Predictive simulation of single-leg landing scenarios for ACL injury risk factors evaluation

Moustridi, Evgenia; Risvas, Konstantinos; Μουστάκας, Κωνσταντίνος

doi:10.1371/journal.pone.0282186

Cited by 2 publications

(2 citation statements)

References 71 publications

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“…Knee joint injuries have become a commonplace in demanding physical activities and competitive sports, such as soccer, basketball, volleyball and skiing [ 1 , 2 ]. One of them is the typical Anterior Cruciate Ligament (ACL) injury where the native ACL is partially or totally ruptured.…”

Section: Introductionmentioning

confidence: 99%

Can lateral tenodesis improve the rotational stability of the ACL reconstruction? A finite element analysis

Risvas,

Stanev,

Moustakas

2024

PLoS ONE

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One of the most common knee injuries is the Anterior Cruciate Ligament (ACL) rupture with severe implications on knee stability. The usual treatment is the ACL Reconstruction (ACLR) surgery where the surgeon replaces the torn ligament with a graft in an effort to restore knee kinematics. In case of excessive rotatory instability, Lateral Extra—Articular Tenodesis (LET) can be performed in combination with ACLR. Additionally, LET appears to reduce ACLR graft forces minimizing graft failure chances. However, there are concerns about overconstraining physiological rotation. To gain insight in this controversial topic, we developed an automatic, open-source tool to create a series of Finite Element (FE) models attempting to investigate the interactions of ACLR and LET through simulation. We started by creating a validated model of the healthy knee joint that served as reference for subsequent FE simulations. Then, we created FE models of standalone ACLR and combined ACLR—LET. Each model was assessed by applying a loading profile that resembles the reduction phase of the Pivot—Shift clinical exam. We measured the External Tibia Rotation (ETR), the Posterior Tibia Translation (PTT) of the lateral tibial compartment, and the ACLR graft stress developed around the femoral tunnel insertion site. We observed the following: a) LET reduces ETR and PTT compared to isolated ACLR, b) combined ACLR—LET is more sensitive to LET graft pretension with lower values showcasing performance closer to the healthy joint, c) LET reduces ACLR graft forces for the same pretension values, d) LET exhibits significant overconstraint for higher pretension values. In general, these findings are in agreement with relevant clinical studies and accentuate the potential of the developed framework as a tool that can assist orthopaedists during surgery planning. We provide open access for the FE models of this study to enhance research transparency, reproducibility and extensibility.

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Section: Introductionmentioning

confidence: 99%

Can lateral tenodesis improve the rotational stability of the ACL reconstruction? A finite element analysis

Risvas,

Stanev,

Moustakas

2024

PLoS ONE

Self Cite

View full text Add to dashboard Cite

show abstract

“…Knee joint injuries have become a commonplace in demanding physical activities and competitive sports, such as soccer, basketball and skiing [1][2][3]. One of them is the typical Anterior Cruciate Ligament (ACL) injury where the Native -ACL ligament is partially or totally ruptured.…”

Section: Introductionmentioning

confidence: 99%

Can lateral tenodesis improve the rotational stability of the ACL reconstruction? A finite element analysis

Risvas,

Stanev,

Moustakas

2023

Preprint

Self Cite

View full text Add to dashboard Cite

One of the most common knee injuries is the Anterior Cruciate Ligament (ACL) rupture with severe implications on knee stability. The usual treatment is the ACL Reconstruction (ACLR) surgery where the surgeon replaces the torn ligament with a graft in an effort to restore knee kinematics. In case of excessive rotatory instability, Lateral Extra - Articular Tenodesis (LET) can be performed in combination with ACLR. Additionally, LET appears to reduce ACLR graft forces reducing graft failure chances. However, there are concerns about overconstraining physiological rotation. To gain insight in this controversial topic, we developed an automatic, open-source tool to create a series of Finite Element (FE) models attempting to investigate the interactions of ACLR and LET through simulation. We started by creating a validated model of the healthy knee joint that served as reference for subsequent FE simulations. Then, we created FE models of standalone ACLR and combined ACLR - LET. Each model was assessed by applying a loading profile that resembles the Pivot - Shift clinical exam. We measured the External Tibia Rotation (ETR), the Anterior Tibia Translation (ATT) of the lateral tibial compartment, and the ACLR graft stress developed around the femoral tunnel insertion site. We observed the following: a) LET reduces ETR and ATT compared to isolated ACLR, b) combined ACLR - LET is more sensitive to LET graft pretension with lower values showcasing performance closer to the healthy joint, c) LET reduces ACLR graft forces for the same pretension values, d) LET exhibits significant overconstraint for higher pretension values. In general, these findings are in agreement with relevant clinical studies and accentuate the potential of the developed framework as a tool that can assist orthopaedists during surgery planning. We provide open access for the FE models of this study to enhance research transparency, reproducibility and extensibility.

show abstract

Predictive simulation of single-leg landing scenarios for ACL injury risk factors evaluation

Cited by 2 publications

References 71 publications

Can lateral tenodesis improve the rotational stability of the ACL reconstruction? A finite element analysis

Can lateral tenodesis improve the rotational stability of the ACL reconstruction? A finite element analysis

Can lateral tenodesis improve the rotational stability of the ACL reconstruction? A finite element analysis

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