Strain in the medial collateral ligament of the human knee under single and combined loads

Hull, M. L.; Berns, Gregory S.; Varmat, H.; Patterson, Hugh A.

Affiliations

¹Department of Mechanical Engineering; University of California, Davis, CA 95616, U.S.A.

²Biomedical Engineering Group; University of California, Davis, CA 95616, U.S.A.

³Department of Human Anatomy, University of California, San Francisco, California, U.S.A.

Abstract and keywords

Strain within the medial collateral ligament (MCL) was measured in 13 human knee specimens to determine both the single and combined external loads most likely to cause injury. Using a load application system which allowed six degrees of freedom with flexion angle being fixed, both single loads of anterior/posterior force, medial/lateral force, varus/valgus torque, and internal/external axial torque and all pairs of these loads were applied at flexion angles of 0° and 30°. Liquid mercury strain gages were used to measure strain at four sites in the MCL. Two of the sites were the anterior fibers superior and inferior to the joint line and the other two were posterior of the two anterior sites.

A factorial analysis revealed a significant interaction between the site experiencing the greatest strain and flexion angle. The posterior superior site experienced significantly greater strain at 0° flexion whereas strain was significantly greater at the anterior superior site at 30° flexion. Of the single moments, external axial was more damaging than valgus in that the strain developed at equivalent load was significantly greater. None of the moment-moment combinations was identified as being significantly more damaging. A similar result held for the force-moment combinations.

Keywords: Strain; Ligament; Knee.

Links

DOI: 10.1016/0021-9290(95)00046-1

PubMed: 8849813

WoS: A1996TP16100007

History

Revised: 1995-02-17

Cited Works (10)

Year	Entry
1976	Kennedy JC, Hawkins RJ, Willis RB, Danylchuck KD. Tension studies of human knee ligaments: yield point, ultimate failure, and disruption of the cruciate and tibial collateral ligaments. J Bone Joint Surg. April 1976;58A(3):350-355.
1976	Crowninshield R, Pope MH, Johnson RJ. An analytical model of the knee. J Biomech. 1976;9(6):397-405.
1980	Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee: a biomechanical study. J Bone Joint Surg. March 1980;62A(2):259-270.
1983	Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.
1970	Edwards RG, Lafferty JF, Lange KO. Ligament strain in the human knee joint. J Biomech Eng. March 1970;92(1):131-136.
1973	Wang C-J, Walker PS, Wolf B. The effects of flexion and rotation on the length patterns of the ligaments of the knee. J Biomech. November 1973;6(6):587-596.
1991	Woo SL-Y, Hollis JM, Adams DJ, Lyon RM, Takai S. Tensile properties of the human femur-anterior cruciate ligament-tibia complex: the effects of specimen age and orientation. Am J Sports Med. 1991;19(3):217-225.
1982	Woo SL-Y. Mechanical properties of tendons and ligaments, I: quasi-static and nonlinear viscoelastic properties. Biorheology. 1982;19(3):385-396.
1983	Arms S, Boyle J, Johnson R, Pope M. Strain measurement in the medial collateral ligament of the human knee: an autopsy study. J Biomech. 1983;16(7):491-496.
1976	Noyes FR, Grood ES. The strength of the anterior cruciate ligament in humans and Rhesus monkeys. J Bone Joint Surg. 1976;58A(8):1074-1082.

Cited By (20)

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2001	Provenzano P, Lakes R, Keenan T, Vanderby R Jr. Nonlinear ligament viscoelasticity. Ann Biomed Eng. October 2001;29(10):908-914.
2001	Gardiner JC, Weiss JA, Rosenberg TD. Strain in the human medial collateral ligament during valgus loading of the knee. Clin Orthop Relat Res. October 2001;391:266-274.
2001	Weiss JA, Gardiner JC. Computational modeling of ligament mechanics. Crit Rev Biomed Eng. 2001;29(3):303-371.
2002	Weiss JA, Gardiner JC, Bonifasi-Lista C. Ligament material behavior is nonlinear, viscoelastic and rate-independent under shear loading. J Biomech. July 2002;35(6):943-950.
2005	Lujan TJ, Lake SP, Plaizier TA, Ellis BJ, Weiss JA. Simultaneous measurement of three-dimensional joint kinematics and ligament strains with optical methods. J Biomech Eng. February 2005;127(1):193-197.
2003	Gardiner JC, Weiss JA. Subject-specific finite element analysis of the human medial collateral ligament during valgus knee loading. J Orthop Res. 2003;21(6):1098-1106.
2005	Weiss JA, Gardiner JC, Ellis BJ, Lujan TJ, Phatak NS. Three-dimensional finite element modeling of ligaments: technical aspects. Med Eng Phys. December 2005;27(10):845-861.
2020	Oldfather T. Knee Valgus Vs. Knee Abduction Angle: Comparative Analysis of Valgus Alignment Measurement Methods in Female Athletes [PhD thesis]. Auburn University; August 8, 2020.
2021	Zaylor W. A Framework to Estimate Prestrain in Spring and Continuum Representations of Knee Ligaments [PhD thesis]. Cleveland State University; August 2021.
2009	Baldwin M. Explicit Finite Element Modeling of Knee Mechanics During Simulated Dynamic Activities [PhD thesis]. University of Denver; June 2009.
1999	Bull AMJ. Measurement and Computer Simulation of Knee Kinematics [PhD thesis]. Imperial College London; 1999.
1996	Levine RE. Heterogeneity of the Medial Collateral Ligament in Uniaxial Tension [PhD thesis]. University of Pittsburgh; 1996.
2005	De Vita R. Structural Constitutive Models for Knee Ligaments [PhD thesis]. Pittsburgh, PA: University of Pittsburgh; 2005.
1996	Bendjaballah MZ. Modélisation et analyse par éléments finis d'un genou humain [PhD thesis]. École polytechnique de Montréal; October 1996.
2012	Marouane H. Effet de la force de compression sur la réponse passive de l'articulation du genou: Une étude numérique non-linéaire [Master's thesis]. École polytechnique de Montréal; November 2012.
2000	Hsieh AH. Biomechanical Regulation of Gene Expression in Knee Ligaments [PhD thesis]. San Diego (UCSD), University of California; 2000.
2002	Bonifasi-Lista C. Multiaxial Viscoelastic Properties of Human Medial Collateral Ligament [Master's thesis]. University of Utah; December 2002.
2002	Gardiner JC. Computational Modeling of Ligament Mechanics [PhD thesis]. University of Utah; May 2002.
2013	Kiapour A. Non-Contact ACL Injuries During Landing: Risk Factors and Mechanisms [PhD thesis]. University of Toledo; August 2013.
2005	Kobayashi H. Application of Acoustoelasticity to Nearly Incompressible Materials (rubber, Biological Tissues) [PhD thesis]. University of Wisconsin – Madison; 2005.