In Vivo Elongation of the Anterior Cruciate Ligament and Posterior Cruciate Ligament during Knee Flexion

Li, Guoan; DeFrate, Louis E.; Sun, Hao; Gill, Thomas J.

doi:10.1177/0363546503262175

Cited by 157 publications

(175 citation statements)

References 34 publications

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“…This is in line with measurements obtained in vivo (Hosseini et al 2009;Yoo et al 2010). Concerning the PCL, our results are in agreement with in vivo studies of Li et al (2004) and DeFrate et al (2004) that reported an elongation of the PCL bundles. The LCL was found to shorten, consistently with the pattern shown by Bergamini and co-authors and by ex vivo studies of Harfe et al (1998).…”

Section: Computer Methods In Biomechanics and Biomedical Engineeringsupporting

confidence: 93%

A dynamic multibody model of the physiological knee to predict internal loads during movement in gravitational field

Bersini

Sansone

Frigo

2015

Computer Methods in Biomechanics and Biomedical Engineering

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Obtaining tibio-femoral (TF) contact forces, ligament deformations and loads during daily life motor tasks would be useful to better understand the aetiopathogenesis of knee joint diseases or the effects of ligament reconstruction and knee arthroplasty. However, methods to obtain this information are either too simplified or too computationally demanding to be used for clinical application. A multibody dynamic model of the lower limb reproducing knee joint contact surfaces and ligaments was developed on the basis of magnetic resonance imaging. Several clinically relevant conditions were simulated, including resistance to hyperextension, varus-valgus stability, anterior -posterior drawer, loaded squat movement. Quadriceps force, ligament deformations and loads, and TF contact forces were computed. During anterior drawer test the anterior cruciate ligament (ACL) was maximally loaded when the knee was extended (392 N) while the posterior cruciate ligament (PCL) was much more stressed during posterior drawer when the knee was flexed (319 N). The simulated loaded squat revealed that the anterior fibres of ACL become inactive after 608 of flexion in conjunction with PCL anterior bundle activation, while most components of the collateral ligaments exhibit limited length changes. Maximum quadriceps and TF forces achieved 3.2 and 4.2 body weight, respectively. The possibility to easily manage model parameters and the low computational cost of each simulation represent key points of the present project. The obtained results are consistent with in vivo measurements, suggesting that the model can be used to simulate complex and clinically relevant exercises.

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Section: Computer Methods In Biomechanics and Biomedical Engineeringsupporting

confidence: 93%

A dynamic multibody model of the physiological knee to predict internal loads during movement in gravitational field

Bersini

Sansone

Frigo

2015

Computer Methods in Biomechanics and Biomedical Engineering

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“…While internal tibial rotation consistently increased with flexion (a trend similar to normal tibial rotation), a lower magnitude was observed than that reported for the normal knee. 9,[14][15][16] However, the magnitude is similar to the CR TKA rotation simulated in in vitro robotic experiments. 13,17 The varus rotation was also detected to be small throughout flexion, with mean values between À0.038 and 1.488.…”

Section: Discussionsupporting

confidence: 53%

Investigation of in vivo 6DOF total knee arthoplasty kinematics using a dual orthogonal fluoroscopic system

Hanson

Suggs

Freiberg

et al. 2006

Journal Orthopaedic Research

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Fluoroscopic techniques have been recently used to detect in vivo knee joint kinematics. This article presents a technique that uses two fluoroscopes to form a dual orthogonal fluoroscopic system for accurately measuring in vivo 6DOF total knee arthoplasty (TKA) kinematics. The system was rigorously validated and used to investigate in vivo kinematics of 12 patients after cruciate-retaining TKA. In a repeatability study, the pose of two different TKA components was reproduced with standard deviations (SD) of 0.17 mm and 0.578 about all three axes. In an accuracy study, the reproduced component positions were compared to the known component positions. Position and rotation mean errors were all within 0.11 mm and 0.248, with SD within 0.11 mm and 0.488, respectively. The results of this study show that the matching process of the imaging system is able to accurately reproduce the spatial positions and orientations of both the femoral and tibial components. For CR TKA patients, a consistent anterior femoral translation was observed with flexion through 458 of flexion, and thereafter, the femur translated posteriorly with further flexion. The medial-lateral translation was measured to be less than 2 mm throughout the entire flexion range. Internal tibial rotation steadily increased through maximum flexion by approximately 68. Varus rotation was also measured with flexion but had a mean magnitude less than 2.08. In conclusion, the dual orthogonal fluoroscopic system accurately detects TKA kinematics and is applicable towards other joints of the musculoskeletal system, including the wrist, elbow, shoulder, ankle, and spine. ß

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“…1). 20,21 The outline of each bone was extracted on the fluoroscopic images, and then the projection of each 3D bone model was matched to the corresponding outline to reproduce the 3D position of the model in space. This technique has an accuracy of <0.1 mm for the measurement of tibiofemoral joint kinematics, 22 0.09 AE 0.16 mm in measuring patellar shift, 0.13 AE 0.328 in patellar rotation, and 0.12 AE 0.218 in patellar tilt.…”

Section: Methodsmentioning

confidence: 99%

In‐vivo patellar tendon kinematics during weight‐bearing deep knee flexion

Kobayashi

Sakamoto

Hosseini

et al. 2012

Journal Orthopaedic Research

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This study quantified in-vivo 3D patellar tendon kinematics during weight-bearing deep knee bend beyond 1508. Each knee was MRI scanned to create 3D bony models of the patella, tibia, femur, and the attachment sites of the patellar tendon on the distal patella and the tibial tubercle. Each attachment site was divided into lateral, central, and medial thirds. The subjects were then imaged using a dual fluoroscopic image system while performing a deep knee bend. The knee positions were determined using the bony models and the fluoroscopic images. The patellar tendon kinematics was analyzed using the relative positions of its patellar and tibial attachment sites. The relative elongations of all three portions of the patellar tendon increased similarly up to 608. Beyond 608, the relative elongation of the medial portion of the patellar tendon decreased as the knee flexed from 608 to 1508 while those of the lateral and central portions showed continuous increases from 1208 to 1508. At 1508, the relative elongation of the medial portion was significantly lower than that of the central portion. In four of seven knees, the patellar tendon impinged on the tibial bony surface at 1208 and 1508 of knee flexion. These data may provide useful insight into the intrinsic patellar tendon biomechanics during a weight-bearing deep knee bend and could provide biomechanical guidelines for future development of total knee arthroplasties that are intended to restore normal knee function. ß 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30: [1596][1597][1598][1599][1600][1601][1602][1603] 2012 Keywords: patellar tendon elongation; patellar tendon orientation; deep knee flexion; weight-bearing activity; knee kinematics Maximum flexion of the knee reaches beyond 1508. 12 Restoration of knee function in the entire flexion range after total knee arthroplasty (TKA) has been challenging. 3 While most follow-up studies reported that knee flexion after TKA of between 110 to 1208, 4 many studies investigated knee biomechanics in deep flexion to understand the biomechanical factors that may affect flexion capabilities. 1,2,5-9 Among these factors, the function of the patellar tendon, an essential component of the extensor mechanism, plays a critical role.Numerous in vitro studies reported the material properties, 10,11 orientation, and/or moment arms of the patellar tendon. 12 In vivo studies measured patellar tendon elongation using ultrasound 13 and MRI. 14 MRI was also used to determine the orientation and moment arms of the patellar tendon. 15,16 Foil strain gages were used to measure the mid-point patellar tendon strain intra-operatively. 17 Recently, DeFrate et al. 18 investigated patellar tendon kinematics using a combined MRI and dual fluoroscopic image technique. However, most of these studies examined patellar tendon biomechanics within the range of knee flexion up to 1108. 18,19 Quantitative data on the patellar tendon function in deep knee flexion are still unclear.Our objective was ...

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In Vivo Elongation of the Anterior Cruciate Ligament and Posterior Cruciate Ligament during Knee Flexion

Abstract: Understanding the biomechanical role of the knee ligaments in vivo is essential to reproduce the structural behavior of the ligament after injury (especially for 2-bundle reconstructions) and thus improve surgical outcomes.

Cited by 157 publications

References 34 publications

A dynamic multibody model of the physiological knee to predict internal loads during movement in gravitational field

A dynamic multibody model of the physiological knee to predict internal loads during movement in gravitational field

Investigation of in vivo 6DOF total knee arthoplasty kinematics using a dual orthogonal fluoroscopic system

In‐vivo patellar tendon kinematics during weight‐bearing deep knee flexion

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