Mechanism of Anterior Cruciate Ligament Loading during Dynamic Motor Tasks

Nasseri, Azadeh; Lloyd, David G.; Bryant, Adam; Headrick, Jonathon; Sayer, Timothy A.; Saxby, David J.

doi:10.1249/mss.0000000000002589

Cited by 17 publications

(26 citation statements)

References 61 publications

(208 reference statements)

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“…Third, ACL force was determined by incorporating lower limb biomechanics from OpenSim and CEINMS into a validated ACL force model. 34,35 The ACL force model 34,35 used in this study was developed by quantifying comprehensive experimental data, 23,30,31 where multiplanar loads (eg, compression and anterior drawer forces, varus/valgus and internal/external rotation moments) were applied to instrumented male and female cadaveric knees. Briefly, the ACL force model 34,35 provides an empirical description of the relationships between experimental multiplanar loads and resulting ACL forces.…”

Section: Biomechanical Modelingmentioning

confidence: 99%

“…34,35 The ACL force model 34,35 used in this study was developed by quantifying comprehensive experimental data, 23,30,31 where multiplanar loads (eg, compression and anterior drawer forces, varus/valgus and internal/external rotation moments) were applied to instrumented male and female cadaveric knees. Briefly, the ACL force model 34,35 provides an empirical description of the relationships between experimental multiplanar loads and resulting ACL forces. The model parameters were determined using nonlinear least square fitting to the experimental data.…”

Section: Biomechanical Modelingmentioning

confidence: 99%

“…10 However, only recently has a computational model of ACL force been developed and validated to estimate ACL force during dynamic tasks. 34,35 This model could be used to study females at different stages of pubertal maturation to reveal the effects of maturation on ACL force.…”

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confidence: 99%

“…The purpose of this study was to determine the effects of pubertal maturation in females on ACL force during a dynamic motor task. An electromyography (EMG)informed neuromusculoskeletal model 39 was used in combination with a validated phenomenological model of ACL loading 34,35 to estimate ACL force and its causes during a standardized drop-land-jump task. It was hypothesized that across pubertal maturation, ACL force would increase and contributors to ACL force would vary.…”

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confidence: 99%

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Effects of Pubertal Maturation on ACL Forces During a Landing Task in Females

et al. 2021

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Background: Rates of anterior cruciate ligament (ACL) rupture in young people have increased by >70% over the past two decades. Adolescent and young adult females are at higher risk of ACL injury as compared with their prepubertal counterparts. Purpose: To determine ACL loading during a standardized drop-land-lateral jump in females at different stages of pubertal maturation. Study Design: Controlled laboratory study. Methods: On the basis of the Tanner classification system, 19 pre-, 19 early-/mid-, and 24 late-/postpubertal females performed a standardized drop-land-lateral jump while 3-dimensional body motion, ground-reaction forces, and surface electromyography data were acquired. These data were used to model external biomechanics, lower limb muscle forces, and knee contact forces, which were subsequently used in a validated computational model to estimate ACL loading. Statistical parametric mapping analysis of variance was used to compare ACL force and its causal contributors among the 3 pubertal maturation groups during stance phase of the task. Results: When compared with pre- and early-/midpubertal females, late-/postpubertal females had significantly higher ACL force with mean differences of 471 and 356 N during the first 30% and 48% to 85% of stance, and 343 and 274 N during the first 24% and 59% to 81% of stance, respectively, which overlapped peaks in ACL force. At the point of peak ACL force, contributions from sagittal and transverse plane loading mechanisms to ACL force were higher in late-/postpubertal compared with pre- and early-/midpubertal groups (medium effect sizes from 0.44 to 0.77). No differences were found between pre- and early-/midpubertal groups in ACL force or its contributors. Conclusion: The highest ACL forces were observed in late-/postpubertal females, consistent with recently reported rises of ACL injury rates in females aged 15 to 19 years. It is important to quantify ACL force and its contributors during dynamic tasks to advance our understanding of the loading mechanism and thereby provide guidance to injury prevention. Clinical Relevance: Growth of ACL volume plateaus around 10 years of age, before pubertal maturation, meaning that a late-/postpubertal female could have an ACL of similar size to their less mature counterparts. However, late-/postpubertal females have higher body mass requiring higher muscle forces to accelerate the body during dynamic tasks, which may increase ACL loading. Thus, if greater forces develop in these females, in part because of their increased body mass, these higher forces will be applied to an ACL that is not proportionally larger. This may partially explain the higher rates of ACL injury in late-/postpubertal females.

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Section: Biomechanical Modelingmentioning

confidence: 99%

Section: Biomechanical Modelingmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Effects of Pubertal Maturation on ACL Forces During a Landing Task in Females

et al. 2021

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“…In most cases these corrective feedback responses facilitate successful completion of the altered motor task. In other cases, such as in non-contact ACL injury, feedback activation of the athlete's own muscle forces [9] may contribute to injury. Insights into both feedforward and feedback mechanisms can help shed light on the underlying causes of non-contact ACL injury.…”

Section: Introductionmentioning

confidence: 99%

Trunk Angle Modulates Feedforward and Feedback Control during Single-Limb Squatting

Johnson

Nozu

Shields

2021

JFMK

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Trunk positioning and unexpected perturbations are high-risk conditions at the time of anterior cruciate ligament injury. The influence of trunk positioning on motor control responses to perturbation during dynamic performance is not known. We tested the influence of trunk position on feedforward and feedback control during unexpected perturbations while performing a novel single-limb squatting task. We also assessed the degree that feedforward control was predictive of feedback responses. In the flexed trunk condition, there were increased quadriceps (p < 0.026) and gluteus medius long-latency reflexes (p < 0.001) and greater quadriceps-to-hamstrings co-contraction during feedforward (p = 0.017) and feedback (p = 0.007) time bins. Soleus long-latency reflexes increased more than 100% from feedforward muscle activity regardless of trunk condition. Feedforward muscle activity differentially predicted long-latency reflex responses depending on the muscle (R2: 0.47–0.97). These findings support the concept that trunk positioning influences motor control responses to perturbation and that feedback responses may be invariant to the feedforward control strategy.

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Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction

Moulin

Bourne

Diamond

et al. 2022

Journal Orthopaedic Research

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Following hamstring autograft anterior cruciate ligament reconstruction (ACLR), muscle length, cross-sectional area, and volume are reduced. However, these discrete measures of morphology do not account for complex three-dimensional muscle shape. The primary aim of this study was to determine between-limb semitendinosus (ST) shape and regional morphology differences in young adults following tendon harvest for ACLR and to compare these differences with those in healthy controls. In this cross-sectional study, magnetic resonance imaging was performed on 18 individuals with unilateral ACLR and 18 healthy controls.Bilaterally, ST muscles were segmented, and shape differences assessed between limbs and compared between groups using Jaccard index (0-1) and Hausdorff distance (mm). Length (cm), peak cross-sectional area (cm 2 ), and volume (cm 3 ) were measured for the entire muscle and proximal, middle, and distal regions, and compared between limbs and groups. Compared to healthy controls, the ACLR group had significantly (p < 0.001, Cohen's d = −2.33) lower bilateral ST shape similarity and shape deviation was significantly (p < 0.001, d = 2.12) greater. Shape deviation was greatest within the distal region of the ACLR (Hausdorff: 23.1 ± 8.68 mm). Compared to both the uninjured contralateral limb and healthy controls, deficits in peak crosssectional area and volume in ACLR group were largest in proximal (p < 0.001, d = −2.52 to −1.28) and middle (p < 0.001, d = −1.81 to −1.04) regions of the ST.Overall, shape analysis provides unique insight into regional adaptations in ST morphology post-ACLR. Findings highlight morphological features in distal ST not identified by traditional discrete morphology measures. Clinical significance:Following ACLR, risk of a secondary knee or primary hamstring injury has been reported to be between 2-to-5 times greater compared to those without ACLR.Change in semitendinosus (ST) shape following ACLR may affect force transmission and distribution within the hamstrings and might contribute to persistent deficits in knee flexor and internal rotator strength.

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Mechanism of Anterior Cruciate Ligament Loading during Dynamic Motor Tasks

Cited by 17 publications

References 61 publications

Effects of Pubertal Maturation on ACL Forces During a Landing Task in Females

Effects of Pubertal Maturation on ACL Forces During a Landing Task in Females

Trunk Angle Modulates Feedforward and Feedback Control during Single-Limb Squatting

Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction

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