scholarly journals The human anterior cruciate ligament: Sex differences in ultrastructure and correlation with biomechanical properties

2008 ◽  
Vol 26 (7) ◽  
pp. 945-950 ◽  
Author(s):  
Javad Hashemi ◽  
Naveen Chandrashekar ◽  
Hossein Mansouri ◽  
James R. Slauterbeck ◽  
Daniel M. Hardy
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sex Differences ◽  
Cruciate Ligament ◽  
Biomechanical Properties ◽  
Anterior Cruciate

scholarly journals Collagen-Platelet Composites Improve the Biomechanical Properties of Healing Anterior Cruciate Ligament Grafts in a Porcine Model

2009 ◽  
Vol 37 (8) ◽  
pp. 1554-1563 ◽  
Author(s):  
Braden C. Fleming ◽  
Kurt P. Spindler ◽  
Matthew P. Palmer ◽  
Elise M. Magarian ◽  
Martha M. Murray
Keyword(s):  
Anterior Cruciate Ligament ◽  
Structural Properties ◽  
Acl Reconstruction ◽  
Porcine Model ◽  
Cruciate Ligament ◽  
Bone Allograft ◽  
Knee Laxity ◽  
Biomechanical Properties ◽  
Anterior Cruciate ◽  
Vessel Infiltration

Background The outcome of anterior cruciate ligament (ACL) reconstruction is variable, and many patients have increased joint laxity postoperatively. Hypothesis Placement of a collagen-platelet composite (CPC) around the graft at the time of ACL reconstruction decreases postoperative knee laxity and improves the structural properties of the graft compared with standard ACL reconstruction. Study Design Controlled laboratory study. Methods Thirteen immature pigs underwent unilateral ACL reconstruction with a bone–patellar tendon–bone allograft. In 6 pigs, a standard allograft was used to reconstruct the ACL. In 7 pigs, a CPC was placed around the allograft. After 15 weeks of healing, the animals were euthanized, and the anterior-posterior (AP) knee laxity and structural properties of the graft were measured. Qualitative histology of the grafts was also performed. Results The AP laxity values of the reconstructed knees, normalized to the contralateral control, were significantly reduced by 28% and 57% at 60° and 90° of knee flexion, respectively, with the addition of CPC (P <. 001). Significant improvements in the graft structural properties were also found; the normalized yield (P =. 044) and maximum failure loads (P =. 025) of the CPC group were 60% higher than the standard ACL-reconstructed group. Although cellular and vessel infiltration were observed in the grafts of both groups, regions of necrosis were present only in the standard ACL-reconstructed group. Conclusion These data demonstrate that the application of CPC at the time of ACL reconstruction improves the structural properties of the graft and reduces early AP knee laxity in the porcine model after 15 weeks of healing. Clinical Relevance Application of a CPC to an ACL graft at the time of surgery decreased knee laxity and increased the structural properties of the graft after 15 weeks of healing.

scholarly journals The Kinematic Control During the Backward Gait and Knee Proprioception: Insights from Lesions of the Anterior Cruciate Ligament

2014 ◽  
Vol 41 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Davide Viggiano ◽  
Katia Corona ◽  
Simone Cerciello ◽  
Michele Vasso ◽  
Alfredo Schiavone-Panni
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Step Length ◽  
Biomechanical Properties ◽  
Proprioceptive Feedback ◽  
Proprioceptive Information ◽  
Knee Motion ◽  
Backward Walking ◽  
Motor Strategy ◽  
Anterior Cruciate

AbstractAn already existing large volume of work on kinematics documents a reduction of step length during unusual gaits, such as backward walking. This is mainly explained in terms of modifications of some biomechanical properties. In the present study, we propose that the proprioceptive information from the knee may be involved in this change of motor strategy. Specifically, we show that a non-automated condition such as backward walking can elicit different motor strategies in subjects with reduced proprioceptive feedback after anterior cruciate ligament lesion (ACL). For this purpose, the kinematic parameters during forward and backward walking in subjects with ACL deficit were compared to two control groups: a group with intact ACL and a group with surgically reconstructed ACL. The knee proprioception was tested measuring the threshold for detection of passive knee motion. Subjects were asked to walk on a level treadmill at five different velocities (1-5km/h) in forward and backward direction, thereby calculating the cadence and step length. Results showed that forward walking parameters were largely unaffected in subjects with ACL damage. However, they failed to reduce step length during backward walking, a correction that was normally observed in all control subjects and in subjects with normal proprioceptive feedback after ACL reconstruction. The main result of the present study is that knee proprioception is an important signal used by the brain to reduce step length during the backward gait. This can have a significant impact on clinical evaluation and rehabilitation.

Evolgate Fixation of Doubled Flexor Graft in Anterior Cruciate Ligament Reconstruction: Biomechanical Evaluation with Cyclic Loading

2005 ◽  
Vol 33 (4) ◽  
pp. 574-582 ◽  
Author(s):  
Andrea Ferretti ◽  
Fabio Conteduca ◽  
Luca Labianca ◽  
Edoardo Monaco ◽  
Angelo De Carli
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cyclic Loading ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Biomechanical Properties ◽  
Interference Screw ◽  
Graft Fixation ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background The weakest points in hamstrings anterior cruciate ligament reconstruction are its points of fixation, especially on the tibial side. Methods for graft fixation to bone should be strong enough to avoid failure, stiff enough to restore load-displacement response, and secure enough to resist slippage under cyclic loading. Hypothesis Biomechanical properties of the interference screw can be improved by reinforcing the walls of the tunnel with a metal spiral (Evolgate fixation). Study Design Controlled laboratory study. Methods Three paired tests were performed using common digital extensor bovine tendons fixed to porcine tibias with interference screw, Intrafix, and Evolgate; critical graft fixation conditions were simulated by applying subsequent cycles to the graft before loading the graft until failure. Results The strength, stiffness, and resistance to slippage of the Evolgate were significantly higher than those of the interference screw; the ultimate failure load of the Evolgate was significantly higher than that of the Intrafix (1058 ± 130 N and 832 ± 156 N, respectively; P =. 02). No statistically significant differences were found between Evolgate and Intrafix regarding the stiffness and slippage under cyclic load. Conclusion Evolgate fixation seems to be stronger, stiffer, and more resistant to slippage than is interference screw fixation of similar length, and it is stronger but not stiffer than Intrafix. Clinical Relevance The Evolgate provides structural properties that seem to be appropriate for an intensive rehabilitation after anterior cruciate ligament reconstruction using a doubled semitendinosus and gracilis graft.

scholarly journals Sex Differences In The Morphology Of The Vastus Lateralis After An Anterior Cruciate Ligament Tear

2020 ◽  
Vol 52 (7S) ◽  
pp. 91-91
Author(s):  
Madalyn G. Romines ◽  
Lauren N. Erickson ◽  
Peter A. Hardy ◽  
Anders H. Andersen ◽  
Brian Noehren
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sex Differences ◽  
Vastus Lateralis ◽  
Cruciate Ligament ◽  
Anterior Cruciate Ligament Tear ◽  
Ligament Tear ◽  
Anterior Cruciate

Intraarticular Injuries Associated with Anterior Cruciate Ligament Tear: Findings at Ligament Reconstruction in High School and Recreational Athletes

2003 ◽  
Vol 31 (4) ◽  
pp. 601-605 ◽  
Author(s):  
Dana P. Piasecki ◽  
Kurt P. Spindler ◽  
Todd A. Warren ◽  
Jack T. Andrish ◽  
Richard D. Parker
Keyword(s):  
High School ◽  
Anterior Cruciate Ligament ◽  
Sex Differences ◽  
Ligament Reconstruction ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Mechanism Of Injury ◽  
Meniscal Tears ◽  
Basketball Players ◽  
Anterior Cruciate

Background Despite research on the increased risk of anterior cruciate ligament tears in female athletes, few studies have addressed sex differences in the incidence of associated intraarticular injuries. Hypothesis When patients are stratified by sport and competition level, no sex differences exist in either the mechanism of injury or pattern of intraarticular injuries observed at anterior cruciate ligament reconstruction. Study Design Prospective cohort study. Methods Two hundred twenty-one athletes undergoing anterior cruciate ligament reconstruction met our inclusion criteria of anterior cruciate ligament tear as a singular event without reinjury or history of prior injury or surgery in either knee. Data were collected on competition level (high school, amateur), sport (basketball, soccer, skiing), mechanism of injury, articular cartilage injuries, and meniscal tears. Data were statistically analyzed by sex with the chi-square test and Student's t-test. Results High school athletes had no significant sex differences in mechanism of injury. Female soccer athletes had fewer medial meniscal tears than did male athletes, and female basketball players had fewer medial femoral condyle injuries. At the amateur level, female basketball players had more contact injuries, an earlier onset of swelling, and fewer lateral meniscal tears than did male players. Conclusion At the high school level, male and female athletes shared a common mechanism of injury, and yet the female athletes had fewer intraarticular injuries in basketball and soccer. If such intraarticular injuries prove to be a significant risk factor for poor long-term outcome, women may enjoy a better prognosis after reconstruction.

scholarly journals Sex Differences on the Landing Error Scoring System Among Individuals With Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 53 (9) ◽  
pp. 837-843 ◽  
Author(s):  
Christopher M. Kuenze ◽  
Stephanie Trigsted ◽  
Caroline Lisee ◽  
Eric Post ◽  
David R. Bell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sex Differences ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Initial Contact ◽  
Medial Knee ◽  
Cruciate Ligament Reconstruction ◽  
History Of ◽  
Anterior Cruciate

Context:  After anterior cruciate ligament reconstruction (ACLR), women have a greater risk of incurring a second anterior cruciate ligament injury and they display different landing movement patterns than men. It remains unclear if clinical movement-assessment tools, such as the Landing Error Scoring System (LESS), can detect sex differences in movement patterns after ACLR. Objective:  To compare total LESS scores and individual LESS errors between men and women with a history of ACLR. Design:  Cross-sectional study. Setting:  Laboratory. Patients or Other Participants:  A total of 168 individuals (41 men and 127 women; mean age: men = 20 years [range, 19–25 years], women = 19 years [range, 18–20 years]; mean time since surgery: men = 21 months [range, 12–36 months], women = 27.5 months [range, 17–39 months]) with a history of primary, unilateral ACLR. Main Outcome Measure(s):  Participants completed a minimum of 3 trials of a drop vertical-jump task scored using the LESS. The between-sexes difference in LESS score was assessed using analysis of covariance, whereas the associations between participant sex and errors on each LESS item were assessed using logistic or multinomial regression. Results:  Women displayed a greater number of total landing errors (men = 4.6 ± 2.3, women = 6.1 ± 2.3; P &lt; .001) and were more likely to commit errors in trunk flexion at initial contact (men = 4.9%, women = 23.6%; odds ratio [OR] = 4.94), medial knee position at initial contact (men = 17.1%, women = 42.5%; OR = 6.01), medial knee displacement (men = 24.4%, women = 73.2%; OR = 7.88), total joint displacement (1 error: men = 58.5%, women = 71.7%, OR = 2.10; 2 errors: men = 7.3%, women = 14.2%, OR = 3.71), and overall impression (1 error: men = 75.6%, women = 84.3%, OR = 3.24; 2 errors: men = 2.4%, women = 10.2%, OR = 12.89) compared with men. Conclusions:  Women with ACLR displayed worse LESS scores and were more likely to commit errors related to medial knee displacement and overall landing quality than men with ACLR.

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