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Frontal Plane Loading Characteristics of Medial Collateral Ligament Strain Concurrent With Anterior Cruciate Ligament Failure
- Source :
- Am J Sports Med
- Publication Year :
- 2019
- Publisher :
- SAGE Publications, 2019.
-
Abstract
- Background: Both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) bear load during athletic tasks of landing, cutting, pivoting, and twisting. As dynamic knee valgus is a purported mechanism for ACL injury, the MCL should bear significant strain load with valgus force. Hypothesis: The intact MCL will demonstrate a significant increase in strain upon failure of the ACL at 25° of knee flexion. Study Design: Controlled laboratory study. Methods: In vivo kinetics/kinematics of 44 healthy athletic participants were measured to determine stratification of injury risk (ie, low, medium, and high) in 3 degrees of knee forces/moments (knee abduction moment, anterior tibial shear, and internal tibial rotation). These stratified kinetic values were input into a cadaveric impact simulator to assess ligamentous strain during a simulated landing task. Uniaxial and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect mechanical data for analysis. Conditions of external loads applied to the cadaveric limbs were varied and randomized. Results: ACL strain increased with increased dynamic knee abduction moment (χ2[5] = 14.123, P = .0148). The most extreme dynamic knee abduction moment condition demonstrated significantly higher ACL strain compared with lower loaded trials ( P≤ .0203). Similarly, MCL strain increased with dynamic knee abduction moment (χ2[5] = 36.578, P < .0001). Matched-pairs analysis compared ACL strain with MCL strain (maximum ACL strain – maximum MCL strain) and demonstrated high strain for the ACL versus the MCL ( S177 = 6223.5, P < .0001). Conclusion: Although significant, MCL strain had minimal increase with increased dynamic knee abduction moment, and the event of ACL failure did not significantly increase MCL strain when compared with high dynamic knee abduction moment conditions in the cadaveric model. The ACL bears more strain than the MCL at increasing amounts of dynamic knee abduction moment at 25° of knee flexion, which may explain the limited concomitant MCL injury rate that can occur during a dynamic valgus collapse of the knee. Clinical Relevance: These characteristics of ACL and MCL strain are important to understand the mechanisms that drive these injuries at the knee and will improve rehabilitation and injury prevention techniques.
- Subjects :
- musculoskeletal diseases
Adult
Male
Knee Joint
Rotation
Movement
Anterior cruciate ligament
Medial Collateral Ligament, Knee
Physical Therapy, Sports Therapy and Rehabilitation
Strain (injury)
Article
Young Adult
03 medical and health sciences
0302 clinical medicine
Cadaver
medicine
Humans
Orthopedics and Sports Medicine
030222 orthopedics
Medial collateral ligament
Tibia
biology
business.industry
Anterior Cruciate Ligament Injuries
030229 sport sciences
Anatomy
Middle Aged
musculoskeletal system
medicine.disease
biology.organism_classification
Biomechanical Phenomena
body regions
Kinetics
Valgus
medicine.anatomical_structure
Coronal plane
Female
Cadaveric spasm
business
human activities
Sports
Subjects
Details
- ISSN :
- 15523365 and 03635465
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- The American Journal of Sports Medicine
- Accession number :
- edsair.doi.dedup.....590ebbb2e508e090c2044437d207488d