In vivo anterior cruciate ligament elongation in response to axial tibial loads |
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Authors: | Ali Hosseini Thomas J Gill Guoan Li |
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Institution: | (1) Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, USA;(2) Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA |
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Abstract: | Background The knowledge of in vivo anterior cruciate ligament (ACL) deformation is fundamental for understanding ACL injury mechanisms
and for improving surgical reconstruction of the injured ACL. This study investigated the relative elongation of the ACL when
the knee is subject to no load (<10 N) and then to full body weight (axial tibial load) at various flexion angles using a
combined dual fluoroscopic and magnetic resonance imaging (MRI) technique.
Methods Nine healthy subjects were scanned with MRI and imaged when one knee was subject to no load and then to full body weight using
a dual fluoroscopic system (0°–45° flexion angles). The ACL was analyzed using three models: a single central bundle; an anteromedial
and posterolateral (double functional) bundle; and multiple (eight) surface fiber bundles.
Results The anteromedial bundle had a peak relative elongation of 4.4% ± 3.4% at 30° and that of the posterolateral bundle was 5.9%
± 3.4% at 15°. The ACL surface fiber bundles at the posterior portion of the ACL were shorter in length than those at the
anterior portion. However, the peak relative elongation of one posterolateral fiber bundle reached more than 13% whereas one
anteromedial fiber bundle reached a peak relative elongation of only about 3% at 30° of flexion by increasing the axial tibial
load from no load to full body weight.
Conclusions The data quantitatively demonstrated that under external loading the ACL experiences nonhomogeneous elongation, with the posterior
fiber bundles stretching more than the anterior fiber bundles. |
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