Abstract
Injuries in the anterior cruciate ligament (ACL), including partial tear and lengthening of the ACL, change the dynamic function of the knee. However, there is a lack of information on the effect of ACL partial tear on knee kinematics during walking. This study aimed to investigate the effects of different levels of ACL injuries on knee stability and ACL tensional force to identify the critical injury level. Motion data of five normal subjects were acquired along with the ground reaction force. A knee model with 14 ligaments was developed using cadaveric specimen data. The initial length and stiffness of the ACL were changed to develop ACL-injured knee models. Musculoskeletal simulations of the knee models were performed using the measured gait data. The average tibial anterior translation increased significantly by 2.6 ± 0.7 mm when the ACL stiffness decreased to 25% of its original stiffness. The average tibial anterior translation increased significantly by 2.6 ± 0.3 mm at an increase in initial length of 10%. The knee with partial ACL tear had a nonlinear decrease in ACL forces owing to the increase in the level of ACL injury, while the knee with ACL lengthening had linear decreased ACL forces. The partial tear of the ACL caused translational instability, while the complete tear caused both rotational and translational instabilities during the musculoskeletal walking simulation. This study presents the effects of partial ACL injuries on joint kinematics and ACL tensional force during the dynamic motion of walking.
Issue Section:
Research Papers
References
1.
Rayan
,
F.
,
Nanjayan
,
S. K.
,
Quah
,
C.
,
Ramoutar
,
D.
,
Konan
,
S.
, and
Haddad
,
F. S.
, 2015
, “
Review of Evolution of Tunnel Position in Anterior Cruciate Ligament Reconstruction
,” World J. Orthop.
,
6
(2
), pp. 252
–262
.10.5312/wjo.v6.i2.2522.
Gobbi
,
A.
, and
Whyte
,
G. P.
, 2018
, “
Long-Term Outcomes of Primary Repair of the Anterior Cruciate Ligament Combined With Biologic Healing Augmentation to Treat Incomplete Tears
,” Am. J. Sport Med.
,
46
(14
), pp. 3368
–3377
.10.1177/03635465188057403.
Chmielewski
,
T. L.
,
Rudolph
,
K. S.
,
Fitzgerald
,
G. K.
,
Axe
,
M. J.
, and
Snyder-Mackler
,
L.
, 2001
, “
Biomechanical Evidence Supporting a Differential Response to Acute ACL Injury
,” Clin. Biomech. (Bristol, Avon)
,
16
(7
), pp. 586
–591
.10.1016/S0268-0033(01)00050-X4.
Gokeler
,
A.
,
Neuhaus
,
D.
,
Benjaminse
,
A.
,
Grooms
,
D. R.
, and
Baumeister
,
J.
, 2019
, “
Principles of Motor Learning to Support Neuroplasticity After ACL Injury: Implications for Optimizing Performance and Reducing Risk of Second ACL Injury (Vol 49, pg 853, 2019)
,” Sports Med.
,
49
(6
), pp. 979
–979
.10.1007/s40279-019-01078-w5.
Andriacchi
,
T. P.
,
Briant
,
P. L.
,
Bevill
,
S. L.
, and
Koo
,
S.
, 2006
, “
Rotational Changes at the Knee After ACL Injury Cause Cartilage Thinning
,” Clin. Orthop. Relat. Res.
,
442
, pp. 39
–44
.10.1097/01.blo.0000197079.26600.096.
Pujol
,
N.
,
Colombet
,
P.
,
Cucurulo
,
T.
,
Graveleau
,
N.
,
Hulet
,
C.
,
Panisset
,
J. C.
,
Potel
,
J. F.
,
Servien
,
E.
,
Sonnery-Cottet
,
B.
,
Trojani
,
C.
,
Djian
,
P.
, and
SFA
,
F. A. S.
, 2012
, “
Natural History of Partial Anterior Cruciate Ligament Tears: A Systematic Literature Review
,” Orthop. Traumatol. Surg.
,
98
(8
), pp. S160
–S164
.10.1016/j.otsr.2012.09.0137.
Berns
,
G. S.
,
Hull
,
M. L.
, and
Patterson
,
H. A.
, 1992
, “
Strain in the Anteromedial Bundle of the Anterior Cruciate Ligament Under Combination Loading
,” J. Orthop. Res.
,
10
(2
), pp. 167
–176
.10.1002/jor.11001002038.
Lohmander
,
L. S.
,
Englund
,
P. M.
,
Dahl
,
L. L.
, and
Roos
,
E. M.
, 2007
, “
The Long-Term Consequence of Anterior Cruciate Ligament and Meniscus Injuries - Osteoarthritis
,” Am. J. Sport Med.
,
35
(10
), pp. 1756
–1769
.10.1177/03635465073073969.
Wang
,
L. J.
,
Zeng
,
N.
,
Yan
,
Z. P.
,
Li
,
J. T.
, and
Ni
,
G. X.
, 2020
, “
Post-Traumatic Osteoarthritis Following ACL Injury
,” Arthritis Res. Ther.
,
22
(1
), pp. 1
–8
.10.1186/s13075-020-02156-510.
Liu
,
W.
,
Maitland
,
M. E.
, and
Bell
,
G. D.
, 2002
, “
A Modeling Study of Partial ACL Injury: Simulated KT-2000 Arthrometer Tests
,” ASME J. Biomech. Eng.
,
124
(3
), pp. 294
–301
.10.1115/1.146863611.
Cone
,
S. G.
,
Lambeth
,
E. P.
,
Piedrahita
,
J. A.
,
Spang
,
J. T.
, and
Fisher
,
M. B.
, 2020
, “
Joint Laxity Varies in Response to Partial and Complete Anterior Cruciate Ligament Injuries Throughout Skeletal Growth
,” J. Biomech.
,
101
, p. 109636
.10.1016/j.jbiomech.2020.10963612.
Hayashi
,
R.
,
Kondo
,
E.
,
Tohyama
,
H.
,
Saito
,
T.
, and
Yasuda
,
K.
, 2008
, “
In Vivo Local Administration of Osteogenic Protein-1 Increases Structural Properties of the Overstretched Anterior Cruciate Ligament With Partial Midsubstance Laceration - A Biomechanical Study in Rabbits
,” J. Bone Jt. Surg. Br.
,
90b
(10
), pp. 1392
–1400
.10.1302/0301-620X.90B10.2092413.
Lopez
,
M. J.
,
Robinson
,
S. O.
,
Quinn
,
M. M.
,
Hosgood
,
G.
, and
Markel
,
M. D.
, 2006
, “
In Vivo Evaluation of Intra-Articular Protection in a Novel Model of Canine Cranial Cruciate Ligament Mid-Substance Elongation Injury
,” Vet. Surg.
,
35
(8
), pp. 711
–720
.10.1111/j.1532-950X.2006.00215.x14.
Sommerlath
,
K.
,
Odensten
,
M.
, and
Lysholm
,
J.
, 1992
, “
The Late Course of Acute Partial Anterior Cruciate Ligament Tears - A 9-Year to 15-Year Follow-Up Evaluation
,” Clin. Orthop. Relat. Res.
,
281
, pp. 152
–158
.10.1097/00003086-199208000-0002515.
Kondo
,
E.
,
Yasuda
,
K.
,
Yamanaka
,
M.
,
Minami
,
A.
, and
Tohyama
,
H.
, 2003
, “
Biomechanical Evaluation of a Newly Devised Model for the Elongation-Type Anterior Cruciate Ligament Injury With Partial Laceration and Permanent Elongation
,” Clin. Biomech.
,
18
(10
), pp. 942
–949
.10.1016/S0268-0033(03)00171-216.
Andriacchi
,
T. P.
, and
Dyrby
,
C. O.
, 2005
, “
Interactions Between Kinematics and Loading During Walking for the Normal and ACL Deficient Knee
,” J. Biomech.
,
38
(2
), pp. 293
–298
.10.1016/j.jbiomech.2004.02.01017.
DeFrate
,
L. E.
,
Papannagari
,
R.
,
Gill
,
T. J.
,
Moses
,
J. M.
,
Pathare
,
N. P.
, and
Li
,
G.
, 2006
, “
The 6 Degrees of Freedom Kinematics of the Knee After Anterior Cruciate Ligament Deficiency - An In Vivo Imaging Analysis
,” Am. J. Sport Med.
,
34
(8
), pp. 1240
–1246
.10.1177/036354650628729918.
Rangger
,
C.
,
Daniel
,
D. M.
,
Stone
,
M. L.
, and
Kaufman
,
K.
, 1993
, “
Diagnosis of an ACL Disruption With KT-1000 Arthrometer Measurements
,” Knee Surg. Sports Traumatol. Arthrosc.
,
1
(1
), pp. 60
–66
.10.1007/BF0155216119.
Gao
,
B.
, and
Zheng
,
N. Q.
, 2010
, “
Alterations in Three-Dimensional Joint Kinematics of Anterior Cruciate Ligament-Deficient and -Reconstructed Knees During Walking
,” Clin. Biomech.
,
25
(3
), pp. 222
–229
.10.1016/j.clinbiomech.2009.11.00620.
Zhang
,
L. Q.
,
Shiavi
,
R. G.
,
Limbird
,
T. J.
, and
Minorik
,
J. M.
, 2003
, “
Six Degrees-of-Freedom Kinematics of ACL Deficient Knees During Locomotion-Compensatory Mechanism
,” Gait Posture
,
17
(1
), pp. 34
–42
.10.1016/S0966-6362(02)00052-821.
Kocher
,
M. S.
,
Micheli
,
L. J.
,
Zurakowski
,
D.
, and
Luke
,
A.
, 2002
, “
Partial Tears of the Anterior Cruciate Ligament in Children and Adolescents
,” Am. J. Sport Med.
,
30
(5
), pp. 697
–703
.10.1177/0363546502030005120122.
Colombet
,
P.
,
Dejour
,
D.
,
Panisset
,
J. C.
,
Siebold
,
R.
, and
French Arthroscopy
,
S.
, 2010
, “
Current Concept of Partial Anterior Cruciate Ligament Ruptures
,” Orthop. Traumatol. Surg. Res.
,
96
(8
), pp. S109
–S118
.10.1016/j.otsr.2010.09.00323.
Noyes
,
F. R.
,
Mooar
,
L. A.
,
Moorman
,
C. T.
, and
Mcginniss
,
G. H.
, 1989
, “
Partial Tears of the Anterior Cruciate Ligament - Progression to Complete Ligament Deficiency
,” J. Bone Jt. Surg. Br.
,
71-B
(5
), pp. 825
–833
.10.1302/0301-620X.71B5.258425524.
Barrack
,
R. L.
,
Buckley
,
S. L.
,
Bruckner
,
J. D.
,
Kneisl
,
J. S.
, and
Alexander
,
A. H.
, 1990
, “
Partial Versus Complete Acute Anterior Cruciate Ligament Tears. The Results of Nonoperative Treatment
,” J. Bone Jt. Surg. Br.
,
72-B
(4
), pp. 622
–624
.10.1302/0301-620X.72B4.238021625.
Li
,
G.
,
Suggs
,
J.
, and
Gill
,
T.
, 2002
, “
The Effect of Anterior Cruciate Ligament Injury on Knee Joint Function Under a Simulated Muscle Load: A Three-Dimensional Computational Simulation
,” Ann. Biomed. Eng.
,
30
(5
), pp. 713
–720
.10.1114/1.148421926.
Borbon
,
C. A.
,
Mouzopoulos
,
G.
, and
Siebold
,
R.
, 2012
, “
Why Perform an ACL Augmentation?
,” Knee Surg. Sport Trautmatol. Arthos.
,
20
(2
), pp. 245
–251
.10.1007/s00167-011-1565-227.
Buda
,
R.
,
Di Caprio
,
F.
,
Giuriati
,
L.
,
Luciani
,
D.
,
Busacca
,
M.
, and
Giannini
,
S.
, 2008
, “
Partial ACL Tears Augmented With Distally Inserted Hamstring Tendons and Over-the-Top Fixation: An MRI Evaluation
,” Knee
,
15
(2
), pp. 111
–116
.10.1016/j.knee.2007.12.00228.
Mansouri
,
M.
,
Clark
,
A. E.
,
Seth
,
A.
, and
Reinbolt
,
J. A.
, 2016
, “
Rectus Femoris Transfer Surgery Affects Balance Recovery in Children With Cerebral Palsy: A Computer Simulation Study
,” Gait Posture
,
43
, pp. 24
–30
.10.1016/j.gaitpost.2015.08.01629.
Purevsuren
,
T.
,
Kim
,
K.
,
Nha
,
K. W.
, and
Kim
,
Y. H.
, 2016
, “
Evaluation of Compressive and Shear Joint Forces on Medial and Lateral Compartments in Knee Joint During Walking Before and After Medial Open-Wedge High Tibial Osteotomy
,” Int. J. Precis. Eng. Manuf.
,
17
(10
), pp. 1365
–1370
.10.1007/s12541-016-0162-130.
Reinbolt
,
J. A.
,
Haftka
,
R. T.
,
Chmielewski
,
T. L.
, and
Fregly
,
B. J.
, 2008
, “
A Computational Framework to Predict Post-Treatment Outcome for Gait-Related Disorders
,” Med. Eng. Phys.
,
30
(4
), pp. 434
–443
.10.1016/j.medengphy.2007.05.00531.
Shelburne
,
K. B.
,
Pandy
,
M. G.
,
Anderson
,
F. C.
, and
Torry
,
M. R.
, 2004
, “
Pattern of Anterior Cruciate Ligament Force in Normal Walking
,” J. Biomech.
,
37
(6
), pp. 797
–805
.10.1016/j.jbiomech.2003.10.01032.
Koo
,
Y. J.
,
Jung
,
Y.
,
Seon
,
J. K.
, and
Koo
,
S.
, 2020
, “
Anatomical ACL Reconstruction Can Restore the Natural Knee Kinematics Than Isometric ACL Reconstruction During the Stance Phase of Walking
,” Int J Precis Eng Man
,
21
(6
), pp. 1127
–1134
.10.1007/s12541-020-00319-733.
Harris
,
M. D.
,
Cyr
,
A. J.
,
Ali
,
A. A.
,
Fitzpatrick
,
C. K.
,
Rullkoetter
,
P. J.
,
Maletsky
,
L. P.
, and
Shelburne
,
K. B.
, 2016
, “
A Combined Experimental and Computational Approach to Subject-Specific Analysis of Knee Joint Laxity
,” ASME J. Biomech. Eng.
,
138
(8
), p. 081004
.10.1115/1.403388234.
Thelen
,
D. G.
,
Won Choi
,
K.
, and
Schmitz
,
A. M.
, 2014
, “
Co-Simulation of Neuromuscular Dynamics and Knee Mechanics During Human Walking
,” ASME J. Biomech. Eng.
,
136
(2
), p. 021033
.10.1115/1.402635835.
Marra
,
M. A.
,
Vanheule
,
V.
,
Fluit
,
R.
,
Koopman
,
B. H. F. J. M.
,
Rasmussen
,
J.
,
Verdonschot
,
N.
, and
Andersen
,
M. S.
, 2015
, “
A Subject-Specific Musculoskeletal Modeling Framework to Predict In Vivo Mechanics of Total Knee Arthroplasty
,” ASME J. Biomech. Eng.
, 137(2), p. 020904
.10.1115/1.402925836.
Kondo
,
E.
,
Yasuda
,
K.
,
Yamanaka
,
M.
,
Minami
,
A.
, and
Tohyama
,
H.
, 2005
, “
Effects of Administration of Exogenous Growth Factors on Biomechanical Properties of the Elongation-Type Anterior Cruciate Ligament Injury With Partial Laceration
,” Am. J. Sport Med.
,
33
(2
), pp. 188
–196
.10.1177/036354650426697937.
Homyk
,
A.
,
Orsi
,
A.
,
Wibby
,
S.
,
Yang
,
N.
,
Nayeb-Hashemi
,
H.
, and
Canavan
,
P. K.
, 2012
, “
Failure Locus of the Anterior Cruciate Ligament: 3D Finite Element Analysis
,” Comput. Method Biomech.
,
15
(8
), pp. 865
–874
.10.1080/10255842.2011.56541238.
Karakilic
,
B.
,
Taskiran
,
E.
,
Doganavsargil
,
B.
,
Uzun
,
B.
,
Celik
,
S.
, and
Bicer
,
E. K.
, 2015
, “
Central Defect Type Partial ACL Injury Model on Goat Knees: The Effect of Infrapatellar Fat Pad Excision
,” J. Orthop. Surg. Res.
,
10
(1
), pp. 1
–8
.10.1186/s13018-015-0281-x39.
Gupta
,
R.
,
Kapoor
,
A.
,
Mittal
,
N.
,
Soni
,
A.
,
Khatri
,
S.
, and
Masih
,
G. D.
, 2018
, “
The Role of Meniscal Tears and Meniscectomy in the Mechanical Stability of the Anterior Cruciate Ligament Deficient Knee
,” Knee
,
25
(6
), pp. 1051
–1056
.10.1016/j.knee.2018.09.00740.
Blankevoort
,
L.
, and
Huiskes
,
R.
, 1991
, “
Ligament-Bone Interaction in a Three-Dimensional Model of the Knee
,” ASME J. Biomech. Eng.
,
113
(3
), pp. 263
–269
.10.1115/1.289488341.
Baldwin
,
M. A.
,
Clary
,
C.
,
Maletsky
,
L. P.
, and
Rullkoetter
,
P. J.
, 2009
, “
Verification of Predicted Specimen-Specific Natural and Implanted Patellofemoral Kinematics During Simulated Deep Knee Bend
,” J. Biomech.
,
42
(14
), pp. 2341
–2348
.10.1016/j.jbiomech.2009.06.02842.
Andersen
,
M. S.
,
de Zee
,
M.
,
Damsgaard
,
M.
,
Nolte
,
D.
, and
Rasmussen
,
J.
, 2017
, “
Introduction to Force-Dependent Kinematics: Theory and Application to Mandible Modeling
,” ASME J. Biomech. Eng.
,
139
(9
), p. 091001
.10.1115/1.403710043.
Damsgaard
,
M.
,
Rasmussen
,
J.
,
Christensen
,
S. T.
,
Surma
,
E.
, and
de Zee
,
M.
, 2006
, “
Analysis of Musculoskeletal Systems in the AnyBody Modeling System
,” Simul. Model. Pract. Ther.
,
14
(8
), pp. 1100
–1111
.10.1016/j.simpat.2006.09.00144.
Jonsson
,
H.
,
Karrholm
,
J.
, and
Elmqvist
,
L. G.
, 1993
, “
Laxity After Cruciate Ligament Injury in 94 Knees - the Kt-1000 Arthrometer Versus Roentgen Stereophotogrammetry
,” Acta Orthop. Scand.
,
64
(5
), pp. 567
–570
.10.3109/1745367930899369445.
Spong
,
M. W.
, and
Vidyasagar
,
M.
, 1989
, Robot Dynamics and Control
,
Wiley
,
New York
.46.
Wu
,
G.
, and
Cavanagh
,
P. R.
, 1995
, “
ISB Recommendations for Standardization in the Reporting of Kinematic Data
,” J. Biomech.
,
28
(10
), pp. 1257
–1261
.10.1016/0021-9290(95)00017-C47.
Bak
,
K.
,
Scavenius
,
M.
,
Hansen
,
S.
,
Norring
,
K.
,
Jensen
,
K. H.
, and
Jorgensen
,
U.
, 1997
, “
Isolated Partial Rupture of the Anterior Cruciate Ligament. Long-Term Follow-Up of 56 Cases
,” Knee Surg. Sports Traumatol. Arthrosc.
,
5
(2
), pp. 66
–71
.10.1007/s00167005002848.
Sandberg
,
R.
, and
Balkfors
,
B.
, 1987
, “
Partial Rupture of the Anterior Cruciate Ligament. Natural Course
,” Clin. Orthop. Relat. Res.
,
220
, pp. 176
–178
.https://pubmed.ncbi.nlm.nih.gov/3594988/49.
Cuppone
,
M.
, and
Seedhom
,
B. B.
, 2001
, “
Effect of Implant Lengthening and Mode of Fixation on Knee Laxity After ACL Reconstruction With an Artificial Ligament: A Cadaveric Study
,” J. Orthop. Sci.
,
6
(3
), pp. 253
–261
.10.1007/s00776010004450.
Grover
,
D.
,
Thompson
,
D.
,
Hull
,
M. L.
, and
Howell
,
S. M.
, 2006
, “
Empirical Relationship Between Lengthening an Anterior Cruciate Ligament Graft and Increases in Knee Anterior Laxity: A Human Cadaveric Study
,” ASME J. Biomech. Eng.
,
128
(6
), pp. 969
–972
.10.1115/1.237893151.
Hollis
,
J. M.
,
Takai
,
S.
,
Adams
,
D. J.
,
Horibe
,
S.
, and
Woo
,
S. L. Y.
, 1991
, “
The Effects of Knee Motion and External Loading on the Length of the Anterior Cruciate Ligament (Acl) - A Kinematic Study
,” ASME J. Biomech. Eng.
,
113
(2
), pp. 208
–214
.10.1115/1.289123652.
Taylor
,
K. A.
,
Cutcliffe
,
H. C.
,
Queen
,
R. M.
,
Utturkar
,
G. M.
,
Spritzer
,
C. E.
,
Garrett
,
W. E.
, and
DeFrate
,
L. E.
, 2013
, “
In Vivo Measurement of ACL Length and Relative Strain During Walking
,” J. Biomech.
,
46
(3
), pp. 478
–483
.10.1016/j.jbiomech.2012.10.03153.
Faul
,
F.
,
Erdfelder
,
E.
,
Lang
,
A. G.
, and
Buchner
,
A.
, 2007
, “
G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences
,” Behav. Res. Methods
,
39
(2
), pp. 175
–191
.10.3758/BF0319314654.
Mcgraw
,
K. O.
, and
Wong
,
S. P.
, 1992
, “
A Common Language Effect Size Statistic
,” Psychol. Bull.
,
111
(2
), pp. 361
–365
.10.1037/0033-2909.111.2.36155.
Siebold
,
R.
, and
Fu
,
F. H.
, 2008
, “
Assessment and Augmentation of Symptomatic Anteromedial or Posterolateral Bundle Tears of the Anterior Cruciate Ligament
,” Arthrosc. J. Arthrosc. Relat. Surg.
,
24
(11
), pp. 1289
–1298
.10.1016/j.arthro.2008.06.01656.
Yasuda
,
K.
,
van Eck
,
C. F.
,
Hoshino
,
Y.
,
Fu
,
F. H.
, and
Tashman
,
S.
, 2011
, “
Anatomic Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction, Part 1 Basic Science
,” Am. J. Sport Med.
,
39
(8
), pp. 1789
–1799
.10.1177/0363546511402659Copyright © 2023 by ASME
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