Nathaniel A Bates1, Maria C Mejia Jaramillo2, Manuela Vargas2, April L McPherson3, Nathan D Schilaty4, Christopher V Nagelli5, Aaron J Krych6, Timothy E Hewett7. 1. Mayo Clinic Biomechanics Laboratories, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Sports Medicine Center, Mayo Clinic, Rochester, MN, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA. Electronic address: bates.nathaniel@mayo.edu. 2. Department of Biomedical Engineering, Universidad EIA, Medellin, Colombia. 3. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA. 4. Mayo Clinic Biomechanics Laboratories, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Sports Medicine Center, Mayo Clinic, Rochester, MN, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA. 5. Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA. 6. Mayo Clinic Biomechanics Laboratories, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Sports Medicine Center, Mayo Clinic, Rochester, MN, USA. 7. Mayo Clinic Biomechanics Laboratories, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Sports Medicine Center, Mayo Clinic, Rochester, MN, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: The aim of the present study was to evaluate the relationship between tibial slope angle and ligament strain during in vitro landing simulations that induce ACL failure through the application of variable external loading at the knee. The hypothesis tested was that steeper posterior tibial slope angle would be associated with higher ACL strain during a simulated landing task across all external loading conditions. METHODS: Kinetics previously derived from an in vivo cohort performing drop landings were reproduced on 45 cadaveric knees via the mechanical impact simulator. MRIs were taken of each specimen and used to calculate medial compartment posterior tibial slope, lateral compartment posterior tibial slope, and coronal plane tibial slope. Linear regression analyses were performed between these angles and ACL strain to determine whether tibial slope was a predictive factor for ACL strain. FINDINGS: Medial and lateral posterior tibial slope were predictive factors for ACL strain during some landings with higher combined loads. Medial posterior slope was more predictive of ACL strain in most landings for male specimens, while lateral posterior and coronal slope were more predictive in female specimens, but primarily when high abduction moments were applied. INTERPRETATION: Tibial slope has the potential to influence ACL strain during landing, especially when large abduction moments are present at the knee. Deleterious external loads to the ACL increase the correlation between tibial slope and ACL strain, which indicates that tibial slope angles are an additive factor for athletes apt to generate large out-of-plane knee moments during landing tasks.
BACKGROUND: The aim of the present study was to evaluate the relationship between tibial slope angle and ligament strain during in vitro landing simulations that induce ACL failure through the application of variable external loading at the knee. The hypothesis tested was that steeper posterior tibial slope angle would be associated with higher ACL strain during a simulated landing task across all external loading conditions. METHODS: Kinetics previously derived from an in vivo cohort performing drop landings were reproduced on 45 cadaveric knees via the mechanical impact simulator. MRIs were taken of each specimen and used to calculate medial compartment posterior tibial slope, lateral compartment posterior tibial slope, and coronal plane tibial slope. Linear regression analyses were performed between these angles and ACL strain to determine whether tibial slope was a predictive factor for ACL strain. FINDINGS: Medial and lateral posterior tibial slope were predictive factors for ACL strain during some landings with higher combined loads. Medial posterior slope was more predictive of ACL strain in most landings for male specimens, while lateral posterior and coronal slope were more predictive in female specimens, but primarily when high abduction moments were applied. INTERPRETATION: Tibial slope has the potential to influence ACL strain during landing, especially when large abduction moments are present at the knee. Deleterious external loads to the ACL increase the correlation between tibial slope and ACL strain, which indicates that tibial slope angles are an additive factor for athletes apt to generate large out-of-plane knee moments during landing tasks.
Authors: Ryo Ueno; Alessandro Navacchia; Christopher A DiCesare; Kevin R Ford; Gregory D Myer; Tomoya Ishida; Harukazu Tohyama; Timothy E Hewett Journal: J Biomech Date: 2020-01-27 Impact factor: 2.712
Authors: Nathan D Schilaty; Nathaniel A Bates; Sydney Kruisselbrink; Aaron J Krych; Timothy E Hewett Journal: Am J Sports Med Date: 2020-07-21 Impact factor: 6.202
Authors: Ryo Ueno; Alessandro Navacchia; Nathan D Schilaty; Gregory D Myer; Timothy E Hewett; Nathaniel A Bates Journal: Orthop J Sports Med Date: 2021-03-09