Comparison of reaction forces on the anterior cruciate and anterolateral ligaments during internal rotation and anterior drawer forces at different flexion angles of the knee joint

Uğur, Levent

doi:10.1002/rcs.1815

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…The other is homogeneous material. Some researchers used homogeneous elastic materials to measure the reaction forces of the ligaments [ 25 ]. Considering the incompressibility of graft, a homogeneous hyperelastic material was used in this study.…”

Section: Discussionmentioning

confidence: 99%

Dual fluoroscopic imaging and CT-based finite element modelling to estimate forces and stresses of grafts in anatomical single-bundle ACL reconstruction with different femoral tunnels

et al. 2021

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Purpose Little is known about the in vivo forces and stresses on grafts used in anterior cruciate ligament (ACL) reconstruction. The aims of this study were to evaluate and compare the forces and stresses on grafts used in anatomical single-bundle ACL reconstruction at different locations of the femoral footprint (anterior vs middle vs posterior; high vs middle vs low) during a lunge motion. Methods Establish subject-specific finite element models with different graft’s tunnel loci to represent the primary ACL reconstructions. A displacement controlled finite element method was used to simulate lunge motions (full extension to ~ 100° of flexion) with six-degree-of-freedom knee kinematics data obtained from the validated dual fluoroscopic imaging techniques. The reaction force of the femur and maximal principal stresses of the grafts were subsequently calculated during knee flexion. Results Increased and decreased graft forces were observed when the grafts were located higher and lower on the femoral footprint, respectively; anterior and posterior graft placement did not significantly affect the graft force. Lower and posterior graft placement resulted in less stress on the graft at higher degrees of flexion; there were no significant differences in stress when the grafts were placed from 0° to 30° of flexion on the femoral footprint. Conclusion The proposed method is able to simulate knee joint motion based on in vivo kinematics. The results demonstrate that posterior to the centre of the femoral footprint is the strategic location for graft placement, and this placement results in anatomical graft behaviour with a low stress state.

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Section: Discussionmentioning

confidence: 99%

Dual fluoroscopic imaging and CT-based finite element modelling to estimate forces and stresses of grafts in anatomical single-bundle ACL reconstruction with different femoral tunnels

et al. 2021

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“…Another factor we correlated with ACL injury, consistent with previous literature, was decreased knee flexion [ 8 , 13 ]. Biomechanical studies have demonstrated that the greatest degree of strain is placed on the ACL, relative to other knee ligaments, at low angles of knee flexion (~15°) [ 20 ]. When the degree of flexion increases, the ACL is off-loaded and greater stress is placed on other knee ligaments [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

The Mechanism of Anterior Cruciate Ligament Injuries in the National Football League: A Systematic Video Review

Schick¹,

Cantrell²,

Young³

et al. 2023

Cureus

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IntroductionAnterior cruciate ligament (ACL) injuries are common among American football athletes, although few studies have performed video analyses of ACL injuries to better understand the injury mechanism. This work aims to characterize the mechanism of ACL injury during professional football competitions using video analysis. We hypothesize that football-specific injury trends will emerge, including high rates of contact injuries and associations with shallow knee and hip flexion angles (0°-30°). MethodsVideos of professional football players suffering ACL injuries from 2007 to 2016 were analyzed. Injured players were identified using the injured reserve (IR) lists of the National Football League (NFL), and videos were discovered via a systematic Google search. Descriptive statistics and frequency analyses were performed on all variables using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM SPSS Statistics, Armonk, NY, USA). ResultsOf the 429 ACL injuries identified, 53 (12%) videos were available. Deceleration was the most common injury maneuver, present in 32 (60%) athletes. Thirty-one (58%) players suffered contact injuries. Twenty-eight (53%) injuries demonstrated valgus collapse of the knee, and 26 (49%) had neutral knee rotation. Defensive backs (26%) and wide receivers (23%) were the most frequently injured positions. ConclusionOverall, we found that most ACL injuries had preceding contact, deceleration, shallow hip and knee flexion, and heel strike, and subsequent valgus collapse and neutral knee rotation. This understanding of American football-specific ACL tear mechanisms could help direct the focus of future injury prevention training modalities.

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“…Anterolateral complex (ALC) injury of the knee is a secondary injury to ACL injury of the knee. The ALL in the ALC is considered to provide an important limitation for knee joint rotational stability, and Segond fracture is also considered to be an avulsion fracture of tibial attachment of the ALL [12][13][14] . However, there are also some studies that oppose this viewpoint.…”

Section: Discussionmentioning

confidence: 99%

Effects of Segond fracture and associated injuries on knee stability

Ruan

liu

et al. 2022

Preprint

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Objective: To investigate the effects of Segond fracture and associated injuries on knee stability. Methods: Retrospective analysis of 35 cases of Segond fracture, allpatients had anterior cruciate ligament rupture (100%), including 6 patients (17.1%) with avulsion fracture of tibia intercondylar eminence. There were 8 cases (22.9%) with medial collateral ligament injury. There were 5 cases (14.3%) with lateral collateral ligament injury. There were 20 cases (57.1%) with combined meniscus injury, 5cases (14.3%) with both medial and lateral meniscus injury, 3 cases (8.6%) with only medial meniscus injury, and 12cases (34.3%) with only lateral meniscus injury. All 35 patients underwent surgical treatment, including 35 cases of ligament reconstruction, 6 cases of intercondylar eminence fracture fixation, and 20 cases of meniscus repair. To compare the function and stability of knee joint before operation and 2 years after operation. Results: The Lysholm score for knee joint function on admission was (43.9±5.3) and the IKDC score was (36.1±3.9). All 35 patients were followed up for 24-36 months. X-rays showed that the Segond fractures healed 3 months after surgery. The anterior drawer test, Lachman test, McMurray test, and Lateral stress test were all negative at the last follow-up. 5 patients with lateral meniscus injury had 1 grade pivot shift at the last follow-up. The Lysholm score was (91.7±3.6), and the difference was statistically significant as compared with that before surgery (P<0.05). The IKDC score was (89.0±1.7), and the difference was statistically significant as compared with that before surgery (P<0.05). Conclusion: The indicative effect of Segond fracture on timely detection of combined injuries in the knee joint cannot be ignored. In addition to repairing the intra-articular injuries, more attention should be paid to the anterolateral structural stability of the knee joint. For Segond fracture patients with higher pivot shift grade may have residual axial migration after surgery, so ALL reconstruction surgery may be considered.

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Comparison of reaction forces on the anterior cruciate and anterolateral ligaments during internal rotation and anterior drawer forces at different flexion angles of the knee joint

Cited by 7 publications

References 23 publications

Dual fluoroscopic imaging and CT-based finite element modelling to estimate forces and stresses of grafts in anatomical single-bundle ACL reconstruction with different femoral tunnels

Dual fluoroscopic imaging and CT-based finite element modelling to estimate forces and stresses of grafts in anatomical single-bundle ACL reconstruction with different femoral tunnels

The Mechanism of Anterior Cruciate Ligament Injuries in the National Football League: A Systematic Video Review

Effects of Segond fracture and associated injuries on knee stability

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