Global Quasi-Static Mechanical Characterization of the Human Knee Under Single- and Multi-Axis Unconstrained Loading Conditions

2012 ◽  
Author(s):  
Ata M. Kiapour ◽  
Carmen E. Quatman ◽  
Richard C. Ditto ◽  
Jason W. Levine ◽  
Samuel C. Wordeman ◽  
...  
Keyword(s):  
Injury Risk ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Knee Injuries ◽  
Knee Kinematics ◽  
The United States ◽  
Ligament Injury ◽  
Knee Biomechanics ◽  
Loading Conditions ◽  
Joint Biomechanics

A substantial number of knee injuries are reported in the United States annually, and are principally observed among young athletes. ACL (anterior cruciate ligament) injury is one of the most common and devastating knee injuries [1]. Many factors influence such injuries, from anatomical variability to magnitude and direction of loading. A better understanding of knee biomechanics and injury mechanisms may improve current preventative, surgical and rehabilitation strategies, and thus, mediate injury risk. Considerable study of knee joint biomechanics under various modes of loading has been undertaken [2–4]. Additional work is needed to characterize the effects of different loading factors on knee biomechanics, especially ACL loading patterns under more physiologically relevant conditions. The purpose of this study is to develop a new technique to investigate the effects of various single- and multi-axes loading conditions on knee kinematics, ACL and MCL (medial collateral ligament) strains, and TF (tibiofemoral) articular cartilage pressure distribution under quasistatic loading conditions that simulate various weight bearing activities.

Detailed Cadaveric Simulation of Landing Reveals Timing Sequence of Multi-Planar Knee Kinematics: Implications for ACL Injury

2013 ◽  
Author(s):  
A. M. Kiapour ◽  
C. E. Quatman ◽  
V. K. Goel ◽  
S. C. Wordeman ◽  
T. E. Hewett ◽  
...  
Keyword(s):  
Injury Risk ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Acl Injury ◽  
The United States ◽  
Anterior Tibial Translation ◽  
Tibial Rotation ◽  
Acl Injuries ◽  
Cadaveric Simulation ◽  
Tibial Translation

Over 120,000 anterior cruciate ligament (ACL) injuries occur annually in the United States, mainly affecting the young athletic population. Non-contact injuries are reported to be the predominant mechanism of ACL injury (>70% of ACL injuries), which often occur during landing with high ground reaction forces, muscle forces and segmental inertia. An improved understanding of the mechanisms underlying non-contact ACL injury and inciting events can be used to improve current prevention strategies and decrease the risk of early-onset osteoarthritis. Previous biomechanical and video analysis studies have demonstrated that anterior tibial translation (ATT), knee valgus and internal tibial rotation (ITR) are associated with non-contact ACL injuries [1–3]. While the effects of these factors on ACL injury risk have been extensively studied, there is still controversy and debate about the timing in which these motions occur and reach maximum values during a jump landing task. The current study aimed to investigate interactions between tibio-femoral joint kinematics and ACL strain through a detailed cadaveric simulation of the knee biomechanical response during landing from a jump. For this purpose, instrumented cadaveric limbs were used to simulate bi-pedal landing following a jump utilizing a novel testing apparatus.

A Method for the Kinematic Evaluation of the Knee following Anterior Cruciate Ligament Injury and Reconstruction

1993 ◽  
Vol 207 (2) ◽  
pp. 73-77 ◽  
Author(s):  
A J Long ◽  
F P Monsell ◽  
M L Porter ◽  
P Bowker ◽  
D W L Hukins
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Knee Kinematics ◽  
Ligament Injury ◽  
Anterior Cruciate ◽  
Centre Of Rotation ◽  
Kinematic Evaluation

A quantitative method for assessing the kinematics of the knee in the sagittal plane has been developed in order to evaluate the role of the anterior cruciate ligament following injury and reconstruction. Measurements were made on a series of lateral radiographs obtained at different angles of flexion with the limb weight-bearing and the foot and ankle rotated so that the condyles of the femur overlapped. The kinematics of the joint were then defined by recording the path of the tip of the medial tibial spine as flexion proceeded, using a coordinate system based on the femur. This method overcomes the problems inherent in quantifying knee kinematics by using the pathway of the centre of rotation. In an amputated knee, tibial positions could be specified to within approximately 1.2 mm. There were no significant differences between results obtained at the beginning and end of a six month period for the normal knees of two patients; the standard deviation of the measured tibial positions was approximately 1.6 mm.

Gender Differences in Knee Kinematics After Anterior Cruciate Ligament Injury

2013 ◽  
Author(s):  
Chelsea Marsh ◽  
Scott Tashman
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
The United States ◽  
Ligament Injury ◽  
Tibial Rotation ◽  
Leg Muscles ◽  
Muscle Activation Patterns ◽  
Anterior Cruciate

Injury to the anterior cruciate ligament (ACL) occurs 200,000 times per year in the United States. About half of these patients opt for ACL reconstruction (ACLr), while the other half choose non-surgical, conservative treatment. ACLr has been found to result in altered kinematics, namely external tibial rotation and knee adduction, during downhill running 1. ACLr also contributes to alterations in muscle activity after surgery. Leg muscles of the affected limb are weakened and contract in different muscle activation patterns when compared to healthy, uninjured patients 2.

Anterior cruciate ligament injury risk factors in football

2019 ◽  
Vol 59 (10) ◽  
Author(s):  
Gian Nicola Bisciotti ◽  
Karim Chamari ◽  
Emanuele Cena ◽  
Andrea Bisciotti ◽  
Alessandro Bisciotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Injury Risk Factors ◽  
Anterior Cruciate

The effect of unloader knee braces on medial meniscal strain

2018 ◽  
Vol 43 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Mayank Kalra ◽  
Ryan Bakker ◽  
Sebastian S Tomescu ◽  
Anna M Polak ◽  
Micah Nicholls ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Compressive Force ◽  
Ligament Injury ◽  
Knee Braces ◽  
Anterior Cruciate

Background: A medial meniscal tear is a common knee injury, especially following an anterior cruciate ligament injury. Decreasing the compressive force on the medial meniscus during dynamic activities using an unloader knee brace could reduce meniscal strain, effectively reducing injury risk and/or severity. Objectives: To investigate the efficacy of two unloader knee braces on medial meniscus strain during dynamic activities in intact & deficient anterior cruciate ligament states. Study design: Combined in vivo/in vitro study. Methods: In vivo knee kinematics and muscle force profiles from a healthy individual performing single/doubleleg squats and walking motions were simulated on 10 cadaveric specimens using a dynamic knee simulator system. Simulations were performed on knees in unbraced and braced scenarios, with and without the anterior cruciate ligament. Anterior and posterior medial meniscal strains were measured. Results: Two different braces each showed a significant reduction in the posteromedial meniscal strain ( p ⩽ 0.01) in an intact anterior cruciate ligament state. Neither brace mirrored this result for the anteromedial strain ( p > 0.05). In the deficient anterior cruciate ligament state, the braces had no significant effect on strain ( p > 0.05). Conclusion: Two unloader knee braces effectively reduced strain in the medial meniscus with an intact anterior cruciate ligament during dynamic activities. Neither brace made a significant reduction in strain for anterior cruciate ligament-deficient knees. Clinical relevance Unloader knee braces could be used to reduce the medial meniscus strain following meniscal surgery and during rehabilitation in patients with an isolated medial meniscus injury. However, these braces cannot be recommended for this purpose in patients with an anterior cruciate ligament deficiency.

scholarly journals Injury Risk Associated With Sports Specialization and Activity Volume in Youth

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711987012 ◽  
Author(s):  
Alison E. Field ◽  
Frances A. Tepolt ◽  
Daniel S. Yang ◽  
Mininder S. Kocher
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
The United States ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Anterior Cruciate

Background: Sports specialization has become increasingly common among youth. Purpose/Hypothesis: To investigate the relative importance of specialization vs volume of activity in increasing risk of injury. Hypotheses were that specialization increases the risk of injury and that risk varies by sport. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective analysis was conducted with data collected from 10,138 youth in the Growing Up Today Study—a prospective cohort study of youth throughout the United States—and their mothers. Activity was assessed via questionnaires in 1997, 1998, 1999, and 2001. Sports specialization was defined as engaging in a single sport in the fall, winter, and spring. Injury history was provided by participants’ mothers via questionnaire in 2004. The outcome was incident stress fracture, tendinitis, chondromalacia patella, anterior cruciate ligament tear, or osteochondritis dissecans or osteochondral defect. Results: Females who engaged in sports specialization were at increased risk of injury (hazard ratio [HR], 1.31; 95% CI, 1.07-1.61), but risk varied by sport. Sports specialization was associated with greater volume of physical activity in both sexes ( P < .0001). Total hours per week of vigorous activity was predictive of developing injury, regardless of what other variables were included in the statistical model (males: HR, 1.04; 95% CI, 1.02-1.06; females: HR, 1.06; 95% CI, 1.05-1.08). Among females, even those engaging in 3 to 3.9 hours per week less than their age were at a significantly increased risk of injury (HR, 1.93; 95% CI, 1.34-2.77). In males, there was no clear pattern of risk. Conclusion: Sports specialization is associated with a greater volume of vigorous sports activity and increased risk of injury. Parents, coaches, and medical providers need to be made aware of the volume threshold above which physical activity is excessive.

scholarly journals The anterolateral ligament is a secondary stabilizer in the knee joint

2019 ◽  
Vol 8 (11) ◽  
pp. 509-517 ◽  
Author(s):  
Kyoung-Tak Kang ◽  
Yong-Gon Koh ◽  
Kyoung-Mi Park ◽  
Chong-Hyuck Choi ◽  
Min Jung ◽  
...  
Keyword(s):  
Knee Joint ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Anterolateral Ligament ◽  
Loading Conditions ◽  
Joint Stability ◽  
Musculoskeletal Models ◽  
Subject Specific ◽  
Cycle Loading

Objectives The aim of this study was to investigate the biomechanical effect of the anterolateral ligament (ALL), anterior cruciate ligament (ACL), or both ALL and ACL on kinematics under dynamic loading conditions using dynamic simulation subject-specific knee models. Methods Five subject-specific musculoskeletal models were validated with computationally predicted muscle activation, electromyography data, and previous experimental data to analyze effects of the ALL and ACL on knee kinematics under gait and squat loading conditions. Results Anterior translation (AT) significantly increased with deficiency of the ACL, ALL, or both structures under gait cycle loading. Internal rotation (IR) significantly increased with deficiency of both the ACL and ALL under gait and squat loading conditions. However, the deficiency of ALL was not significant in the increase of AT, but it was significant in the increase of IR under the squat loading condition. Conclusion The results of this study confirm that the ALL is an important lateral knee structure for knee joint stability. The ALL is a secondary stabilizer relative to the ACL under simulated gait and squat loading conditions. Cite this article: Bone Joint Res 2019;8:509–517.

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