1
|
Rishiraj N, Taunton JE, Lloyd-Smith R, Regan W, Niven B, Woollard R. Functional knee brace use for 21 h leads to a longer duration to achieve peak vertical ground reaction forces and the removal of the brace after 17.5 h results in faster loading of the knee joint. Knee Surg Sports Traumatol Arthrosc 2024; 32:1096-1104. [PMID: 38461373 DOI: 10.1002/ksa.12135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE To investigate the landing strategies used after discontinuing and continuing the use of a functional knee brace (FKB) while performing a drop jump. METHODS Following published methodology and power analysis, 23 uninjured male athletes, mean age of 19.4 ± 3.0 years, performed seven tests, during three test conditions (nonbraced, braced and removed brace or continued brace use), over 6 days of 12 testing sessions (S) for a total of 38.5 h. Each subject was provided with a custom-fitted FKB. This study focuses on the single leg drop jump kinetics during S12 when subjects were randomly selected to remove the FKB after 17.5 h or continued use of FKB. The time to peak vertical ground reaction forces (PVGRF) and PVGRF were recorded on landing in eight trials. RESULTS After brace removal, a significantly shorter mean time to PVGRF was recorded (9.4 ± 22.9 msec (3.9%), p = 0.005, 95% confidence interval (95% CI): -168.1, 36.1), while continued brace use required a nonsignificant (n.s.) longer mean duration to achieve PVGRF (19.4 ± 53.6 msec (8.9%), n.s., 95% CI: -49.7, 73.4). No significant mean PVGRF difference was found in brace removal (25.3 ± 65.8 N) and continued brace use (25.1 ± 23.0 N). CONCLUSION Removal of FKB after 17.5 h of use led to a significantly shorter time to achieve PVGRF, while continued brace use for 21 h required a longer duration to achieve PVGRF, suggesting faster and slower knee joint loading, respectively. Understanding the concerns associated with the use of FKB and the kinetics of the knee joint will assist clinicians in counselling athletes about the risks and benefits of using an FKB. LEVEL OF EVIDENCE Level II.
Collapse
Affiliation(s)
- Neetu Rishiraj
- High Performance and Rehabilitation, ACTIN Health & Rehabilitation Inc., Vancouver, British Columbia, Canada
| | - Jack E Taunton
- Allan McGavin Sports Medicine Clinic (Primary Care), University of British Columbia, Vancouver, British Columbia, Canada
| | - Rob Lloyd-Smith
- Allan McGavin Sports Medicine Clinic (Primary Care), University of British Columbia, Vancouver, British Columbia, Canada
| | - William Regan
- Allan McGavin Sports Medicine Clinic (Orthopaedics), University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian Niven
- Department of Mathematics & Statistics, University of Otago, Otago, New Zealand
| | - Robert Woollard
- Department of Family Practice, University of British Columbia, British Columbia, Canada
| |
Collapse
|
2
|
Knee Joint Contact Forces during High-Risk Dynamic Tasks: 90° Change of Direction and Deceleration Movements. Bioengineering (Basel) 2023; 10:bioengineering10020179. [PMID: 36829673 PMCID: PMC9952676 DOI: 10.3390/bioengineering10020179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Pivoting sports expose athletes to a high risk of knee injuries, mainly due to mechanical overloading of the joint which shatters overall tissue integrity. The present study explored the magnitude of tibiofemoral contact forces (TFCF) in high-risk dynamic tasks. A novel musculoskeletal model with modifiable frontal plane knee alignment was developed to estimate the total, medial, and lateral TFCF developed during vigorous activities. Thirty-one competitive soccer players performing deceleration and 90° sidestepping tasks were assessed via 3D motion analysis by using a marker-based optoelectronic system and TFCF were assessed via OpenSim software. Statistical parametric mapping was used to investigate the effect of frontal plane alignment, compartment laterality, and varus-valgus genu on TFCF. Further, in consideration of specific risk factors, sex influence was also assessed. A strong correlation (R = 0.71 ÷ 0.98, p < 0.001) was found between modification of compartmental forces and changes in frontal plane alignment. Medial and lateral TFCF were similar throughout most of the tasks with the exception of the initial phase, where the lateral compartment had to withstand to higher loadings (1.5 ÷ 3 BW higher, p = 0.010). Significant sex differences emerged in the late phase of the deceleration task. A comprehensive view of factors influencing the mediolateral distribution of TFCF would benefit knee injury prevention and rehabilitation in sport activities.
Collapse
|
3
|
Beaulieu ML, Ashton-Miller JA, Wojtys EM. Loading mechanisms of the anterior cruciate ligament. Sports Biomech 2023; 22:1-29. [PMID: 33957846 PMCID: PMC9097243 DOI: 10.1080/14763141.2021.1916578] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/08/2021] [Indexed: 01/26/2023]
Abstract
This review identifies the three-dimensional knee loads that have the highest risk of injuring the anterior cruciate ligament (ACL) in the athlete. It is the combination of the muscular resistance to a large knee flexion moment, an external reaction force generating knee compression, an internal tibial torque, and a knee abduction moment during a single-leg athletic manoeuvre such as landing from a jump, abruptly changing direction, or rapidly decelerating that results in the greatest ACL loads. While there is consensus that an anterior tibial shear force is the primary ACL loading mechanism, controversy exists regarding the secondary order of importance of transverse-plane and frontal-plane loading in ACL injury scenarios. Large knee compression forces combined with a posteriorly and inferiorly sloped tibial plateau, especially the lateral plateau-an important ACL injury risk factor-causes anterior tibial translation and internal tibial rotation, which increases ACL loading. Furthermore, while the ACL can fail under a single supramaximal loading cycle, recent evidence shows that it can also fail following repeated submaximal loading cycles due to microdamage accumulating in the ligament with each cycle. This challenges the existing dogma that non-contact ACL injuries are predominantly due to a single manoeuvre that catastrophically overloads the ACL.
Collapse
Affiliation(s)
- Mélanie L. Beaulieu
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - James A. Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Edward M. Wojtys
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
4
|
Collings TJ, Bourne MN, Barrett RS, du Moulin W, Hickey JT, Diamond LE. Risk Factors for Lower Limb Injury in Female Team Field and Court Sports: A Systematic Review, Meta-analysis, and Best Evidence Synthesis. Sports Med 2021; 51:759-776. [DOI: 10.1007/s40279-020-01410-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 02/01/2023]
|
5
|
Intra- and interrater reliability of subjective assessment of the drop vertical jump and tuck jump in youth athletes. Phys Ther Sport 2021; 47:156-164. [DOI: 10.1016/j.ptsp.2020.11.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 01/16/2023]
|
6
|
Markolf KL, Du PZ, McAllister DR. Changes in knee kinematics from applied external Tibial torque: Implications for stabilizing an anterior cruciate ligament deficient knee. Clin Biomech (Bristol, Avon) 2021; 81:105230. [PMID: 33261893 DOI: 10.1016/j.clinbiomech.2020.105230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Changes in knee kinematics from internal tibial torque under tibiofemoral compression force have been studied, but the potentially stabilizing effects of external tibial torque have not been reported. We hypothesized that for a given knee flexion angle, 1) external torque would significantly reduce anterior tibial translation, internal tibial rotation, and valgus tibial rotation before and after sectioning the anterior cruciate ligament and 2) changes in kinematics from applied external torque would be significantly greater with the cruciate cut. METHODS A robotic test system was used to flex intact human knees continuously from 0° to 50° under 200 N compression, without and with 5 Nm external torque. Tests were repeated after cruciate section. FINDINGS With the cruciate intact, external torque had no significant effect on anterior translation, and significantly reduced internal and valgus rotations at all flexion angles. With the cruciate cut, external torque significantly reduced anterior translation beyond 25° flexion, significantly reduced internal rotation at all flexion angles, and significantly reduced valgus rotation beyond 15° flexion. Although external torque had no significant effect on anterior translation with the ACL intact, external torque produced relatively large decreases in anterior translation with the cruciate sectioned (-11.6 mm at 50° flexion). Reductions in valgus rotation from applied external torque were significantly greater for cruciate deficient knees beyond 25° flexion. INTERPRETATION We conclude that external tibial torque may be important for controlling the abnormal kinematics associated with an anterior cruciate ligament deficient knee, and possibly help stabilize the knee during in vivo activities.
Collapse
Affiliation(s)
- Keith L Markolf
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
| | - Peter Z Du
- Department of Orthopaedic Surgery, University of Arizona, Tucson, Arizona, USA
| | - David R McAllister
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| |
Collapse
|
7
|
Adouni M, Faisal TR, Dhaher YY. Computational frame of ligament in situ strain in a full knee model. Comput Biol Med 2020; 126:104012. [PMID: 33045650 DOI: 10.1016/j.compbiomed.2020.104012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 01/12/2023]
Abstract
The biomechanical function of connective tissues in a knee joint is to stabilize the kinematics-kinetics of the joint by augmenting its stiffness and limiting excessive coupled motion. The connective tissues are characterized by an in vivo reference configuration (in situ strain) that would significantly contribute to the mechanical response of the knee joint. In this work, a novel iterative method for computing the in situ strain at reference configuration was presented. The framework used an in situ strain gradient approach (deformed reference configuration) and a detailed finite element (FE) model of the knee joint. The effect of the predicted initial configuration on the mechanical response of the joint was then investigated under joint axial compression, passive flexion, and coupled rotations (adduction and internal), and during the stance phase of gait. The inclusion of the reference configuration has a minimal effect on the knee joint mechanics under axial compression, passive flexion, and at two instances (0% and 50%) of the stance phase of gait. However, the presence of the ligaments in situ strains significantly increased the joint stiffness under passive adduction and internal rotations, as well as during the other simulated instances (25%, 75% and 100%) of the stance phase of gait. Also, these parameters substantially altered the local loading state of the ligaments and resulted in better agreement with the literature during joint flexion. Therefore, the proposed computational framework of ligament in situ strain will help to overcome the challenges in considering this crucial biological aspect during knee joint modeling. Besides, the current construct is advantageous for a better understanding of the mechanical behavior of knee ligaments under physiological and pathological states and provide relevant information in the design of reconstructive treatments and artificial grafts.
Collapse
Affiliation(s)
- Malek Adouni
- Northwestern University, Physical Medicine and Rehabilitation Department, 345 East Superior Street, Chicago, IL, 60611, United States; Australian College of Kuwait, Mechanical Engineering Department, East Meshrif, P.O. Box 1411, Kuwait.
| | - Tanvir R Faisal
- Department of Mechanical Engineering, University of Louisiana at Lafayette, LA, 70508, USA
| | - Yasin Y Dhaher
- Northwestern University, Physical Medicine and Rehabilitation Department, 345 East Superior Street, Chicago, IL, 60611, United States; Department of Physical Medicine and Rehabilitation, University of Texas Southwest, Dallas, TX, United States; Department of Orthopedic Surgery, University of Texas Southwest, Dallas, TX, United States; Bioengineering, University of Texas Southwest, Dallas, TX, United States
| |
Collapse
|
8
|
Zahradnik D, Jandacka D, Beinhauerova G, Hamill J. Associated ACL risk factors differences during an unanticipated volleyball blocking movement. J Sports Sci 2020; 38:2367-2373. [DOI: 10.1080/02640414.2020.1785727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- David Zahradnik
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava, Czech Republic
| | - Daniel Jandacka
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava, Czech Republic
| | - Gabriela Beinhauerova
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava, Czech Republic
| | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts, Amherst, MA, USA
| |
Collapse
|