Forces in anterior cruciate ligament during simulated weight-bearing flexion with anterior and internal rotational tibial load

Lo, JiaHsuan; Müller, Otto; Wünschel, Markus; Bauer, Steffen; Wülker, Nikolaus

doi:10.1016/j.jbiomech.2008.04.010

Cited by 43 publications

(42 citation statements)

References 33 publications

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“…This finding is affirmed by kinetically driven robotic models because the application of internal tibial torsion to weightbearing knees did not affect ACL load and did not increase internal tibial rotation in ACL-deficient knees compared with ACL-intact knees [33,55]. Particularly for the MCL in the isolated ligament condition, all transverse plane stimuli resulted in negative strain values, which indicated the ligament was slack and not bearing load from the perturbation (Table 3).…”

Section: Discussionmentioning

confidence: 68%

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

Bates

Nesbitt

Shearn

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Anterior cruciate ligament (ACL) injures incur over USD 2 billion in annual medical costs and prevention has become a topic of interest in biomechanics. However, literature conflicts persist over how knee rotations contribute to ACL strain and ligament injury. To maximize the efficacy of ACL injury prevention, the effects of underlying mechanics need to be better understood. Questions/purposes We applied robotically controlled, in vivo-derived kinematic stimuli to the knee to assess ligament biomechanics in a cadaver model. We asked: (1) Does the application of abduction rotation increase ACL and medial collateral ligament (MCL) strain relative to the normal condition? (2) Does the application of internal tibial rotation impact ACL strain relative to the neutral condition? (3) Does combined abduction and internal tibial rotation increase ligament strain more than either individual contribution?Methods A six-degree-of-freedom robotic manipulator was used to position 17 cadaveric specimens free from knee pathology outside of low-grade osteoarthritis (age, 47 ± 8 years; 13 males, four females) into orientations that mimic initial contact recorded from in vivo male and female drop vertical jump and sidestep cutting activities. Four-degree rotational perturbations were applied in both directions from the neutral alignment position (creating an 8°range) for each frontal, transverse, and combined planes while ACL and MCL strains were continuously recorded with DVRT strain gauges implanted directly on each ligament. Analysis of variance models with least significant difference post hoc analysis were used to assess differences in ligament strain and joint loading between sex, ligament condition, or motion task and rotation type. Results For the female drop vertical jump simulation in the intact knee, isolated abduction and combined abduction/internal rotational stimuli produced the greatest This work was supported by National Institutes of Health/NIAMS Grants #R01-AR049735 (TEH), #R01-AR055563 (TEH), #R01-AR056660 (JTS), and #R01-AR056259 (TEH -017-5367-9 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® change in strain from the neutral position as compared with all other stimuli within the ACL (1.5% ± 1.0%, p B 0.035; 1.8% ± 1.3%, p B 0.005) and MCL (1.8% ± 1.0%, p \ 0.001; 1.6% ± 1.3%, p \ 0.001) compared with all other applied stimuli. There were no differences in mean peak ACL strain between any rotational stimuli (largest mean difference = 2.0%; 95% confidence interval [CI], À0.9% to 5.0%; p = 0.070). These trends were consistent for all four simulated tasks. Peak ACL strain in the intact knee was larger than peak MCL strain for all applied rotational stimuli in the drop vertical jump simulations (smallest mean difference = 2.1%; 95% CI, À0.4% to 4.5%; p = 0.047). Conclusions Kinematically constrained cadaveric knee models using peak strain as an outcome variable require greater than 4°rotational perturbations to elicit changes in intraa...

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Section: Discussionmentioning

confidence: 68%

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

Bates

Nesbitt

Shearn

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…These differences though were typically small though statistically significant; Wroble et al (1993) concluded their results were "clinically unimportant". However other transection studies in cadaver knees have not shown an increase in internal rotation range (Lane et al, 1994;Reuben et al, 1989;Wünschel et al, 2010), and Lo et al (2008) showed no increase in ACL force on internal rotation in vitro. In an in vivo study, Hemmerich and colleagues (2011) found that ACL-deficient patients showed an increase in internal rotation range, but at 0° flexion and not at 30°.…”

Section: Internal Rotationmentioning

confidence: 78%

“…In other cadaveric studies, application of a 100N anterior force produced coupled internal rotation (Hollis et al, 1991), and simulated 200N quadriceps contraction caused anterior tibial translation coupled with internal rotation (Li et al, 1999). Internal rotation due to anterior force is not a universal finding, with Lo et al (2008) showing a 50N anterior force (with a 100N joint compressive force) did not elicit a significant increase in rotation. Many authors have measured the opposite of this, i.e.…”

Section: Combined Anterior Translation/internal Rotationmentioning

confidence: 85%

“…Ligament strain (Ahmed et al, 1987;Bach & Hull, 1998;Berns et al, 1992;Beynnon et al, 1992;Beynnon et al, 1997;Fleming et al, 2001;Gabriel et al, 2004;Sakane et al, 1997;Takai et al, 1993;Torzilli et al, 1994) or load Markolf et al, 1995) increases with an anterior force on the tibia. When the ACL is cut anterior translation increases (Diermann et al, 2009;Fukubayashi et al, 1982;Hsieh & Walker, 1976;Markolf et al, 1976;Oh et al, 2011;Reuben et al, 1989;Wroble et al, 1993;Yoo et al, 2005;Zantop et al, 2007), or a given translation is resisted by a lesser force (Butler et al, 1980;Li et al, 1999;Lo et al, 2008;. And while the function of the whole ligament is beyond question here, that of the two bands is another matter.…”

Section: Anterior Translationmentioning

confidence: 99%

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The Biomechanics of the Anterior Cruciate Ligament and Its Reconstruction

Jones¹,

Grimshaw²

2011

Theoretical Biomechanics

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“…Tibial rotation in a standing and weightbearing position is used in clinical knee examinations [7][8][9] . A previous study recommended that knee motion during dynamic movements such as gait should be measured, owing to the lack of correlation of knee motion measurements between static and dynamic conditions 10) .…”

Section: Introductionmentioning

confidence: 99%

Correlation between the Angle of Lateral Tibial Rotation and the Ratio of Medial and Lateral Hamstring Muscle Activities during Standing Knee Flexion

2013

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Abstract. [Purpose] This study investigated the correlation between the angle of lateral tibial rotation and the ratio of the medial and lateral hamstring muscle activities during standing knee flexion.[Subjects] Eighteen healthy subjects (6 females, 12 males) participated in this study.[Methods] Surface electromyography was used to record medial and lateral hamstring muscle activities, and the muscle activities were expressed as a percentage of the reference voluntary contraction. The angle of tibial rotation was measured with a three-dimensional motion analysis system. Subjects were instructed to perform knee flexion on one side in the standing position. Pearson's correlation coefficient was used to test the relationship between the angle of the lateral tibial rotation and the ratio of the activity of the medial and lateral hamstring muscles during standing knee flexion.[Results] The angle of the lateral tibial rotation and the ratio of the medial and lateral hamstring muscle activities showed good to excellent correlation (r = −0.767).[Conclusion] These results suggest that asymmetry of the medial and lateral hamstring muscle activities may cause tibial lateral rotation during standing knee flexion.

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Forces in anterior cruciate ligament during simulated weight-bearing flexion with anterior and internal rotational tibial load

Cited by 43 publications

References 33 publications

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

The Biomechanics of the Anterior Cruciate Ligament and Its Reconstruction

Correlation between the Angle of Lateral Tibial Rotation and the Ratio of Medial and Lateral Hamstring Muscle Activities during Standing Knee Flexion

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