Knee Anatomy

Blackburn, T.A.; Craig, Emily

doi:10.1093/ptj/60.12.1556

Cited by 47 publications

(14 citation statements)

References 3 publications

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“…medial collateral ligament, lateral collateral ligament, anterior cruciate ligament, and posterior cruciate ligament. In addition to the lateral collateral ligament that is attached to fibula, the other three ligaments are all attached to proximal tibia [38,39]. Shelburne et al used a 3D model of lower limb to calculate the joint contact force and ligament forces on the normal knee in a complete gait cycle [40].…”

Section: Methodsmentioning

confidence: 99%

Simulation on the internal structure of three-dimensional proximal tibia under different mechanical environments

et al. 2013

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BackgroundBone can adjust its morphological structure to adapt to the changes of mechanical environment, i.e. the bone structure change is related to mechanical loading. This implies that osteoarthritis may be closely associated with knee joint deformity. The purposes of this paper were to simulate the internal bone mineral density (BMD) change in three-dimensional (3D) proximal tibia under different mechanical environments, as well as to explore the relationship between mechanical environment and bone morphological abnormity.MethodsThe right proximal tibia was scanned with CT to reconstruct a 3D proximal tibia model in MIMICS, then it was imported to finite element software ANSYS to establish 3D finite element model. The internal structure of 3D proximal tibia of young normal people was simulated using quantitative bone remodeling theory in combination with finite element method, then based on the changing pattern of joint contact force on the tibial plateau in valgus knees, the mechanical loading was changed, and the simulated normal tibia structure was used as initial structure to simulate the internal structure of 3D proximal tibia for old people with 6° valgus deformity. Four regions of interest (ROIs) were selected in the proximal tibia to quantitatively analyze BMD and compare with the clinical measurements.ResultsThe simulation results showed that the BMD distribution in 3D proximal tibia was consistent with clinical measurements in normal knees and that in valgus knees was consistent with the measurement of patients with osteoarthritis in clinics.ConclusionsIt is shown that the change of mechanical environment is the main cause for the change of subchondral bone structure, and being under abnormal mechanical environment for a long time may lead to osteoarthritis. Besides, the simulation method adopted in this paper can more accurately simulate the internal structure of 3D proximal tibia under different mechanical environments. It helps to better understand the mechanism of osteoarthritis and provides theoretical basis and computational method for the prevention and treatment of osteoarthritis. It can also serve as basis for further study on periprosthetic BMD changes after total knee arthroplasty, and provide a theoretical basis for optimization design of prosthesis.

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Section: Methodsmentioning

confidence: 99%

Simulation on the internal structure of three-dimensional proximal tibia under different mechanical environments

et al. 2013

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“…The ACL is composed of a highly organized collagen matrix consisting mainly of type I and III collagen, as well as elastin, proteoglycans, glycosaminoglycans, and adhesion proteins [ 5 , 6 ]. The ACL has been described as a continuum of fibres [ 7 , 8 , 9 ] or as three distinct fibre bundles [ 10 , 11 , 12 ]. In all cases, it is clear that the fibres of the ACL align in the same direction, parallel to the long axis of the ligament [ 8 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Investigating Commercial Filaments for 3D Printing of Stiff and Elastic Constructs with Ligament-Like Mechanics

et al. 2020

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The current gold standard technique for treatment of anterior cruciate ligament (ACL) injury is reconstruction with autograft. These treatments have a relatively high failure and re-tear rate. To overcome this, tissue engineering and additive manufacturing are being used to explore the potential of 3D scaffolds as autograft substitutes. However, mechanically optimal polymers for this have yet to be identified. Here, we use 3D printing technology and various materials with the aim of fabricating constructs better matching the mechanical properties of the native ACL. A fused deposition modeling (FDM) 3D printer was used to microfabricate dog bone-shaped specimens from six different polymers—PLA, PETG, Lay FOMM 60, NinjaFlex, NinjaFlex-SemiFlex, and FlexiFil—at three different raster angles. The tensile mechanical properties of these polymers were determined from stress–strain curves. Our results indicate that no single material came close enough to successfully match reported mechanical properties of the native ACL. However, PLA and PETG had similar ultimate tensile strengths. Lay FOMM 60 displayed a percentage strain at failure similar to reported values for native ACL. Furthermore, raster angle had a significant impact on some mechanical properties for all of the materials except for FlexiFil. We therefore conclude that while none of these materials alone is optimal for mimicking ACL mechanical properties, there may be potential for creating a 3D-printed composite constructs to match ACL mechanical properties. Further investigations involving co-printing of stiff and elastomeric materials must be explored.

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“…Since the quadriceps are the primary active stabilizers of the knee joint during dynamic tasks 10 , its ability to generate force during these tasks could lend important insights into the altered mechanics often observed after ACL reconstruction that potentially predispose the patient to post-traumatic osteoarthritis 5, 19 . Little is known of quadriceps RTD during dynamic functional tasks such as running.…”

Section: Introductionmentioning

confidence: 99%

Impaired Quadriceps Rate of Torque Development and Knee Mechanics After Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft

et al. 2015

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Background Rate of torque development (RTD) measures the ability of a muscle to produce torque quickly. Decreased quadriceps RTD may impair performance of sporting tasks after surgery. Currently, little is known about variations in quadriceps RTD between ACL reconstructed and non-injured limbs. Purpose To determine the differences in RTD of the quadriceps, the rate and timing of knee extensor moment (KEM) development, and knee flexion excursion during running following ACL reconstruction with patellar tendon autograft. Study Design Cross-Sectional Methods Twenty-one (11 females) subjects 6-months post-ACL reconstruction with patellar tendon autograft. (Median±IQR) age 18±4 years, mass 68.18±13.64 kg, height 1.74±0.11 m. Subjects performed four, 5-second maximal voluntary isometric strength trials of both limbs on an isokinetic dynamometer. RTD was calculated as the mean slope of the torque-time curve between 20 – 80% of total time to peak torque. Then, subjects underwent 3-D motion analysis while running on an instrumented treadmill at a self-selected running speed (mean 2.68 ± 0.28 m/s). Rate of knee extensor moment (RKEM) was calculated as the mean slope of the moment curve between 10–30% of stance phase. Between-limb comparisons were determined with a paired t-test for peak KEM, RKEM, knee flexion excursion during 10–30% of stance, and time to generate KEM. Results Deficits in peak rate of quadriceps torque development existed both isometrically (RTD 257.56 vs. 569.11 Nm/s, p<0.001) and dynamically (RKEM 16.47 vs. 22.38 Nm/kg*m*s, p<0.001) in the reconstructed limb. The reconstructed limb also generated a KEM later in the stance phase (11.37 vs. 9.61 % stance, p<0.001) and underwent less knee flexion excursion (15.5 vs. 19.8°, p<0.001) than the non-injured limb. Conclusions Following ACL reconstruction with patellar tendon autograft, patients have lower RTD and RKEM in the reconstructed limb. Deviations in RTD and the timing of the KEM can change the way the knee is loaded and potentially increases injury risk and future development of post-traumatic osteoarthritis. Clinical Relevance Deficits in RTD affect the ability of the limb to generate sufficient KEM at the appropriate time during dynamic tasks. Rehabilitation should consider exercises designed to improve RTD and prepare the limb for the demands of sport performance.

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Knee Anatomy

Cited by 47 publications

References 3 publications

Simulation on the internal structure of three-dimensional proximal tibia under different mechanical environments

Simulation on the internal structure of three-dimensional proximal tibia under different mechanical environments

Investigating Commercial Filaments for 3D Printing of Stiff and Elastic Constructs with Ligament-Like Mechanics

Impaired Quadriceps Rate of Torque Development and Knee Mechanics After Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft

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