Ligament Strain in the Human Knee Joint

Edwards, Richard; Lafferty, J. F.; Lange, K. O.

doi:10.1115/1.3424920

Cited by 61 publications

(17 citation statements)

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“…Others have measured ACL displacement patterns, enabling calculation of strain pattern, in order to understand the effect of knee joint position and muscle activity on ligament biomechanics [2,6,7,37,38,51,53,54,59,60,61]. Edwards, Lafferty and Lang [16], Kennedy et al [37] and Brown et al [11] utilized mercury filled strain gauges to measure the displacement of ligaments at various angles of knee flexion. Others [8,28,46,62] have constructed transducers to measure strain in different biological materials.…”

Section: Biomechanical Backgroundmentioning

confidence: 99%

“…A number of possible explanations for these differences exist. Firstly, the reference used in strain calculation is carefully defined in our invivo work, while previously published studies have arbitrarily chosen a strain reference [2,16,37,51,53,59,60]. This enabled us to differentiate between the strained and unstrained condition of the AMB.…”

Section: S O M E T R I C Q U a D R I C E P S Activity At 3 0 ° A N mentioning

confidence: 99%

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The measurement of anterior cruciate ligament strain in vivo

Beynnon

Howe

Pope

et al. 1992

International Orthopaedics

236

159

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This article describes the use of the Hall Effect strain transducer (HEST) in a new arthroscopic technique to study the normal anterior cruciate ligament (ACL) in-vivo. Study participants were patient volunteers with normal ACLs undergoing diagnostic arthroscopic or meniscal surgery under local anaesthesia. The HEST was implanted into the Anterior Medial Band (AMB) of the ACL. Anterior shear loading of the tibia in relation to the fixed femur at 30 degrees of knee flexion (Lachman test), produced significantly greater strain values in comparison to anterior shear loading at 90 degrees (Anterior Drawer test). During isometric quadriceps contraction a significant increase in AMB strain was measured with the knee flexed to 30 degrees, while no significant change was measured at 90 degrees. For quadriceps contraction there were significantly higher values of AMB strain measured at 30 degrees of knee flexion in comparison to that observed at 90 degrees. For active range of motion (AROM) the AMB was strained between 10 degrees and 48 degrees, and unstrained between 48 degrees and 110 degrees. During passive range of motion (PROM) the AMB remained unstrained until the joint was brought into extension. There were significant differences in strain values found between AROM and PROM at the flexion angles 10 degrees, 20 degrees, 30 degrees and 40 degrees, while between 50 degrees and 110 degrees there were no significant differences. These results confirm previous studies that the Lachman test is a superior technique in comparison to the classic anterior drawer test for evaluating the AMB. They suggest that isometric quadriceps activity at 90 degrees of knee flexion can be prescribed for rehabilitation immediately after ACL reconstruction. These data indicate that AROM (between the limits of 50 degrees and 110 degrees) and PROM may also be performed with minimal risk of strain to a reconstructive replacement. The PROM data may also serve as an important standard for the reconstruction of the ACL.

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Section: Biomechanical Backgroundmentioning

confidence: 99%

Section: S O M E T R I C Q U a D R I C E P S Activity At 3 0 ° A N mentioning

confidence: 99%

The measurement of anterior cruciate ligament strain in vivo

Beynnon

Howe

Pope

et al. 1992

International Orthopaedics

236

159

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show abstract

“…Therefore, experimental evidence is provided which we think strongly supports the coaches, physical therapists, physiatrists, and surgeons who say "Build u p those quads to protect your knee!". Because the design of this study recorded per cent of elongation to just 90" of flexion, it was necessary to alter the graphs of Edwards et al (1970) to allow for comparison. In their study the knee was flexed to 130" at which their zero percentage or minimum elongation was reached.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Quadriceps Loads and Knee Position on Strain Measurements of the Tibial Collateral Ligament:An Experimental Study on Human Amputation Specimens

White

Raphael

1972

Acta Orthopaedica Scandinavica

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“…If the positions of the ligament insertion sites are known relative to the geo metry of the bones, and the force-displacement character istics of the ligament as well, the ligament force can be calculated from prescribed motions of the bones relative to each other. This method was applied frequently in the past (Blankevoort et a l 1991;Crowninshield et a l, 1976;Edwards et al, 1970;Grood and Hefzy, 1982). These studies were limited in scope, because usually the liga ments were arbitrarily represented by a limited number of line elements, disregarding their three-dimensional multibundle structures.…”

Section: Introductionmentioning

confidence: 99%

An inverse dynamics modeling approach to determine the restraining function of human knee ligament bundles

Mommersteeg

Huiskes

Blankevoort

et al. 1997

Journal of Biomechanics

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Abstract-During knee motion, the fiber bundles of ligaments are nonuniformly loaded in a recruitment pattern which is different for successive knee-joint positions. As a result, the restraining functions of these ligaments are variable. To analyze the relative restraint contributions of the fiber bundles in different knee-joint positions, a new method was developed. Its application was illustrated for the cruciate ligaments of one knee-joint specimen.The methods developed to estimate bundle forces comprise five steps. First, the three-dimensional motions of a knee specimen are measured for anterior-posterior forces, using Rdntgcn Stereophotogrammetric Analysis. Second, bone-ligament-bone tensile tests are performed to evaluate the mechanical properties of these structures in several relative orientations of the bones. Third, multiple fiber bundles are identified in each ligament, based on the main fiber orientations. Fourth, the nonlinear force-length relationship of each functional bundle, as defined by a stiffness and a recruitment parameter, is determined by combining the multidirectional tensile tests with a multiline-element ligament model. Finally, the information obtained is combined in a whole-joint computer model of the knee, to determine the internal forces in the initial kinematic experiment, using an inverse dynamics approach.The technique appeared to be extremely time consuming and technologically involved. However, it was demonstrated to be useful and effective. The preliminary results reveal that the fiber bundle restraints are extremely sensitive to the knee flexion angle and the restraining forces are highly variable within the ligaments. For both cruciate ligaments, a gradual transition was demonstrated in load transfer from the posterior bundles to the more anteriorly positioned ones during knee flexion. Furthermore, it appeared that relatively high forces were carried by only a few fiber bundles at each flexion angle. Based on these preliminary results, it is concluded that the determination of forces in multiple ligament bundles is important for the understanding of failure mechanisms of ligaments. In particular, alternate loading of different fiber bundles suggests that successful operative reconstruc tion of the cruciate ligaments may not be achieved simply by a one-bundle preparation.

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Ligament Strain in the Human Knee Joint

Cited by 61 publications

References 0 publications

The measurement of anterior cruciate ligament strain in vivo

The measurement of anterior cruciate ligament strain in vivo

The Effect of Quadriceps Loads and Knee Position on Strain Measurements of the Tibial Collateral Ligament:An Experimental Study on Human Amputation Specimens

An inverse dynamics modeling approach to determine the restraining function of human knee ligament bundles

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