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Bozkurt M, Gungor Y, Apaydin N, Feigl G, Acar HI. Posteromedial Compartment Arthroscopy of the Knee and Resection of Osteophytes: An Anatomic Perspective on Posteromedial Knee Impingement. Arthrosc Tech 2022; 11:e1911-e1916. [PMID: 36457412 PMCID: PMC9705394 DOI: 10.1016/j.eats.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
Posteromedial knee pain is a common clinical problem. It is often accompanied by degenerative changes or tears in the posterior horn of the medial meniscus and/or pain during deep flexion of the knee. In more advanced cases, it is accompanied by the osteophytic formation of a cam lesion that develops gradually in the posterior of the medial condyle of the femur and, with it (or less frequently without it), an osteophytic lesion at the posterior of the tibia (i.e. pincer lesion) occurs. It is believed that resection of the cam lesion may delay the progression of knee osteoarthritis, similarly to repairing the posterior horn of the medial meniscus. In this technical note, we describe a 2-portal technique for resection of cam lesions by posteromedial knee arthroscopy using anatomic landmarks. Using both portals provides better visualization and a better approach.
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Affiliation(s)
- Murat Bozkurt
- Department of Orthopaedics and Traumatology, Ankara Acibadem Hospital, Ankara, Turkey,Address correspondence to Murat Bozkurt, M.D., Ph.D., Mahall Ankara Mustafa Kemal Mah, Dumlupinar Bul, No. 274 B Blok 12 Kat No. 131, 06530, Cankaya/Ankara, Turkey.
| | - Yigit Gungor
- Department of Anatomy, School of Medicine, Ankara University, Ankara, Turkey
| | - Nihal Apaydin
- Department of Anatomy, School of Medicine, Ankara University, Ankara, Turkey
| | - Georg Feigl
- Institute of Anatomy and Clinical Morphology, Witten/Herdecke University, Witten, Germany
| | - Halil Ibrahim Acar
- Department of Anatomy, School of Medicine, Ankara University, Ankara, Turkey
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Mokhtarzadeh H, Yeow CH, Goh JCH, Oetomo D, Ewing K, Lee PVS. Antagonist muscle co-contraction during a double-leg landing maneuver at two heights. Comput Methods Biomech Biomed Engin 2017; 20:1382-1393. [DOI: 10.1080/10255842.2017.1366992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hossein Mokhtarzadeh
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
- Department of Orthopedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Chen Hua Yeow
- Division of Bioengineering, National University of Singapore, Singapore, Singapore
| | - James Cho Hong Goh
- Division of Bioengineering, National University of Singapore, Singapore, Singapore
| | - Denny Oetomo
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
| | - Katie Ewing
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
| | - Peter Vee Sin Lee
- Department of Mechanical Engineering, University of Melbourne, Victoria, Australia
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Blaker CL, Little CB, Clarke EC. Joint loads resulting in ACL rupture: Effects of age, sex, and body mass on injury load and mode of failure in a mouse model. J Orthop Res 2017; 35:1754-1763. [PMID: 27601010 DOI: 10.1002/jor.23418] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/29/2016] [Indexed: 02/04/2023]
Abstract
Anterior cruciate ligament (ACL) tears are a common knee injury with a known but poorly understood association with secondary joint injuries and post-traumatic osteoarthritis (OA). Female sex and age are known risk factors for ACL injury but these variables are rarely explored in mouse models of injury. This study aimed to further characterize a non-surgical ACL injury model to determine its clinical relevance across a wider range of mouse specifications. Cadaveric and anesthetized C57BL/6 mice (9-52 weeks of age) underwent joint loading to investigate the effects of age, sex, and body mass on ACL injury mechanisms. The ACL injury load (whole joint load required to rupture the ACL) was measured from force-displacement data, and mode of failure was assessed using micro-dissection and histology. ACL injury load was found to increase with body mass and age (p < 0.001) but age was not significant when controlling for mass. Sex had no effect. In contrast, the mode of ACL failure varied with both age and sex groups. Avulsion fractures (complete or mixed with mid-substance tears) were common in all age groups but the proportion of mixed and mid-substance failures increased with age. Females were more likely than males to have a major avulsion relative to a mid-substance tear (p < 0.01). This data compliments studies in human cadaveric knees, and provides a basis for determining the severity of joint injury relative to a major ACL tear in mice, and for selecting joint loading conditions in future experiments using this model. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1754-1763, 2017.
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Affiliation(s)
- Carina L Blaker
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Kolling Institute, Sydney Medical School Northern, University of Sydney, St. Leonards, New South Wales, 2065, Australia.,Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Sydney Medical School Northern, University of Sydney, St. Leonards, New South Wales, 2065, Australia
| | - Christopher B Little
- Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Sydney Medical School Northern, University of Sydney, St. Leonards, New South Wales, 2065, Australia
| | - Elizabeth C Clarke
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Kolling Institute, Sydney Medical School Northern, University of Sydney, St. Leonards, New South Wales, 2065, Australia
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Kiapour AM, Demetropoulos CK, Kiapour A, Quatman CE, Wordeman SC, Goel VK, Hewett TE. Strain Response of the Anterior Cruciate Ligament to Uniplanar and Multiplanar Loads During Simulated Landings: Implications for Injury Mechanism. Am J Sports Med 2016; 44:2087-96. [PMID: 27159285 DOI: 10.1177/0363546516640499] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite basic characterization of the loading factors that strain the anterior cruciate ligament (ACL), the interrelationship(s) and additive nature of these loads that occur during noncontact ACL injuries remain incompletely characterized. HYPOTHESIS In the presence of an impulsive axial compression, simulating vertical ground-reaction force during landing (1) both knee abduction and internal tibial rotation moments would result in increased peak ACL strain, and (2) a combined multiplanar loading condition, including both knee abduction and internal tibial rotation moments, would increase the peak ACL strain to levels greater than those under uniplanar loading modes alone. STUDY DESIGN Controlled laboratory study. METHODS A cadaveric model of landing was used to simulate dynamic landings during a jump in 17 cadaveric lower extremities (age, 45 ± 7 years; 9 female and 8 male). Peak ACL strain was measured in situ and characterized under impulsive axial compression and simulated muscle forces (baseline) followed by addition of anterior tibial shear, knee abduction, and internal tibial rotation loads in both uni- and multiplanar modes, simulating a broad range of landing conditions. The associations between knee rotational kinematics and peak ACL strain levels were further investigated to determine the potential noncontact injury mechanism. RESULTS Externally applied loads, under both uni- and multiplanar conditions, resulted in consistent increases in peak ACL strain compared with the baseline during simulated landings (by up to 3.5-fold; P ≤ .032). Combined multiplanar loading resulted in the greatest increases in peak ACL strain (P < .001). Degrees of knee abduction rotation (R(2) = 0.45; β = 0.42) and internal tibial rotation (R(2) = 0.32; β = 0.23) were both significantly correlated with peak ACL strain (P < .001). However, changes in knee abduction rotation had a significantly greater effect size on peak ACL strain levels than did internal tibial rotation (by ~2-fold; P < .001). CONCLUSION In the presence of impulsive axial compression, the combination of anterior tibial shear force, knee abduction, and internal tibial rotation moments significantly increases ACL strain, which could result in ACL failure. These findings support multiplanar knee valgus collapse as one the primary mechanisms of noncontact ACL injuries during landing. CLINICAL RELEVANCE Intervention programs that address multiple planes of loading may decrease the risk of ACL injury and the devastating consequences of posttraumatic knee osteoarthritis.
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Affiliation(s)
- Ata M Kiapour
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA Engineering Center for Orthopaedic Research Excellence (ECORE), Departments of Orthopaedics and Bioengineering, University of Toledo, Toledo, Ohio, USA
| | - Constantine K Demetropoulos
- Biomechanics & Injury Mitigation Systems, Research & Exploratory Development Department, The Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, USA
| | - Ali Kiapour
- Engineering Center for Orthopaedic Research Excellence (ECORE), Departments of Orthopaedics and Bioengineering, University of Toledo, Toledo, Ohio, USA
| | - Carmen E Quatman
- Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA Department of Orthopaedic Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Samuel C Wordeman
- Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Vijay K Goel
- Engineering Center for Orthopaedic Research Excellence (ECORE), Departments of Orthopaedics and Bioengineering, University of Toledo, Toledo, Ohio, USA
| | - Timothy E Hewett
- Mayo Biomechanics Laboratories, Mayo Sports Medicine Center, Departments of Orthopedic Surgery, Physical Medicine & Rehabilitation, and Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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Wheatley BB, Fischenich KM, Button KD, Haut RC, Haut Donahue TL. An optimized transversely isotropic, hyper-poro-viscoelastic finite element model of the meniscus to evaluate mechanical degradation following traumatic loading. J Biomech 2015; 48:1454-60. [PMID: 25776872 DOI: 10.1016/j.jbiomech.2015.02.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/15/2015] [Indexed: 01/13/2023]
Abstract
Inverse finite element (FE) analysis is an effective method to predict material behavior, evaluate mechanical properties, and study differences in biological tissue function. The meniscus plays a key role in load distribution within the knee joint and meniscal degradation is commonly associated with the onset of osteoarthritis. In the current study, a novel transversely isotropic hyper-poro-viscoelastic constitutive formulation was incorporated in a FE model to evaluate changes in meniscal material properties following tibiofemoral joint impact. A non-linear optimization scheme was used to fit the model output to indentation relaxation experimental data. This study is the first to investigate rate of relaxation in healthy versus impacted menisci. Stiffness was found to be decreased (p=0.003), while the rate of tissue relaxation increased (p=0.010) at twelve weeks post impact. Total amount of relaxation, however, did not change in the impacted tissue (p=0.513).
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Affiliation(s)
- Benjamin B Wheatley
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | | | - Keith D Button
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA; Department of Radiology, Michigan State University, East Lansing, MI, USA
| | - Tammy L Haut Donahue
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA.
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Mokhtarzadeh H, Ng A, Yeow CH, Oetomo D, Malekipour F, Lee PVS. Restrained tibial rotation may prevent ACL injury during landing at different flexion angles. Knee 2015; 22:24-9. [PMID: 25456655 DOI: 10.1016/j.knee.2014.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 09/11/2014] [Accepted: 09/23/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Internal tibial rotation is a risk factor for anterior cruciate ligament (ACL) injury. The effect of restraining tibial rotation (RTR) to prevent ACL injury during single-leg landing is not well understood. We aimed to investigate the effect of impact load and RTR on ACL injury with respect to flexion angle. We hypothesized that RTR could protect the knee from ACL injury compared to free tibial rotation (FTR) regardless of flexion angle and create a safety zone to protect the ACL. METHODS Thirty porcine specimens were potted in a rig manufactured to replicate single-leg landing maneuvers. A mechanical testing machine was used to apply external forces in the direction of the tibial long axis. A 3D displacement sensor measured anterior tibial translation (ATT). The specimens were divided into 3 groups of 10 specimens and tested at flexion angles of 22 ± 1°, 37 ± 1° and 52 ± 1° (five RTR and five FTR) through a consecutive range of actuator displacements until ACL failure. After dissection, damage to the joint was visually recorded. Two-way ANOVA were utilized in order to compare compressive forces, torques and A/P displacements with respect to flexion angle. RESULTS The largest difference between peak axial compressive forces (~3.4 kN) causing ACL injury between RTR and FTR was reported at a flexion angle of 22°. Tibial torques with RTR was in the same range and < 20 Nm at the instance and just before ACL failure, compared to a significant reduction when cartilage/bone damage (no ACL failure) was reported. Isolated ACL injuries were observed in ten of the 15 FTR specimens. Injuries to bone and cartilage were more common with RTR. CONCLUSIONS RTR increases the threshold for ACL injury by elevating the compressive impact load required at lower flexion angles. These findings may contribute to neuromuscular training programs or brace designs used to avoid excessive internal/external tibial rotation. Caution must be exercised as bone/cartilage damage may result.
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Affiliation(s)
- Hossein Mokhtarzadeh
- Department of Mechanical Engineering, University of Melbourne, Victoria 3010 Australia
| | - Andrew Ng
- Department of Orthopaedic Surgery The Royal Melbourne Hospital Victoria, 3050, Australia
| | - Chen Hua Yeow
- Department of Biomedical Engineering National University of Singapore 9 Engineering Drive 1, 117575 Singapore
| | - Denny Oetomo
- Department of Mechanical Engineering, University of Melbourne, Victoria 3010 Australia
| | - Fatemeh Malekipour
- Department of Mechanical Engineering, University of Melbourne, Victoria 3010 Australia
| | - Peter Vee Sin Lee
- Department of Mechanical Engineering, University of Melbourne, Victoria 3010 Australia.
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Zhu Y, Meili S, Dong MJ, Zhai QL, Yao L, Wang JC, Hu CF, Sun H, Luo CF. Pathoanatomy and incidence of the posterolateral fractures in bicondylar tibial plateau fractures: a clinical computed tomography-based measurement and the associated biomechanical model simulation. Arch Orthop Trauma Surg 2014; 134:1369-80. [PMID: 25077782 DOI: 10.1007/s00402-014-2037-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of our study is to evaluate the incidence and pathoanatomy of posterolateral fragments and analyze the associated fracture mechanism in bicondylar tibial plateau fractures. METHODS From 1.1.2008 to 3.15.2012, all patients suffering bicondylar tibial plateau fractures were identified, scanned and analyzed at the Shanghai Clinical Trauma Center. Furthermore cadaver knees were selected into three groups of 30/60/90 knee flexion to simulate the posterolateral tibial plateau fracture by an impact device. RESULTS One hundred and sixty-four (44.32 %) bicondylar tibial plateau fractures finally satisfied our requirements. Fifty-three and ninety-four cases were measured eventually in the groups of posterolateral split and depression. The posterolateral articular fragment proportion was 15.43 %. The posterolateral articular fragment angle showed an average of 12.94°. The posterolateral fragment cortical height was on average 2.96 cm. The posterolateral sagittal fragment angle averaged at 72.06°. Ninety-four cases were measured in the posterolateral depression group. The average posterolateral articular depression proportion was 16.74 %. The average posterolateral articular depression height was 2.47 cm. In the biomechanical modeling of such kinds of fracture patterns, posterolateral split fractures in 30° and 60° flexion are significantly more than those in 90° flexion. Posterolateral splits combined with anterolateral depression fractures in 30° flexion are significantly more than those in 90° flexion. CONCLUSION The incidence of posterolateral fractures is 44.32 % in bicondylar tibial plateau fractures. The morphology of posterolateral area can be referenced for the surgeon in the future clinical work. The information is also helpful for the design of locking plate and fracture modeling in biomechanical test. In addition, that posterolateral split and posterolateral depression might be caused by different injury mechanisms. Different angles of knee flexion under the axial impact loading are possibly the interpretations for these two fracture patterns.
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Affiliation(s)
- Yi Zhu
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, 600 YiShan Road, Shanghai, 200233, China,
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Kiapour AM, Quatman CE, Goel VK, Wordeman SC, Hewett TE, Demetropoulos CK. Timing sequence of multi-planar knee kinematics revealed by physiologic cadaveric simulation of landing: implications for ACL injury mechanism. Clin Biomech (Bristol, Avon) 2014; 29:75-82. [PMID: 24238957 PMCID: PMC3894911 DOI: 10.1016/j.clinbiomech.2013.10.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 10/21/2013] [Accepted: 10/22/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Challenges in accurate, in vivo quantification of multi-planar knee kinematics and relevant timing sequence during high-risk injurious tasks pose challenges in understanding the relative contributions of joint loads in non-contact injury mechanisms. Biomechanical testing on human cadaveric tissue, if properly designed, offers a practical means to evaluate joint biomechanics and injury mechanisms. This study seeks to investigate the detailed interactions between tibiofemoral joint multi-planar kinematics and anterior cruciate ligament strain in a cadaveric model of landing using a validated physiologic drop-stand apparatus. METHODS Sixteen instrumented cadaveric legs, mean 45(SD 7) years (8 female and 8 male) were tested. Event timing sequence, change in tibiofemoral kinematics (position, angular velocity and linear acceleration) and change in anterior cruciate ligament strain were quantified. FINDINGS The proposed cadaveric model demonstrated similar tibiofemoral kinematics/kinetics as reported measurements obtained from in vivo studies. While knee flexion, anterior tibial translation, knee abduction and increased anterior cruciate ligament strain initiated and reached maximum values almost simultaneously, internal tibial rotation initiated and peaked significantly later (P<0.015 for all comparisons). Further, internal tibial rotation reached mean 1.8(SD 2.5)°, almost 63% of its maximum value, at the time that peak anterior cruciate ligament strain occurred, while both anterior tibial translation and knee abduction had already reached their peaks. INTERPRETATION Together, these findings indicate that although internal tibial rotation contributes to increased anterior cruciate ligament strain, it is secondary to knee abduction and anterior tibial translation in its effect on anterior cruciate ligament strain and potential risk of injury.
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Affiliation(s)
- Ata M. Kiapour
- Sports Medicine Research Laboratory, Department of Orthopaedic Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA,Engineering Center for Orthopaedic Research Excellence (ECORE), Departments of Orthopaedics and Bioengineering, University of Toledo, Toledo, OH
| | - Carmen E. Quatman
- Sports Health and Performance Institute, The Ohio State University, Columbus, OH,Department of Orthopaedic Surgery, The Ohio State University, Columbus, OH
| | - Vijay K. Goel
- Engineering Center for Orthopaedic Research Excellence (ECORE), Departments of Orthopaedics and Bioengineering, University of Toledo, Toledo, OH
| | - Samuel C. Wordeman
- Sports Health and Performance Institute, The Ohio State University, Columbus, OH,Department of Biomedical Engineering, The Ohio State University, Columbus, OH
| | - Timothy E. Hewett
- Sports Health and Performance Institute, The Ohio State University, Columbus, OH,Department of Orthopaedic Surgery, The Ohio State University, Columbus, OH,Department of Biomedical Engineering, The Ohio State University, Columbus, OH,Departments of Physiology and Cell Biology, Family Medicine and the School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
| | - Constantine K. Demetropoulos
- Biomechanics & Injury Mitigation Systems, Research & Exploratory Development Department, The Johns Hopkins University Applied Physics Laboratory, Laurel, MD
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Does Wearing a Prophylactic Ankle Brace During Drop Landings Affect Lower Extremity Kinematics and Ground Reaction Forces? J Appl Biomech 2013; 29:205-13. [DOI: 10.1123/jab.29.2.205] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of the study was to determine if prophylactic ankle bracing worn by females during landings produces abnormal lower extremity mechanics. Angular kinematic and ground reaction force (GRF) data were obtained for 16 athletically experienced females who performed brace and no-brace drop landings. The brace condition displayed reduced in/external rotation and flexion displacements about the ankle and knee joints and increased vertical and mediolateral GRF peak magnitudes and rate of vertical GRF application (pairedttest,P< .05). The ankle and knee joints landed in a less plantar flexed and more flexed position, respectively. No significant ab/adduction outcomes may have occurred due to interparticipant variability and/or a lack of brace restriction. Conclusion: During typical landings, this lace-up brace increases vertical GRF, decreases ankle and knee joint displacements of flexion and int/external rotation, but minimally affects ab/adduction displacements.
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Yeow CH. Hamstrings and quadriceps muscle contributions to energy generation and dissipation at the knee joint during stance, swing and flight phases of level running. Knee 2013; 20:100-5. [PMID: 23022030 DOI: 10.1016/j.knee.2012.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 08/15/2012] [Accepted: 09/03/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human movements involve the generation and dissipation of mechanical energy at the lower extremity joints. However, it is unclear how the individual knee muscles contribute to the energetics during running. OBJECTIVE This study aimed to determine how each hamstring and quadricep muscle generates and dissipates energy during stance, swing and flight phases of running. METHODS A three-dimensional lower extremity musculoskeletal model was used to estimate the energetics of the individual hamstrings (semimembranosus, semitendinosus, biceps femoris long and short-heads) and quadriceps (rectus femoris, vastus medialis, vastus intermedius and vastus lateralis) muscles for a male subject during level running on a treadmill at a speed of 3.96 m/s. RESULTS Our findings demonstrated that the knee flexors generated energy during stance phase and dissipated energy during swing phase, while the knee extensors dissipated energy during the flexion mode of both stance and swing phases, and generated energy during the extension mode. During flight phase, the knee flexors generated energy during the flight phase transiting from toe-off to swing, while the knee extensors generated energy during the flight phase transiting from swing to heel-strike. CONCLUSION Individual knee flexors and extensors in the hamstrings and quadriceps play important roles in knee joint energetics, which are necessary for proper execution and stabilization of the stance, swing and flight phases of running.
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Affiliation(s)
- C H Yeow
- Division of Bioengineering, National University of Singapore, Singapore.
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Bradshaw EJ, Hume PA. Biomechanical approaches to identify and quantify injury mechanisms and risk factors in women's artistic gymnastics. Sports Biomech 2012; 11:324-41. [PMID: 23072044 DOI: 10.1080/14763141.2011.650186] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Targeted injury prevention strategies, based on biomechanical analyses, have the potential to help reduce the incidence and severity of gymnastics injuries. This review outlines the potential benefits of biomechanics research to contribute to injury prevention strategies for women's artistic gymnastics by identification of mechanisms of injury and quantification of the effects of injury risk factors. One hundred and twenty-three articles were retained for review after searching electronic databases using key words, including 'gymnastic', 'biomech*', and 'inj*', and delimiting by language and relevance to the paper aim. Impact load can be measured biomechanically by the use of instrumented equipment (e.g. beatboard), instrumentation on the gymnast (accelerometers), or by landings on force plates. We need further information on injury mechanisms and risk factors in gymnastics and practical methods of monitoring training loads. We have not yet shown, beyond a theoretical approach, how biomechanical analysis of gymnastics can help reduce injury risk through injury prevention interventions. Given the high magnitude of impact load, both acute and accumulative, coaches should monitor impact loads per training session, taking into consideration training quality and quantity such as the control of rotation and the height from which the landings are executed.
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Affiliation(s)
- Elizabeth J Bradshaw
- Centre for Physical Activity Across the Lifespan, School of Exercise Science, Australian Catholic University, Melbourne, Australia.
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