Dataset Information

Knee biomechanics during a jump-cut maneuver: effects of sex and ACL surgery.

ABSTRACT: The purpose of this study was to compare kinetic and knee kinematic measurements from male and female anterior cruciate ligament (ACL)-intact (ACLINT) and ACL-reconstructed (ACLREC) subjects during a jump-cut maneuver using biplanar videoradiography.Twenty subjects were recruited; 10 ACLINT (5 men and 5 women) and 10 ACLREC (4 men and 6 women, 5 yr postsurgery). Each subject performed a jump-cut maneuver by landing on a single leg and performing a 45° side-step cut. Ground reaction force (GRF) was measured by a force plate and expressed relative to body weight. Six-degree-of-freedom knee kinematics were determined from a biplanar videoradiography system and an optical motion capture system.ACLINT female subjects landed with a larger peak vertical GRF (P < 0.001) compared with ACLINT male subjects. ACLINT subjects landed with a larger peak vertical GRF (P ? 0.036) compared with ACLREC subjects. Regardless of ACL reconstruction status, female subjects underwent less knee flexion angle excursion (P = 0.002) and had an increased average rate of anterior tibial translation (0.05%·ms ± 0.01%·ms, P = 0.037) after contact compared with male subjects. Furthermore, ACLREC subjects had a lower rate of anterior tibial translation compared with ACLINT subjects (0.05%·ms ± 0.01%·ms, P = 0.035). Finally, no striking differences were observed in other knee motion parameters.Women permit a smaller amount of knee flexion angle excursion during a jump-cut maneuver, resulting in a larger peak vertical GRF and increased rate of anterior tibial translation. Notably, ACLREC subjects also perform the jump cut maneuver with lower GRF than ACLINT subjects 5 yr postsurgery. This study proposes a causal sequence whereby increased landing stiffness (larger peak vertical GRF combined with less knee flexion angle excursion) leads to an increased rate of anterior tibial translation while performing a jump-cut maneuver.

SUBMITTER: Miranda DL

PROVIDER: S-EPMC3594620 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Knee biomechanics during a jump-cut maneuver: effects of sex and ACL surgery.

Miranda Daniel L DL Fadale Paul D PD Hulstyn Michael J MJ Shalvoy Robert M RM Machan Jason T JT Fleming Braden C BC

Medicine and science in sports and exercise 20130501 5

<h4>Purpose</h4>The purpose of this study was to compare kinetic and knee kinematic measurements from male and female anterior cruciate ligament (ACL)-intact (ACLINT) and ACL-reconstructed (ACLREC) subjects during a jump-cut maneuver using biplanar videoradiography.<h4>Methods</h4>Twenty subjects were recruited; 10 ACLINT (5 men and 5 women) and 10 ACLREC (4 men and 6 women, 5 yr postsurgery). Each subject performed a jump-cut maneuver by landing on a single leg and performing a 45° side-step cu ...[more]

PMID: 23190595

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Project description:BackgroundLittle is known about knee mechanics and muscle control after augmented ACL repair. Our aim was to compare knee biomechanics and leg muscle activity during walking between the legs of patients 2 years after InternalBraceTM-augmented anterior cruciate ligament repair (ACL-IB) and between patients after ACL-IB and ACL reconstruction (ACL-R), and controls.MethodsTwenty-nine ACL-IB, 27 sex- and age-matched ACL-R (hamstring tendon autograft) and 29 matched controls completed an instrumented gait analysis. Knee joint angles, moments, power, and leg muscle activity were compared between the involved and uninvolved leg in ACL-IB (paired t-tests), and between the involved legs in ACL patients and the non-dominant leg in controls (analysis of variance and posthoc Bonferroni tests) using statistical parametric mapping (SPM, P < 0.05). Means and 95% confidence intervals (CI) of differences in discrete parameters (DP; i.e., maximum/minimum) were calculated.ResultsSignificant differences were observed in ACL-IB only in minimum knee flexion angle (DP: 2.4°, CI [-4.4;-0.5]; involved > uninvolved) and maximum knee flexion moment during stance (-0.07Nm/kg, CI [-0.13;-0.00]; involved < uninvolved), and differences between ACL-IB and ACL-R only in maximum knee flexion during swing (DP: 3.6°, CI [0.5;7.0]; ACL-IB > ACL-R). Compared to controls, ACL-IB (SPM: 0-3%GC, P = 0.015; 98-100%, P = 0.016; DP: -6.3 mm, CI [-11.7;-0.8]) and ACL-R (DP: -6.0 mm, CI [-11.4;-0.2]) had lower (maximum) anterior tibia position around heel strike. ACL-R also had lower maximum knee extension moment (DP: -0.13Nm/kg, CI [-0.23;-0.02]) and internal knee rotation moment (SPM: 34-41%GC, P < 0.001; DP: -0.03Nm/kg, CI [-0.06;-0.00]) during stance, and greater maximum semitendinosus activity before heel strike (DP: 11.2%maximum voluntary contraction, CI [0.1;21.3]) than controls.ConclusionOur results suggest comparable ambulatory knee function 2 years after ACL-IB and ACL-R, with ACL-IB showing only small differences between legs. However, the differences between both ACL groups and controls suggest that function in the involved leg is not fully recovered and that ACL tear is not only a mechanical disruption but also affects the sensorimotor integrity, which may not be restored after surgery. The trend toward fewer abnormalities in knee moments and semitendinosus muscle function during walking after ACL-IB warrants further investigation and may underscore the importance of preserving the hamstring muscles as ACL agonists.Level of evidenceLevel III, case-control study.Trial registrationclinicaltrials.gov, NCT04429165 (12/06/2020).

Project description:PurposeGreater femoral internal rotation (via anteversion or passive hip ROM) is associated with knee biomechanics thought to contribute to anterior cruciate ligament (ACL) injury, but it is unknown if femoral internal rotation contributes to actual ACL injury occurrence. The objective of this systematic review and meta-analysis was to quantify the extent to which femoral anteversion and hip range of motion (ROM) influence knee biomechanics consistent with ACL injury and actual ACL injury occurrence.MethodsUsing PRISMA guidelines, PubMed, CINAHL, SportDiscus, and Scopus databases were searched. Inclusion criteria were available passive hip ROM or femoral anteversion measure, ACL injury OR biomechanical analysis of functional task. Two reviewers independently reviewed titles, abstracts, and full texts when warranted. Included studies were submitted to Downs & Black Quality Assessment Tool. Meta-analyses were conducted for comparisons including at least two studies.ResultsTwenty-three studies were included (11 injury outcome, 12 biomechanical outcome). Decreased internal rotation ROM was significantly associated with history of ACL injury (MD -5.02°; 95% CI [-8.77°--1.27°]; p = 0.01; n = 10). There was no significant effect between passive external rotation and ACL injury (MD -2.62°; 95% CI [-5.66°-- 0.41°]; p = 0.09; n = 9) Participants displaying greater frontal plane knee projection angle had greater passive external rotation (MD 4.77°; 95% CI [1.17° - 8.37°]; p = 0.01; n = 3). There was no significant effect between femoral anteversion and ACL injury (MD -0.46°; 95% CI [-2.23°-1.31°]; p = 0.61; n = 2). No within-sex differences were observed between injured and uninjured males and females (p range = 0.09 - 0.63).ConclusionThough individuals with injured ACLs have statistically less passive internal and external rotation, the observed heterogeneity precludes generalizability. There is no evidence that femoral anteversion influences biomechanics or ACL injury. Well-designed studies using reliable methods are needed to investigate biomechanical patterns associated with more extreme ROM values within each sex, and their prospective associations with ACL injury.Level of evidenceIV.

Project description:Young female soccer players are at high risk of anterior cruciate ligament injury due to the fast-paced nature of the sport and surplus of unplanned movements during play. Neuromuscular training programs that aim to reduce this injury by targeting the associated biomechanical movements are a potential solution. While previous studies have examined the lack of dynamic knee control during landing, there are few that outline the role that maturation can play during unanticipated cutting. Therefore, the purpose of this study was to determine if young female soccer players across multiple phases of maturation exhibited the before seen differences in knee control during a drop landing as well as an unanticipated cutting task. 139 female soccer players volunteered to participate in this study and were classified in three maturational groups based on percent adult stature: prepubertal (PRE), pubertal (PUB), and post-pubertal (POST). Each group performed a drop vertical jump (DVJ) and an unanticipated cutting task (CUT). Standard 3D motion capture techniques were used to determine peak knee flexion/abduction angles and moments during each task. Within tasks, POST exhibited significantly greater peak abduction angles and moments compared to PUB/PRE. While each maturational group exhibited greater peak knee abduction angles during the DVJ compared to the CUT, peak knee abduction moments during the CUT were greater compared to the DVJ. Participants within each maturational group exhibited greater knee flexion during the DVJ compared to the CUT, however there were no differences identified between groups. During both tasks, POST/PUB exhibited greater peak knee flexion moments compared to PRE, as well as POST compared to PUB. Overall, each group exhibited significantly greater peak knee flexion moments during the CUT compared to the DVJ. These observed differences indicate the need for neuromuscular training programs that target both jumping and cutting techniques to reduce ACL injuries.

Project description:Background: Little is known about sex-based differences in anterior cruciate ligament (ACL) tissue quality in vivo or the association of ACL size (ie, volume) and tissue quality (ie, normalized signal intensity on magnetic resonance imaging [MRI]) with knee anatomy. Hypothesis: We hypothesized that (1) women have smaller ACLs and greater ACL normalized signal intensity compared with men, and (2) ACL size and normalized signal intensity are associated with age, activity levels, body mass index (BMI), bicondylar width, intercondylar notch width, and posterior slope of the lateral tibial plateau. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Knee MRI scans of 108 unique ACL-intact knees (19.7 ± 5.5 years, 62 women) were used to quantify the ACL signal intensity (normalized to cortical bone), ligament volume, mean cross-sectional area, and length. Independent t tests were used to compare the MRI-based ACL parameters between sexes. Univariate and multivariate linear regression analyses were used to investigate the associations between normalized signal intensity and size with age, activity levels, BMI, bicondylar width, notch width, and posterior slope of the lateral tibial plateau. Results: Compared with men, women had significantly smaller mean ACL volume (men vs women: 2028 ± 472 vs 1591 ± 405 mm3), cross-sectional area (49.4 ± 9.6 vs 41.5 ± 8.6 mm2), and length (40.8 ± 2.8 vs 38.1 ± 3.1 mm) (P < .001 for all), even after adjusting for BMI and bicondylar width. There was no difference in MRI signal intensity between men and women (1.15 ± 0.24 vs 1.12 ± 0.24, respectively; P = .555). BMI, bicondylar width, and intercondylar notch width were independently associated with a larger ACL (R2 > 0.16, P < .001). Younger age and steeper lateral tibial slope were independently associated with shorter ACL length (R2 > 0.03, P < .04). The combination of BMI and bicondylar width was predictive of ACL volume and mean cross-sectional area (R2 < 0.3). The combination of BMI, bicondylar width, and lateral tibial slope was predictive of ACL length (R2 = 0.39). Neither quantified patient characteristics nor anatomic variables were associated with signal intensity. Conclusion: Men had larger ACLs compared with women even after adjusting for BMI and knee size (bicondylar width). No sex difference was observed in signal intensity, suggesting no difference in tissue quality. The association of the intercondylar notch width and lateral tibial slope with ACL size suggests that the influence of these anatomic features on ACL injury risk may be partially explained by their effect on ACL size. Registration: NCT02292004 and NCT02664545 (ClinicalTrials.gov identifier).

Project description:Knee laxity increases during exercise. However, no one, to our knowledge, has examined whether these increases contribute to higher-risk landing biomechanics during prolonged, fatiguing exercise.To examine associations between changes in fatigue (measured as sprint time [SPTIME]), multiplanar knee laxity (anterior-posterior [APLAX], varus-valgus [VVLAX] knee laxity, and internal-external rotation [IERLAX]) knee laxity and landing biomechanics during prolonged, intermittent exercise.Descriptive laboratory study.Laboratory and gymnasium.A total of 30 male (age = 20.3 ± 2.0 years, height = 1.79 ± 0.05 m, mass = 75.2 ± 7.2 kg) and 29 female (age = 20.5 ± 2.3 years, height = 1.67 ± 0.08 m, mass = 61.8 ± 9.0 kg) competitive athletes.A 90-minute intermittent exercise protocol (IEP) designed to simulate the physiologic and biomechanical demands of a soccer match.We measured SPTIME, APLAX, and landing biomechanics before and after warm-up, every 15 minutes during the IEP, and every 15 minutes for 1 hour after the IEP. We measured VVLAX and IERLAX before and after the warm-up, at 45 and 90 minutes during the IEP, and at 30 minutes after the IEP. We used hierarchical linear modeling to examine associations between exercise-related changes in SPTIME and knee laxity with exercise-related changes in landing biomechanics while controlling for initial (before warm-up) knee laxity.We found that SPTIME had a more global effect on landing biomechanics in women than in men, resulting in a more upright landing and a reduction in landing forces and out-of-plane motions about the knee. As APLAX increased with exercise, women increased their knee internal-rotation motion (P = .02), and men increased their hip-flexion motion and energy-absorption (P = .006) and knee-extensor loads (P = .04). As VVLAX and IERLAX increased, women went through greater knee-valgus motion and dorsiflexion and absorbed more energy at the knee (P ≤ .05), whereas men were positioned in greater hip external and knee internal rotation and knee valgus throughout the landing (P = .03). The observed fatigue- and laxity-related changes in landing biomechanics during exercise often depended on initial knee laxity.Both exercise-related changes in fatigue and knee laxity were associated with higher-risk landing biomechanics during prolonged exercise. These relationships were more pronounced in participants with greater initial knee laxity.

Project description:While there are many opinions about the expected knee function, sports participation, and risk of knee reinjury following nonsurgical treatment of injuries of the anterior cruciate ligament (ACL), there is a lack of knowledge about the clinical course following nonsurgical treatment compared with that after surgical treatment.This prospective cohort study included 143 patients with an ACL injury. Isokinetic knee extension and flexion strength and patient-reported knee function as recorded on the International Knee Documentation Committee (IKDC) 2000 form were collected at baseline, six weeks, and two years. Sports participation was reported monthly for two years with use of an online activity survey. Knee reinjuries were reported at the follow-up evaluations and in a monthly online survey. Repeated analysis of variance (ANOVA), generalized estimating equation (GEE) models, and Cox regression analysis were used to analyze group differences in functional outcomes, sports participation, and knee reinjuries, respectively.The surgically treated patients (n = 100) were significantly younger, more likely to participate in level-I sports, and less likely to participate in level-II sports prior to injury than the nonsurgically treated patients (n = 43). There were no significant group-by-time effects on functional outcome. The crude analysis showed that surgically treated patients were more likely to sustain a knee reinjury and to participate in level-I sports in the second year of the follow-up period. After propensity score adjustment, these differences were nonsignificant; however, the nonsurgically treated patients were significantly more likely to participate in level-II sports during the first year of the follow-up period and in level-III sports over the two years. After two years, 30% of all patients had an extensor strength deficit, 31% had a flexor strength deficit, 20% had patient-reported knee function below the normal range, and 20% had experienced knee reinjury.There were few differences between the clinical courses following nonsurgical and surgical treatment of ACL injury in this prospective cohort study. Regardless of treatment course, a considerable number of patients did not fully recover following the ACL injury, and future work should focus on improving the outcomes for these patients.Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Dataset Information

Knee biomechanics during a jump-cut maneuver: effects of sex and ACL surgery.

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Knee biomechanics during a jump-cut maneuver: effects of sex and ACL surgery.

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