Uni-directional coupling between tibiofemoral frontal and axial plane rotation supports valgus collapse mechanism of ACL injury

JOURNAL OF BIOMECHANICS

卷:48

Article

Kiapour, Ata M.^1,2,3  Kiapour, Ali^2,3  Goel, Vijay K.^2,3  Quatman, Carmen E.^4,5  Wordeman, Samuel C.^4,6  Hewett, Timothy E.^4,5,6,7,8,9  Demetropoulos, Constantine K.¹⁰ 

[1] Harvard Univ, Sch Med, Boston Childrens Hosp, Sports Med Res Lab,Dept Orthopaed Surg, Boston, MA 02115 USA

[2] Univ Toledo, Engn Ctr Orthopaed Res Excellence, Dept Orthopaed, Toledo, OH 43606 USA

[3] Univ Toledo, Dept Bioengn, Toledo, OH 43606 USA

[4] Ohio State Univ, Sports Hlth & Performance Inst, Columbus, OH 43210 USA

[5] Ohio State Univ, Dept Orthopaed, Columbus, OH 43210 USA

[6] Ohio State Univ, Dept Biomed Engn, Columbus, OH 43210 USA

[7] Ohio State Univ, Dept Physiol, Columbus, OH 43210 USA

[8] Ohio State Univ, Dept Cell Biol, Family Med, Columbus, OH 43210 USA

[9] Ohio State Univ, Sch Hlth & Rehabil Sci, Columbus, OH 43210 USA

[10] Johns Hopkins Univ, Appl Phys Lab, Biomech & Injury Mitigat Syst, Res & Exploratory Dev Dept, Laurel, MD USA

关键词: Knee;    ACL;    Injury;    Valgus;    Coupling;   

DOI  :  10.1016/j.jbiomech.2015.05.017

来源: Elsevier

【 摘 要 】

Despite general agreement on the effects of knee valgus and internal tibial rotation on anterior cruciate ligament (ACL) loading, compelling debate persists on the interrelationship between these rotations and how they contribute to the multi-planar ACL injury mechanism. This study investigates coupling between knee valgus and internal tibial rotation and their effects on ACL strain as a quantifiable measure of injury risk. Nineteen instrumented cadaveric legs were imaged and tested under a range of knee valgus and internal tibial torques. Posterior tibial slope and the medial tibial depth, along with changes in tibiofemoral kinematics and ACL strain, were quantified. Valgus torque significantly increased knee valgus rotation and ACL strain (p <0.020), yet generated minimal coupled internal tibial rotation (p=0.537). Applied internal tibial torque significantly increased internal tibial rotation and ACL strain and generated significant coupled knee valgus rotation (p < 0.001 for all comparisons). Similar knee valgus rotations (7.3 degrees vs 7.4 degrees) and ACL strain levels (4.4% vs 4.9%) were observed under 50 Nm of valgus and 20 Nm of internal tibial torques, respectively. Coupled knee valgus rotation under 20 Nm of internal tibial torque was significantly correlated with internal tibial rotation, lateral and medial tibial slopes, and medial tibial depth (R-2 > 0.30; p < 0.020). These findings demonstrate uni-directional coupling between knee valgus and internal tibial rotation in a cadaveric model. Although both knee valgus and internal tibial torques contribute to increased ACL strain, knee valgus rotation has the ultimate impact on ACL strain regardless of loading mode. (C) 2015 Elsevier Ltd. All rights reserved.

【 授权许可】

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