The Relationship Between Anterior Tibial Acceleration, Tibial Slope, and ACL Strain During a Simulated Jump Landing Task

McLean, Scott; Oh, Youkeun K.; Palmer, Mark L.; Lucey, Sarah M.; Lucarelli, Dustin G; Ashton‐Miller, James A.; Wojtys, Edward M.

doi:10.2106/jbjs.j.00259

Cited by 142 publications

(135 citation statements)

References 64 publications

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“…II). The resulting peak relative AM-ACL strain ranged from 9.4 to 27%, which is also substantially higher compared to the results reported in 19,[21][22][23][24][25][26] . It is likely that the larger strain magnitudes are due to the larger VIF magnitudes as well as differences in simulating the contribution of muscle-tendon forces prior to and during landing.…”

Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Icontrasting

confidence: 63%

The influence of muscle-tendon forces on ACL loading during jump landing: a systematic review

Oberhofer

Nasab

Schütz

et al. 2017

MLTJ

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SummaryBackground: The goal of this review is to summarise and discuss the reported influence of muscle-tendon forces on anterior cruciate ligament (ACL) loading during the jump-landing task by means of biomechanical analyses of the healthy knee. Methods: A systematic review of the literature was conducted using different combinations of the terms "knee", ''ligament'', ''load'', "tension ", "length", ''strain'', "elongation'' and ''lengthening''. 26 original articles (n=16 in vitro studies; n=10 in situ studies) were identified which complied with all inclusion/exclusion criteria. Results: No apparent trend was found between ACL loading and the ratio between hamstrings and quadriceps muscle-tendon forces prior to or during landing. Four in vitro studies reported reduced peak ACL strain if the quadriceps force was increased; while one in vitro study and one in situ study reported reduced ACL loading if the hamstrings force was increased. A meta-analysis of the reported results was not possible because of the heterogeneity of the confounding factors. Conclusion:The reported results suggest that increased hip flexion during landing may help in reducing ACL strain by lengthening the hamstrings, and thus increasing its passive resistance to

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Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Icontrasting

confidence: 63%

The influence of muscle-tendon forces on ACL loading during jump landing: a systematic review

Oberhofer

Nasab

Schütz

et al. 2017

MLTJ

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“…This proximal tibial anterior shear force shifts the lateral tibial plateau anteriorly, leading the ACL to eventually rupture. 18 Supporting this potential mechanism of ACL injury, several investigators [31][32][33][34][35] have shown relationships between the posterior slope of the tibial plateau and knee biomechanics or ACL injury risk. Meyer and Haut 18 suggested that sustaining a large GRF during sudden decelerating motions could harm the ACL because it increases the amount of tibial axial force and, thus, the proximal tibial anterior shear force due to the posterior slope of the tibial plateau.…”

Section: Discussionmentioning

confidence: 97%

Changing Sagittal-Plane Landing Styles to Modulate Impact and Tibiofemoral Force Magnitude and Directions Relative to the Tibia

Shimokochi

Ambegaonkar

Meyer

2016

Journal of Athletic Training

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Context: Ground reaction force (GRF) and tibiofemoral force magnitudes and directions have been shown to affect anterior cruciate ligament loading during landing. However, the kinematic and kinetic factors modifying these 2 forces during landing are unknown.Objective: To clarify the intersegmental kinematic and kinetic links underlying the alteration of the GRF and tibiofemoral force vectors secondary to changes in the sagittal-plane body position during single-legged landing.Design: Crossover study. Setting: Laboratory.Patients or Other Participants: Twenty recreationally active participants (age ¼ 23.4 6 3.6 years, height ¼ 171.0 6 9.4 cm, mass ¼ 73.3 6 12.7 kg).Intervention(s): Participants performed single-legged landings using 3 landing styles: self-selected landing (SSL), body leaning forward and landing on the toes (LFL), and body upright with flat-footed landing (URL). Three-dimensional kinetics and kinematics were recorded.Main Outcome Measure(s): Sagittal-plane tibial inclination and knee-flexion angles, GRF magnitude and inclination angles relative to the tibia, and proximal tibial forces at peak tibial axial forces.Results: The URL resulted in less time to peak tibial axial forces, smaller knee-flexion angles, and greater magnitude and a more anteriorly inclined GRF vector relative to the tibia than did the SSL. These changes led to the greatest peak tibial axial and anterior shear forces in the URL among the 3 landing styles. Conversely, the LFL resulted in longer time to peak tibial axial forces, greater knee-flexion angles, and reduced magnitude and a more posteriorly inclined GRF vector relative to the tibia than the SSL. These changes in LFL resulted in the lowest peak tibial axial and largest posterior shear forces among the 3 landing styles.Conclusions: Sagittal-plane intersegmental kinematic and kinetic links strongly affected the magnitude and direction of GRF and tibiofemoral forces during the impact phase of singlelegged landing. Therefore, improving sagittal-plane landing mechanics is important in reducing harmful magnitudes and directions of impact forces on the anterior cruciate ligament.Key Words: anterior cruciate ligament, tibial posterior slope, lower extremity biomechanics, injury prevention, landing strategy Key PointsAt the impact phase of single-legged landing, sagittal-plane kinetics and kinematics of body segments were strongly related, affecting both the magnitude and direction of the ground reaction force (GRF) and tibiofemoral forces relative to the tibia and anterior cruciate ligament injury risk. A longer time to peak GRF in single-legged landing on the toes with the body leaning forward allowed greater knee flexion, anterior tibial inclination, and shock attenuation, leading to a reduced magnitude of GRF that was more posteriorly inclined relative to the tibia and smaller tibial axial forces and posteriorly directed tibial shear forces. A shorter time to peak GRF during flat-footed landing with the body upright led to less knee flexion, anterior tibial inclination, and s...

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“…95,98,110 Biomechanically, good evidence indicates that knee-joint geometry is related to higher-risk biomechanics. Greater posterior-inferior lateral tibial slopes are associated with greater anterior joint reaction forces, 116 anterior translation of the tibia relative to the femur, 117,118 and peak anterior tibial acceleration 119 ; when combined with a smaller ACL cross-sectional area, these factors are associated with greater peak ACL strains. 120 Greater relative posteriorinferior slope of the lateral versus the medial tibial plateau has been associated with greater peak knee-abduction and internal-rotation angles, 116,121 whereas a reduced coronal slope has been associated with greater hip adduction and knee valgus upon landing in females.…”

Section: Anatomical and Structural Risk Factorsmentioning

confidence: 97%

“…10. Although investigators have elucidated the influence of anatomical and structural factors on weight-bearing kneejoint neuromechanics, 116,119,120,153,154,160 this information has yet to be incorporated in our ACL injury-prevention efforts.…”

Section: During Injury-prevention Training Programs Techniquementioning

confidence: 99%

ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention

Shultz

Schmitz

Benjaminse

et al. 2015

Journal of Athletic Training

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The Relationship Between Anterior Tibial Acceleration, Tibial Slope, and ACL Strain During a Simulated Jump Landing Task

Abstract: Impact-induced ACL strain is directly proportional to anterior tibial acceleration, with this relationship being moderately dependent on the posterior slope of the tibial plateau.

Cited by 142 publications

References 64 publications

The influence of muscle-tendon forces on ACL loading during jump landing: a systematic review

The influence of muscle-tendon forces on ACL loading during jump landing: a systematic review

Changing Sagittal-Plane Landing Styles to Modulate Impact and Tibiofemoral Force Magnitude and Directions Relative to the Tibia

ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention

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