The function of the primary ligaments of the knee in varus-valgus and axial rotation

Seering, Warren P.; Piziali, Robert L.; Nagel, Donald A.; Schurman, David J.

doi:10.1016/0021-9290(80)90240-7

Cited by 150 publications

(68 citation statements)

References 9 publications

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“…Sectioning did not change the amount of varus-valgus rotation under f 1 0 N m applied varus-valgus torque at any of the flexion angles. This is in agreement with the results of other studies [13,27,37,40]. However, we did not examine the strain distributions in the MCL after sectioning of the meniscal attachment.…”

Section: Discussionsupporting

confidence: 93%

Subject‐specific finite element analysis of the human medial collateral ligament during valgus knee loading

Gardiner

Weiss

2003

Journal Orthopaedic Research

195

177

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The objectives of this study were (1) to develop subject-specific experimental and finite element (FE) techniques to study the three-dimensional stress-strain behavior of ligaments, with application to the human medial collateral ligament (MCL), and (2) to determine the importance of subject-specific material properties and initial (in situ) strain distribution for prediction of the strain distribution in the MCL under valgus loading. Eight male knees were subjected to varus-valgus loading at flexion angles of O", 30", and 60". Three-dimensional joint kinematics and MCL strains were recorded during kinematic testing. Following testing, the MCL of each knee was removed to allow measurement of the in situ strain distribution and to perform material testing. A FE model of the femur-MCL-tibia complex was constructed for each knee to simulate valgus loading at each flexion angle, using subject-specific bone and ligament geometry, material properties, and joint kinematics. A transversely isotropic hyperelastic material model was used to represent the MCL. The MCL in situ strain distribution at full extension was used to apply in situ strain to each MCL FE model. FE predicted MCL strains during valgus loading were compared to experimental measurements using regression analysis. The subject-specific FE predictions of strain correlated reasonably well with experimentally measured MCL strains (R' = 0.83, 0.72, and 0.66 at O", 30°, and 60", respectively). Despite large inter-subject variation in MCL material properties, MCL strain distributions predicted by individual FE models that used average MCL material properties were strongly correlated with subject-specific FE strain predictions (R' = 0.99 at all flexion angles). However, predictions by FE models that used average in situ strain distributions yielded relatively poor correlations with subject-specific FE predictions (R' = 0.44,0.35, and 0.33 at flexion angles of O", 30". and 60", respectively). The strain distribution within the MCL was nonuniform and changed with flexion angle. The highest MCL strains occurred at full extension in the posterior region of the MCL proximal to the joint line during valgus loading, suggesting this region may be most vulnerable to injury under these loading conditions. This work demonstrates that subject-specific FE models can predict the complex, nonuniform strain fields that occur in ligaments due to external loading of the joint.

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Section: Discussionsupporting

confidence: 93%

Subject‐specific finite element analysis of the human medial collateral ligament during valgus knee loading

Gardiner

Weiss

2003

Journal Orthopaedic Research

195

177

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“…Effect of initial contact NMC perturbations (n = 5000) on mean resultant (A) anterior drawer force (FD Ant ) and (B) valgus (M Val ) moments quantified in male and female sidestep models. ACL injury was deemed to occur when anterior drawer force and peak external valgus moment exceeded 2000 N (Woo et al, 1991) and 125 Nm (Seering et al, 1980) respectively. Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The number of ACL injuries via either an isolated anterior tibial shear or valgus load mechanism was quantified for each Monte Car lo Simulation series. Specifically, sagittal or transverse plane injuries were defined to occur when peak FD Ant or M Val values exceeded 2000 N (Woo et al, 1991) or 125 Nm (Seering et al, 1980) respectively. Non-parametric statistical methods (Friedman test) were then utilized to determine whether respective (n = 6) perturbations in each of the three initial contact kinematic parameters increased or decreased the number of ACL injuries compared to baseline Monte Carlo levels.…”

Section: Data Analysesmentioning

confidence: 99%

Investigating isolated neuromuscular control contributions to non-contact anterior cruciate ligament injury risk via computer simulation methods

McLean¹,

Huang²,

Bogert³

2008

Clinical Biomechanics

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“…Previous research has shown that valgus and internal rotation knee loads, both in isola tion and in combination, have a significant impact on ACL loading (Kanamori et al, 2000;Markolf et al, 1995). (Seering et al, 1980) have also shown that liga ment damage occurred in cadaveric knee joints within 125-210 Nm of valgus torque or 35-80 Nm of internal rotation torque. Significant out-of-plane loading was evident for the optimized sidestep cutting models and Monte Carlo simulations produced peak valgus and internal torques well above these injury ranges.…”

Section: Potential For Acl Injury In the Sagittal Planementioning

confidence: 98%

Sagittal plane biomechanics cannot injure the ACL during sidestep cutting

McLean

Huang

et al. 2004

Clinical Biomechanics

325

284

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The function of the primary ligaments of the knee in varus-valgus and axial rotation

Cited by 150 publications

References 9 publications

Subject‐specific finite element analysis of the human medial collateral ligament during valgus knee loading

Subject‐specific finite element analysis of the human medial collateral ligament during valgus knee loading

Investigating isolated neuromuscular control contributions to non-contact anterior cruciate ligament injury risk via computer simulation methods

Sagittal plane biomechanics cannot injure the ACL during sidestep cutting

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