Anterior laxity, lateral tibial slope, and in situ ACL force differentiate knees exhibiting distinct patterns of motion during a pivoting event: A human cadaveric study.

Autor: Kent RN 3rd; Department of Biomechanics, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States. Electronic address: rnkent@umich.edu., Amirtharaj MJ; Department of Biomechanics, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States., Hardy BM; Department of Biomechanics, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States., Pearle AD; Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States., Wickiewicz TL; Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States., Imhauser CW; Department of Biomechanics, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States.
Jazyk: angličtina
Zdroj: Journal of biomechanics [J Biomech] 2018 Jun 06; Vol. 74, pp. 9-15. Date of Electronic Publication: 2018 Apr 11.
DOI: 10.1016/j.jbiomech.2018.04.002
Abstrakt: Knee instability following anterior cruciate ligament (ACL) rupture compromises function and increases risk of injury to the cartilage and menisci. To understand the biomechanical function of the ACL, previous studies have primarily reported the net change in tibial position in response to multiplanar torques, which generate knee instability. In contrast, we retrospectively analyzed a cohort of 13 consecutively tested cadaveric knees and found distinct motion patterns, defined as the motion of the tibia as it translates and rotates from its unloaded, initial position to its loaded, final position. Specifically, ACL-sectioned knees either subluxated anteriorly under valgus torque (VL-subluxating) (5 knees) or under a combination of valgus and internal rotational torques (VL/IR-subluxating) (8 knees), which were applied at 15 and 30° flexion using a robotic manipulator. The purpose of this study was to identify differences between these knees that could be driving the two distinct motion patterns. Therefore, we asked whether parameters of bony geometry and tibiofemoral laxity (known risk factors of non-contact ACL injury) as well as in situ ACL force, when it was intact, differentiate knees in these two groups. VL-subluxating knees exhibited greater sagittal slope of the lateral tibia by 3.6 ± 2.4° (p = 0.003); less change in anterior laxity after ACL-sectioning during a simulated Lachman test by 3.2 ± 3.2 mm (p = 0.006); and, at the peak applied valgus torque (no internal rotation torque), higher posteriorly directed, in situ ACL force by 13.4 ± 11.3 N and 12.0 ± 11.6 N at 15° and 30° of flexion, respectively (both p ≤ 0.03). These results may suggest that subgroups of knees depend more on their ACL to control lateral tibial subluxation in response to uniplanar valgus and multiplanar valgus and internal rotation torques as mediated by anterior laxity and bony morphology.
(Copyright © 2018 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: