Direct in vitro measurement of forces in the cruciate ligaments. Part I

Wascher, Daniel C.; Markolf, Keith L.; Shapiro, Matthew S.; Finerman, Gerald A. M.

doi:10.2106/00004623-199303000-00009

Cited by 172 publications

(94 citation statements)

References 13 publications

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“…Fanelli ( 5 ) noted that 27 had a posterior cruciate ligament injury and that only two of those were "isolated." Other than limited experiments performed previously in our laboratory, in which posterior tibial force and tibial torque were applied simultaneously at selected angles of knee flexion (16). there have been no reports in the literature related to force generation in the posterior cruciate ligament under combined tibial loadings, to our knowlcdge.…”

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confidence: 87%

Effects of combined knee loadings on posterior cruciate ligament force generation

Markolf

Slauterbeck

Armstrong

et al. 1996

Journal Orthopaedic Research

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Resultant forces in the posterior cruciate ligament were measured under paired combinations of posterior tibial force, internal and external tibial torque, and varus and valgus moment. The force generated in the ligament from a straight 100 N posterior tibial force was highly sensitive to the angle of knee flexion. For example, at 90 degrees of flexion the mean resultant force in the posterior cruciate ligament was 112% of the applied posterior tibial force, whereas at 0 degree, only 16% of the applied posterior force was measured in the ligament. When the tibia was preloaded by 10 Nm of external torque, only 9-13% of the 100 N posterior tibial force was transmitted to the posterior cruciate ligament at flexion angles less than 60 degrees; at 90 degrees of flexion, 61% was carried by the ligament. This "off-loading" of the posterior cruciate ligament also occurred when the tibia was preloaded by 10 Nm of internal torque, but only at knee flexion angles between 20 and 40 degrees. The addition of 10 Nm of valgus moment to a knee loaded by a 100 N posterior tibial force increased the mean force in the posterior cruciate ligament at all flexion angles except hyperextension; this represents a common and potentially dangerous loading combination. The addition of 10 Nm of varus moment to a knee loaded by a 100 N posterior tibial force decreased the mean force in the ligament between 10 and 70 degrees of flexion. External tibial torque (alone or combined with varus or valgus moment) was not an important loading mechanism in the posterior cruciate ligament. The application of internal torque plus varus moment at 90 degrees of flexion produced the greatest posterior cruciate ligament forces in our study and represented the only potential injury mechanism that did not involve posterior tibial force.

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confidence: 87%

Effects of combined knee loadings on posterior cruciate ligament force generation

Markolf

Slauterbeck

Armstrong

et al. 1996

Journal Orthopaedic Research

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“…The ACL serves as the primary restraint to tibial anterior translation and as a secondary restraint to knee internal rotation, abduction, and adduction. 29,30 As a result, knee external rotation moments combined with either adduction or extension moments are associated with nontrivial ACL loads when the knee is flexed to less than 306. 29,30 That an LFS was characterized by knee abduction, internal rotation, and 156 to 206 of flexion at and shortly after initial contact, accompanied by adduction and external rotation moments, thus suggests that the ACL was being loaded.…”

Section: Discussionmentioning

confidence: 99%

“…29,30 As a result, knee external rotation moments combined with either adduction or extension moments are associated with nontrivial ACL loads when the knee is flexed to less than 306. 29,30 That an LFS was characterized by knee abduction, internal rotation, and 156 to 206 of flexion at and shortly after initial contact, accompanied by adduction and external rotation moments, thus suggests that the ACL was being loaded. Furthermore, with increasing step width, the peak knee abduction angles (found most often near initial contact) and peak internal rotation angles increased, and the peak knee adduction moments both increased and occurred more often near initial contact.…”

Section: Discussionmentioning

confidence: 99%

Knee Joint Kinematics and Kinetics During a Lateral False-Step Maneuver

Golden

Pavol

Hoffman

2009

Journal of Athletic Training

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Context: Cutting maneuvers have been implicated as a mechanism of noncontact anterior cruciate ligament (ACL) injuries in collegiate female basketball players.Objective: To investigate knee kinematics and kinetics during running when the width of a single step, relative to the path of travel, was manipulated, a lateral false-step maneuver.Design: Crossover design. Setting: University biomechanics laboratory.Patients or Other Participants: Thirteen female collegiate basketball athletes (age 5 19.7 6 1.1 years, height 5 172.3 6 8.3 cm, mass 5 71.8 6 8.7 kg).Intervention(s): Three conditions: normal straight-ahead running, lateral false step of width 20% of body height, and lateral false step of width 35% of body height.Main Outcome Measure(s): Peak angles and internal moments for knee flexion, extension, abduction, adduction, internal rotation, and external rotation.Results: Differences were noted among conditions in peak knee angles (flexion [P , .01], extension [P 5 .02], abduction [P , .01], and internal rotation [P , .01]) and peak internal knee moments (abduction [P , .01], adduction [P , .01], and internal rotation [P 5 .03]). The lateral false step of width 35% of body height was associated with larger peak flexion, abduction, and internal rotation angles and larger peak abduction, adduction, and internal rotation moments than normal running. Peak flexion and internal rotation angles were also larger for the lateral false step of width 20% of body height than for normal running, whereas peak extension angle was smaller. Peak internal rotation angle increased progressively with increasing step width.Conclusions: Performing a lateral false-step maneuver resulted in changes in knee kinematics and kinetics compared with normal running. The differences observed for lateral false steps were consistent with proposed mechanisms of ACL loading, suggesting that lateral false steps represent a hitherto neglected mechanism of noncontact ACL injury.

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“…In the outpatient department, the same surgeon who performed the PCL reconstruction also evaluated graft failure clinically based on a physical examination, including a positive posterior drawer test, and clinical findings of swelling and discomfort on knee flexion or a limping gait. [6][7][8] The posterior drawer sign has 85% accuracy in the diagnosis of PCL laxity. 8 We considered the result of the posterior drawer test as positive if posterior subluxation of the tibia from the distal femur could be elicited with knee joint flexion.…”

Section: Methods and Materials Case Selection And Clinical Diagnosismentioning

confidence: 99%

“…[6][7][8] The posterior drawer sign has 85% accuracy in the diagnosis of PCL laxity. 8 We considered the result of the posterior drawer test as positive if posterior subluxation of the tibia from the distal femur could be elicited with knee joint flexion. 9 Other radiologic findings, such as a positive Telos stress view and clinical results, such as a response to physical therapy and course of clinical symptoms, were also included in the final diagnosis of non-surgical cases.…”

Section: Methods and Materials Case Selection And Clinical Diagnosismentioning

confidence: 99%

Usefulness of oblique coronal magnetic resonance images of the knee after posterior cruciate ligament reconstruction

Park

Lee

Hong

et al. 2016

BJR

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Objective: To know the usefulness of the oblique coronal view of the posterior cruciate ligament (PCL) in the evaluation of the graft normal anatomy and the diagnostic accuracy of combining the PCL view with orthogonal views for the evaluation of PCL graft failure or impingement after reconstruction procedures. Methods: This retrospective study included 54 patients who underwent PCL-view MRI after PCL reconstruction surgery. Anatomic identification of graft failure and impingement was scored by two radiologists. The ability to diagnose PCL graft failure with the PCL view, orthogonal view or combined PCL/orthogonal views was evaluated by calculating the sensitivity, specificity and accuracy. Results: The entire width discrimination scores and margin sharpness scores for the PCL view were significantly higher than those for the orthogonal view for both readers. The specificities and accuracies for the PCL view and the combined PCL/orthogonal views were higher than those for the orthogonal view alone, but these differences were not statistically significant. Conclusion:The PCL view provided a better anatomic evaluation than the orthogonal view with regard to the entire width evaluation and margin sharpness evaluation of the PCL graft. The combined view of orthogonal and PCL views was slightly more sensitive and accurate, but not significantly so, in the diagnoses of graft failure and impingement. Advances in knowledge: The PCL view provided a better anatomic evaluation than the orthogonal view with regard to the entire width evaluation and margin sharpness evaluation of the PCL graft. The PCL view was slightly more sensitive and accurate, but not significantly so, in the diagnoses of graft failure and impingement.

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Direct in vitro measurement of forces in the cruciate ligaments. Part I

Cited by 172 publications

References 13 publications

Effects of combined knee loadings on posterior cruciate ligament force generation

Effects of combined knee loadings on posterior cruciate ligament force generation

Knee Joint Kinematics and Kinetics During a Lateral False-Step Maneuver

Usefulness of oblique coronal magnetic resonance images of the knee after posterior cruciate ligament reconstruction

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