 concentrations may affect GR and GJL during the menstrual cycle.

scholarly journals A comparison of cyclic variations in anterior knee laxity, genu recurvatum, and general joint laxity across the menstrual cycle

2010 ◽  
Vol 28 (11) ◽  
pp. 1411-1417 ◽  
Author(s):  
Sandra J. Shultz ◽  
Beverly J. Levine ◽  
Anh-Dung Nguyen ◽  
Hyunsoo Kim ◽  
Melissa M. Montgomery ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Knee Laxity ◽  
Joint Laxity ◽  
Anterior Knee Laxity ◽  
Genu Recurvatum ◽  
Cyclic Variations ◽  
Anterior Knee

Lower Extremity Posture is Related to Anterior Knee Laxity

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S93
Author(s):  
Sandra J. Shultz ◽  
Anh-Dung Nguyen ◽  
Beverly J. Levine ◽  
David H. Perrin
Keyword(s):  
Lower Extremity ◽  
Knee Laxity ◽  
Anterior Knee Laxity ◽  
Anterior Knee

Effect of Tibial Tunnel Placement Using the Lateral Meniscus as a Landmark on Clinical Outcomes of Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652199967
Author(s):  
Kadir Büyükdoğan ◽  
Michael S. Laidlaw ◽  
Michael A. Fox ◽  
Michelle E. Kew ◽  
Mark D. Miller
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Lateral Meniscus ◽  
Knee Laxity ◽  
Pivot Shift Test ◽  
Anterior Knee Laxity ◽  
Posterior Group ◽  
Kt 1000 ◽  
Anterior Knee

Background: It remains unclear if use of the lateral meniscus anterior horn (LMAH) as a landmark will produce consistent tunnel positions in the anteroposterior (AP) distance across the tibial plateau. Purpose: To evaluate the AP location of anterior cruciate ligament (ACL) reconstruction tibial tunnels utilizing the LMAH as an intra-articular landmark and to examine how tunnel placement affects knee stability and clinical outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted of 98 patients who underwent primary ACL reconstruction with quadrupled hamstring tendon autografts between March 2013 and June 2017. Patients with unilateral ACL injuries and a minimum follow-up of 2 years were included in the study. All guide pins for the tibial tunnel were placed using the posterior border of the LMAH as an intra-articular landmark. Guide pins were evaluated with the Bernard-Hertel grid in the femur and the Stäubli-Rauschning method in the tibia. Patients were divided by the radiographic location of the articular entry point of the guide pin with relation to the anterior 40% of the tibial plateau. Outcomes were evaluated by the Marx Activity Scale and International Knee Documentation Committee (IKDC) form. Anterior knee laxity was evaluated using a KT-1000 arthrometer and graded with the objective portion of the IKDC form. Rotational stability was evaluated using the pivot-shift test. Results: A total of 60 patients were available for follow-up at a mean 28.6 months. The overall percentage of AP placement of the tibial tunnel was 39.3% ± 3.8% (mean ± SD; range, 31%-47%). Side-to-side difference of anterior knee laxity was significantly lower in the anterior group than the posterior group (1.2 ± 1.1 mm vs 2.5 ± 1.3 mm; P < .001; r = 0.51). The percentage of AP placement of the tibial tunnel demonstrated a positive medium correlation with side-to-side difference of anterior knee laxity as measured by a KT-1000 arthrometer ( r = 0.430; P < .001). The anterior group reported significantly better distribution of IKDC grading as compared with the posterior group (26 grade A and 6 grade B vs 15 grade A and 13 grade B; P = .043; V = 0.297). The pivot-shift test results and outcome scores showed no significant differences between the groups. Conclusion: Using the posterior border of the LMAH as an intraoperative landmark yields a wide range of tibial tunnel locations along the tibial plateau, with anterior placement of the tibial tunnel leading toward improved anterior knee stability.

Assessing Laxity Characteristics of Hyperextension Knee in Healthy Young Females Using a Knee Ligament Arthrometer

2007 ◽  
Author(s):  
Hsiu-Chen Lin ◽  
Weng-Hang Lai ◽  
Chia-Ming Chang ◽  
Horng-Chaung Hsu
Keyword(s):  
Female Athletes ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Acl Injury ◽  
Male Athletes ◽  
Knee Ligament ◽  
Young Females ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate ◽  
Anterior Knee

Female athletes are more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Previous study has showed that female individuals had larger anterior knee laxity than their male counterparts [1]. Researchers have also reported that knee laxity and hyperextension knee were a possible factor contributing to ACL injury [2]. Loudon showed that a person with hyperextension knee, either healthy or ACL-injured, had poorer proprioceptive control. Even more, ACL-injured subjects with hyperextension knee demonstrated a declined function of proprioception feedback loop and the ability to initiate protective reflexes [3].

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