Subscribe to RSS
DOI: 10.1055/s-0037-1603799
Biomechanics of Knee Joints after Anterior Cruciate Ligament Reconstruction
Publication History
07 February 2017
02 May 2017
Publication Date:
30 June 2017 (online)
![](https://www.thieme-connect.de/media/jks/201804/lookinside/thumbnails/10-1055-s-0037-1603799_170025oa-1.jpg)
Abstract
This study aimed to investigate the biomechanical properties of anterior cruciate ligament (ACL); tibial, femoral articular cartilage; and meniscus in knee joints receiving computer-aided or conventional ACL reconstruction. Three-dimensional (3D) knee joint finite element models were established for healthy volunteers (normal group) and patients receiving computer-aided surgery (CAS) or conventional (traditional surgery [TS]) ACL reconstruction. The stress and stress distribution on the ACL, tibial, femoral articular cartilage, and meniscus were examined after force was applied on the 3D knee joint finite element models. No significant differences were observed in the stress on ACL among normal group, CAS group, and TS group when a femoral backward force was loaded. However, when a vertical force of 350 N was loaded on the knee joints, TS group had significant higher stress on the articular cartilage and meniscus than the other two groups at any flexion angle of 0, 30, 60, and 90 degrees. However, no significant differences were observed between CAS group and normal group. In conclusion, computer-aided ACL reconstruction has advantages over conventional surgery approach in restoring the biomechanical properties of knee joints, thus reducing the risk of damage to the knee joint cartilage and meniscus after ACL reconstruction.
* The authors Chuan He, Wu He, and Yanlin Li contributed equally to the article.
-
References
- 1 Feucht MJ, Cotic M, Saier T. , et al. Patient expectations of primary and revision anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2016; 24 (01) 201-207
- 2 Pietrosimone B, Blackburn JT, Harkey MS. , et al. Greater mechanical loading during walking is associated with less collagen turnover in individuals with anterior cruciate ligament reconstruction. Am J Sports Med 2016; 44 (02) 425-432
- 3 Risberg MA, Oiestad BE, Gunderson R. , et al. Changes in knee osteoarthritis, symptoms, and function after anterior cruciate ligament reconstruction: a 20-year prospective follow-up study. Am J Sports Med 2016; 44 (05) 1215-1224
- 4 Marriott K, Birmingham TB, Kean CO, Hui C, Jenkyn TR, Giffin JR. Five-year changes in gait biomechanics after concomitant high tibial osteotomy and ACL reconstruction in patients with medial knee osteoarthritis. Am J Sports Med 2015; 43 (09) 2277-2285
- 5 Wright RW, Gill CS, Chen L. , et al. Outcome of revision anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am 2012; 94 (06) 531-536
- 6 Van Ginckel A, Verdonk P, Witvrouw E. Cartilage adaptation after anterior cruciate ligament injury and reconstruction: implications for clinical management and research? A systematic review of longitudinal MRI studies. Osteoarthritis Cartilage 2013; 21 (08) 1009-1024
- 7 Li G, Lopez O, Rubash H. Variability of a three-dimensional finite element model constructed using magnetic resonance images of a knee for joint contact stress analysis. J Biomech Eng 2001; 123 (04) 341-346
- 8 LeRoux MA, Setton LA. Experimental and biphasic FEM determinations of the material properties and hydraulic permeability of the meniscus in tension. J Biomech Eng 2002; 124 (03) 315-321
- 9 Homyk A, Orsi A, Wibby S, Yang N, Nayeb-Hashemi H, Canavan PK. Failure locus of the anterior cruciate ligament: 3D finite element analysis. Comput Methods Biomech Biomed Engin 2012; 15 (08) 865-874
- 10 Yang NH, Nayeb-Hashemi H, Canavan PK, Vaziri A. Effect of frontal plane tibiofemoral angle on the stress and strain at the knee cartilage during the stance phase of gait. J Orthop Res 2010; 28 (12) 1539-1547
- 11 Yao J, Snibbe J, Maloney M, Lerner AL. Stresses and strains in the medial meniscus of an ACL deficient knee under anterior loading: a finite element analysis with image-based experimental validation. J Biomech Eng 2006; 128 (01) 135-141
- 12 Gabriel MT, Wong EK, Woo SLY, Yagi M, Debski RE. Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads. J Orthop Res 2004; 22 (01) 85-89
- 13 Zhang X, Jiang G, Wu C, Woo SLY. A subject-specific finite element model of the anterior cruciate ligament. Conf Proc IEEE Eng Med Biol Soc 2008; 2008: 891-894
- 14 Suggs JF, Li G, Park SE, Steffensmeier S, Rubash HE, Freiberg AA. Function of the anterior cruciate ligament after unicompartmental knee arthroplasty: an in vitro robotic study. J Arthroplasty 2004; 19 (02) 224-229
- 15 Peña E, Calvo B, Martínez MA, Doblaré M. A three-dimensional finite element analysis of the combined behavior of ligaments and menisci in the healthy human knee joint. J Biomech 2006; 39 (09) 1686-1701
- 16 Hosseini A, Van de Velde S, Gill TJ, Li G. Tibiofemoral cartilage contact biomechanics in patients after reconstruction of a ruptured anterior cruciate ligament. J Orthop Res 2012; 30 (11) 1781-1788
- 17 Hosseini A, Van de Velde SK, Kozanek M. , et al. In-vivo time-dependent articular cartilage contact behavior of the tibiofemoral joint. Osteoarthritis Cartilage 2010; 18 (07) 909-916
- 18 Murrell GAC, Maddali S, Horovitz L, Oakley SP, Warren RF. The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss. Am J Sports Med 2001; 29 (01) 9-14
- 19 Kazemi M, Dabiri Y, Li LP. Recent advances in computational mechanics of the human knee joint. Comput Math Methods Med 2013; 2013: 718423
- 20 Guess TM, Liu H, Bhashyam S, Thiagarajan G. A multibody knee model with discrete cartilage prediction of tibio-femoral contact mechanics. Comput Methods Biomech Biomed Engin 2013; 16 (03) 256-270
- 21 Song Y, Debski RE, Musahl V, Thomas M, Woo SLY. A three-dimensional finite element model of the human anterior cruciate ligament: a computational analysis with experimental validation. J Biomech 2004; 37 (03) 383-390
- 22 Wan C, Hao Z, Wen S. The effect of the variation in ACL constitutive model on joint kinematics and biomechanics under different loads: a finite element study. J Biomech Eng 2013; 135 (04) 041002
- 23 Luites JW, Wymenga AB, Blankevoort L, Kooloos JG. Description of the attachment geometry of the anteromedial and posterolateral bundles of the ACL from arthroscopic perspective for anatomical tunnel placement. Knee Surg Sports Traumatol Arthrosc 2007; 15 (12) 1422-1431
- 24 Frank RM, Seroyer ST, Lewis PB, Bach Jr BR, Verma NN. MRI analysis of tibial position of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 2010; 18 (11) 1607-1611
- 25 Iriuchishima T, Ingham SJ, Tajima G. , et al. Evaluation of the tunnel placement in the anatomical double-bundle ACL reconstruction: a cadaver study. Knee Surg Sports Traumatol Arthrosc 2010; 18 (09) 1226-1231
- 26 Colombet P, Robinson J, Christel P. , et al. Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 2006; 22 (09) 984-992
- 27 Dargel J, Pohl P, Tzikaras P, Koebke J. Morphometric side-to-side differences in human cruciate ligament insertions. Surg Radiol Anat 2006; 28 (04) 398-402
- 28 Zhu W, Lu W, Han Y. , et al. Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction. Int Orthop 2013; 37 (02) 233-238