Comparison of kinematics of ACL-deficient and healthy knees during passive flexion and isometric leg press

Esfandiarpour, Fateme; Shakourirad, Ali; Talebian, Saeed; Olyaei, Gholamreza; Eslami, Abouzar; Farahmand, Farzam

doi:10.1016/j.knee.2012.09.009

Cited by 10 publications

(5 citation statements)

References 38 publications

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“…For a real dynamic in vivo validation of the model, the subject's 3D tracking data is needed to be measured during a dynamic activity using a noninvasive technique. The currently available imagining modalities, e.g., MRI and fluoroscopy, however, are unable to produce such data with sufficient accuracy [48]. Moreover, the closed MRI, with a limited tunnel diameter, used in our study, forced us to limit our investigation to the knee mid flexion range, i.e., between full extension and 50 degrees flexion.…”

Section: Discussionmentioning

confidence: 99%

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A Detailed and Validated Three Dimensional Dynamic Model of the Patellofemoral Joint

Akbar

Farahmand

Jafari

et al. 2012

Journal of Biomechanical Engineering

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A detailed 3D anatomical model of the patellofemoral joint was developed to study the tracking, force, contact and stability characteristics of the joint. The quadriceps was considered to include six components represented by 15 force vectors. The patellar tendon was modeled using four bundles of viscoelastic tensile elements. Each of the lateral and medial retinaculum was modeled by a three-bundle nonlinear spring. The femur and patella were considered as rigid bodies with their articular cartilage layers represented by an isotropic viscoelastic material. The geometrical and tracking data needed for model simulation, as well as validation of its results, were obtained from an in vivo experiment, involving MR imaging of a normal knee while performing isometric leg press against a constant 140 N force. The model was formulated within the framework of a rigid body spring model and solved using forth-order Runge-Kutta, for knee flexion angles between zero and 50 degrees. Results indicated a good agreement between the model predictions for patellar tracking and the experimental results with RMS deviations of about 2 mm for translations (less than 0.7 mm for patellar mediolateral shift), and 4 degrees for rotations (less than 3 degrees for patellar tilt). The contact pattern predicted by the model was also consistent with the results of the experiment and the literature. The joint contact force increased linearly with progressive knee flexion from 80 N to 210 N. The medial retinaculum experienced a peak force of 18 N at full extension that decreased with knee flexion and disappeared entirely at 20 degrees flexion. Analysis of the patellar time response to the quadriceps contraction suggested that the muscle activation most affected the patellar shift and tilt. These results are consistent with the recent observations in the literature concerning the significance of retinaculum and quadriceps in the patellar stability.

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Section: Discussionmentioning

confidence: 99%

“…The slice thickness of MR imaging was 4 mm during the experiments, to avoid muscular fatigue which could cause unwanted limb movements and disturb the image quality. With such a large slice thickness, experimental errors in the order of 2 to 4 mm for the translations and 3 to 5 degrees for the rotations are inevitable [48,53].…”

Section: Discussionmentioning

confidence: 99%

A Detailed and Validated Three Dimensional Dynamic Model of the Patellofemoral Joint

Akbar

Farahmand

Jafari

et al. 2012

Journal of Biomechanical Engineering

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“…It is hypothesized that the change in the joint laxity, caused by ACL deficiency, leads to side-to-side difference in the acceleration responses recorded by the IMU sensors, which enables diagnosing of the ACL injury. This hypothesis is supported by the fact that several studies have shown that the kinematics of the healthy and ACL-injured knees are significantly different during gait, 11,12 isometric leg press, 13 and clinical tests. 14 A few researchers have recently investigated the acceleration responses of the ACL-injured knees using IMU sensors.…”

Section: Introductionmentioning

confidence: 85%

“…In the biomechanics literature, [11][12][13][14] the kinematic effects associated with the ACL injury have been often assessed and described in terms of the resulting alteration in the tibiofemoral configuration, e.g., tibial anterior translation or internal/external rotation relative to femur. Also, the basis behind all types of the currently available devices for ACL injury diagnosis [6][7][8][9] is to apply an external mechanical perturbation to the knee and measure the resulting changes in the knee configuration.…”

Section: Discussionmentioning

confidence: 99%

Effect of anterior cruciate ligament injury on acceleration response of knee joint

Ahmadi,

Hosseini Lorgan,

Sherafat Vaziri

et al. 2024

Proc Inst Mech Eng H

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This study investigated the effect of anterior cruciate ligament (ACL) injury on relative acceleration of the tibia and femur during a number of tests/activities, in order to assess the feasibility of acceleration-based diagnosis of ACL injury using inertial sensors. First, a detailed finite element model of the knee joint was developed to simulate the target tests/activities, and identify those in which a large difference between the maximum acceleration peaks (MAPs) of the healthy and ACL injured knees is likely to be observed. The promising tests/activities were entered in an experimental study, where the relative accelerations of the tibiae and femurs of 20 individuals with unilateral ACL injury, allocated randomly to two groups of conscious and unconscious test conditions, were recorded. Model predictions indicated MAP ratios>1.5 for the ACL-injured to healthy knees, during the anterior drawer, Lachman, and pivot-shift tests, as well as the lunge activity. The experimental MAP results indicated acceptable test–retest reliabilities for all tests (coefficient of variation<0.25), and significant MAP differences ( p < 0.05) in the anterior drawer and pivot-shift tests, in both coconscious and unconscious conditions. The individualized MAP results indicated side-to-side differences>2 m/s2 for all subjects during unconscious pivot shift tests, and >0.5 m/s2 for eight cases out of ten during conscious anterior drawer tests. It was concluded that the pivot shift test had a great repeatability and discriminative ability for acceleration-based diagnosis of ACL injury in unconscious condition. For the conscious condition, however, the anterior drawer test was appeared to be most promising.

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“…As such, the most reliable methodology to investigate the kinematical efficacy of FKBs is to use medical imaging modalities that provide direct visualization of the position and hence the relative motion of the bones noninvasively. Imaging techniques have been employed for kinematics analysis of the ACL deficient knees in two ( 31 ) and three ( 9 , 32 - 34 ) dimensions often during quasi-static activities. Also, video fluoroscopy has been recently used to measure the kinematic behavior of the normal and ACL injured knees during dynamic activities ( 8 , 35 ).…”

Section: Introductionmentioning

confidence: 99%

Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge

et al. 2015

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Background:Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information.Objectives:In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients.Patients and Methods:For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur.Results:Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant.Conclusion:Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient patients during lunge exercise.

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Comparison of kinematics of ACL-deficient and healthy knees during passive flexion and isometric leg press

Cited by 10 publications

References 38 publications

A Detailed and Validated Three Dimensional Dynamic Model of the Patellofemoral Joint

A Detailed and Validated Three Dimensional Dynamic Model of the Patellofemoral Joint

Effect of anterior cruciate ligament injury on acceleration response of knee joint

Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge

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