Valgus Plus Internal Rotation Moments Increase Anterior Cruciate Ligament Strain More Than Either Alone
ABSTRACT To test the influence of combined knee valgus and internal tibial rotation moment on anterior cruciate ligament (ACL) strain during single-leg landing. We tested the following hypotheses: the combination of the valgus and internal rotation moments observed during single-leg landing produces a higher ACL strain than either moment applied individually, the combined rotational moments at the physiological levels observed could theoretically increase strain in the ACL high enough to rupture the ACL, and the location of the peak contact force was at the posterior-lateral side for combined loading.
The study was conducted by applying in vivo human loading data to a validated simulation model of the three-dimensional dynamic knee joint to predict ACL strains.
The peak ACL strain increased nonlinearly when either applied valgus moment or internal rotation moment was increased in the model. When the two rotational moments were applied individually, neither caused ACL strain >0.077. However, when applied in combination, the two rotational moments had a much larger effect, and the predicted peak ACL strain increased up to 0.105. During landing, the peak contact force occurred at the posterior-lateral side of the tibial cartilage in the model when the combined maximum valgus moment and tibial internal rotation moments were applied.
Combined knee valgus and internal rotation moments increases ACL strain more than either alone. The combination of a valgus and internal rotational moment at magnitudes that occurs in vivo during landing can cause ACL strains that may be high enough to cause ACL rupture. This predicted high ACL strain and the contact force location suggest that combined valgus and internal tibial rotational moments during single-leg landing are relevant to ACL injuries.
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ABSTRACT: Cutting is necessary for participation in multidirectional sports but is also associated with non-contact ACL injury. Whole body demands of deceleration and redirection increase with greater cut angles. However, it is not known how these demands relate to differences in joint and segmental mechanics. Understanding the relationship between whole body and joint mechanics necessary for cutting and those related to risk for injury is important for the development of injury prevention training programs. The purpose of this study is to determine how joint and segmental mechanics change to meet increasing deceleration and redirection demands during cutting. Lower limb and trunk kinematics and kinetics were evaluated during the execution of two sidestep cutting maneuvers (to 45 and 90 degrees) in twenty-five healthy soccer players. A two-way multi-variate analysis of covariance (MANCOVA) determined that differences existed between task directions but not sexes when considering all dependent variables and covarying for approach velocity (α ≤0.05). Post-hoc analyses revealed that the larger deceleration and redirection demands of the 90-degree cut did not translate into larger angles, moments and power across all lower extremity joints. In the sagittal plane, the knee appeared to primarily accommodate the greater deceleration demands of the sharper cut. These data further suggest that the hip may play a different role during cutting to smaller and larger angles and also illustrate a pattern of engagement in the sagittal and frontal planes that has not been described previously.Gait & Posture 01/2014; 41(1). DOI:10.1016/j.gaitpost.2014.08.005 · 2.30 Impact Factor
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ABSTRACT: Many factors contributing to anterior cruciate ligament (ACL) injury risk have been investigated. Recently, some ACL-injured individuals have presented with a decreased range of hip internal rotation compared with controls. The pathomechanics of why decreased hip range of motion increases risk of ACL injury have not yet been studied.The American Journal of Sports Medicine 09/2014; DOI:10.1177/0363546514549446 · 4.70 Impact Factor