An in vivo biomechanical evaluation of anterior-posterior motion of the knee. Roentgenographic measurement technique, stress machine, and stable population.

Torzilli, Peter A.; Greenberg, Ronald; Insall, J N

doi:10.2106/00004623-198163060-00014

Cited by 101 publications

(35 citation statements)

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“…2.7 mm). These findings are consistent with previous work published by our research center and others [18,32,34,361. The internal tibial rotation in response to a combined rotatory load was also similar to those found by previous studies [17,25,32,36].…”

Section: Discussionsupporting

confidence: 94%

“…This testing system enabled the precise measurement of the 5 DOF kinematics (at a predetermined flexion angle) and non-contact measurements of the in situ force in the ACL, as well as the distribution of in situ force in its AM and PL bundles in response to these externally applied loads. These loading conditions were designed to simulate clinical examinations used to diagnose ACL deficiency, such as the Noulis-Lachman, anterior drawer [25,32,34], and pivot shift tests [6,15,20].…”

Section: Discussionmentioning

confidence: 99%

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Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads

Gabriel

Wong

Woo

et al. 2004

Journal Orthopaedic Research

590

431

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The anterior cruciate ligament (ACL) can be anatomically divided into anteromedial (AM) and posterolateral (PL) bundles. Current ACL reconstruction techniques focus primarily on reproducing the AM bundle, but are insufficient in response to rotatory loads. The objective of this study was to determine the distribution of in situ force between the two bundles when the knee is subjected to anterior tibial and rotatory loads. Ten cadaveric knees (50 k 10 years) were tested using a roboticluniversal forcemoment sensor (UFS) testing system. Two external loading conditions were applied: a 134 N anterior tibial load at full knee extension and 15", 30°, 60", and 90" of flexion and a combined rotatory load of 10 N m valgus and 5 N m internal tibial torque at 15" and 30" of flexion. The resulting 6 degrees of freedom kinematics of the knee and the in situ forces in the ACL and its two bundles were determined. Under an anterior tibial load, the in situ force in the PL bundle was the highest at full extension (67 k 30 N) and decreased with increasing flexion. The in situ force in the AM bundle was lower than in the PL bundle at full extension, but increased with increasing flexion, reaching a maximum (90 f 17 N) at 60" of flexion and then decreasing at 90". Under a combined rotatory load, the in situ force of the PL bundle was higher at 15" (21 k 11 N) and lower at 30" of flexion (14 f 6 N). The in situ force in the AM bundle was similar at 15" and 30" of knee flexion (30k 15 vs. 3 5 2 16 N, respectively). Comparing these two external loading conditions demonstrated the importance of the PL bundle, especially when the knee is near full extension. These findings provide a better understanding of the function of the two bundles of the ACL and could serve as a basis for future considerations of surgical reconstruction in the replacement of the ACL.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads

Gabriel

Wong

Woo

et al. 2004

Journal Orthopaedic Research

590

431

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show abstract

“…Torzilli et al (1981) have shown that an internal tibial rotation coupled with anterior tibial translation occurs Three-dimensional motion analysis Several prior studies described normal and pathologic motions of the knee using instant center analysis (Gerber andMatter 1983, Tamea andHenning 1981). This approach, popularized by Frankel et al (1971).…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional motion analysis of clinical stress tests for anterior knee subluxations

Noyes

Grood

Suntay

1989

Acta Orthopaedica Scandinavica

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“…To measure and document sagittal knee instability in flexion, several authors have advocated stressradiography of the knee at 90 degrees of flexion (Nyga 1970, Kennedy and Fowler 1971, Jacobsen 1976, LevCn 1977, Jacobsen 1981, Torzilli et al 1981, Stedtfeld and Strobe1 1983. With the introduction of drawer testing at 15 degrees of flexion, examiners were able to demonstrate, with stressradiography, the advantages of assessing anterior knee motion (Jakob et al 1987) and posterior knee motion (Staubli and Jakob 1990b) in the near extended position.…”

Section: Evolution Of Stressradiographymentioning

confidence: 99%

“…In an in vivo, mechanical evaluation of anteriorposterior motion of the knee, Torzilli et al (1981) modified the method of Jacobsen (1976) by including five additional measurements to analyze coupled knee motions at 90 degrees of flexion. They found large errors if rotational motions were not accounted for in the analyses.…”

Section: Evolution Of Stressradiographymentioning

confidence: 99%

Stressradiography of the knee

Stäubli¹,

Noesberger²,

Jakob

1992

Acta Orthopaedica Scandinavica

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An in vivo biomechanical evaluation of anterior-posterior motion of the knee. Roentgenographic measurement technique, stress machine, and stable population.

Cited by 101 publications

References 0 publications

Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads

Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads

Three-dimensional motion analysis of clinical stress tests for anterior knee subluxations

Stressradiography of the knee

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