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CHANGES IN LENGTHS OF ANTERIOR CRUCIATE LIGAMENT FIBRES DURING TIBIAL TRANSLATION AT THE KNEE
Ahmed Imran
Ajman University of Science and Technology, Ajman, UAE.
Introduction
At the knee joint, anterior cruciate ligament (ACL)
is the primary restrain to anterior tibial translation
(ATT) relative to femur. Experimental studies have
recorded the variation of ATT due to applied
anterior loads on tibia at selected flexion angles
[Lo, 2011]. Depending on the relative positions of
the two bones, some fibres in the ACL can stretch
while others can slacken. Therefore, it is important
to study the state of different fibres of the ligament
during any specific motion.
In the present study a mathematical model of the
knee is used to analyze the patterns of ACL fibre
length changes resulting from ATT at several
flexion angles of the joint.
Methods
The knee was modelled in the sagittal plane with
cruciate and collateral ligaments represented as
bundles of non-linear elastic fibres. The articular
surfaces were assumed to be frictionless and
impenetrable. Passive motion of the joint was
defined during 0–120o flexion such that selected
fibres in the cruciate ligaments remained isometric.
Anatomical data and material properties of the
ligaments were taken from literature [Zavatsky,
1992]
An anterior laxity test was simulated at selected
flexion positions by applying 130N anterior force
on tibia along with a balancing moment to maintain
joint angle. Distance between bony attachments of
a ligament fibre gave its length. In comparison to
reference lengths defined at 0o flexion, a fibre
stretched if its length increased and slackened if its
length decreased. During passive flexion and with
ATT, changes in the fibre lengths were calculated
for three fibres as percentage of their respective
reference lengths – anterior (dLa), intermediate
(dLi) and posterior (dLp).
Results and Analysis
Figure 1 shows results of the simulated laxity test
and comparison with mean values from
experimental observations on intact cadaver knees
[Lo, 2011]. The ATT first increased for 0–45o range
and then decreased in higher flexion. The
calculations agree reasoably with the experiment.
Figure 2 shows the calculated % change in lengths,
dLa, dLi and dLp, for the three ligament fibres.
During passive motion, the anterior fibre remained
just taut, while the intermediate and posterior fibres
were slack. Further, with ATT due to 130N test, the
anterior fibre remained stretched for all flexion
angles; the middle fibre stretched till 60o and then
at 120o; The posterior fibre stretched only at 120o.
In vitro experimental observations during passive
flexion show that the antero-medial bundle of the
ACL was first slack and then tight in flexion, while
the intermediate and postero-lateral bundles
remained slack relative to 0o flexion [Amis, 1991].
Figure 1: Anterior tibial translation (ATT) over the
flexion range. ‘×’ show standard deviation.
Figure 2: ACL fibre length changes (%) calculated
during passive flexion (dashed lines) and with ATT
due to 130N laxity test (continuous lines).
Conclusions
Lengths of the ACL fibres showed variation with
flexion angle and with tibial translation. Such
changes suggest that the ligament injuries can affect
different fibres depending on the joint position at
the time of injury. The model results agree
qualitatively with the experimental observations.
References
Amis et al, J Bone Jt. Surg. 73B(2): 260–267, 1991.
Lo JH et al, The Knee, 18(6):491–495, 2011.
Zavatsky et al, J Engg in Med. 206: 125–134, 1992.
Presentation 1192 − Topic 29. Knee biomechanics S373
ESB2012: 18th Congress of the European Society of Biomechanics Journal of Biomechanics 45(S1)