Robotic testing was performed with a 6-degree of freedom load cell in order to analyze functional contributions of the soft tissues in the knee under physiologically relevant loading conditions. Age groups ranging from 1.5 months to 18 months, porcine equivalent to early youth through late adolescent human ages, were studied. Complete ACL transection resulted in increased APTT and VVR across all ages (p<0.05), while injury to the AM bundle did not affect APTT or VVR. Additionally, increasing age resulted in decreased APTT normalized to the tibial plateau (p<0.05) and an average 19° decrease in VVR across states from 0 to 18 months of age (p<0.05). The ACL was the primary restraint against anterior drawer in the intact knee state [75-111%]. Following AM bundle dissection, the PL bundle carried the vast majority of the anterior load regardless of age [66-112%]. Following complete ACL transection, the MCL and medial meniscus carried most of the force across ages under anterior drawer. The LCL contributed increasing resistance to varus torque across states with age, as did the MCL under valgus torque.
Listed In: Biomechanical Engineering, Biomechanics, Orthopedic Research, Sports Science

Disc function is mechanical, and measures of disc mechanical function are important to address spine function, degenerative disc disease, and low back pain. In vivo measures of disc mechanical function are needed, however the current standard in disc imaging is to acquire a single static image and classify the disc’s appearance using qualitative integer scales for degree of degeneration. Current grading standards are acknowledged as insufficient to identify symptomatic discs for treatment. In addition, static T2 weighted MRI cannot provide mechanical function information – mechanics must be measured as the change following a load or deformation perturbation. Because the disc experiences significant compression and height loss throughout the day, and because flexion-extension postures are often associated with low back pain, these physiological mechanical perturbations have potential to be used to quantify disc mechanics in vivo. The objective of this study was to use MRI-based methods to quantify in vivo disc function by measuring changes in disc geometry and T2 relaxation time with diurnal changes and with controllable posture. Quantification of in vivo disc mechanics by using diurnal loading or prescribed posture changes has potential to improve our ability to identify, evaluate, and treat degenerative disc disease. Symptomatic discs may have aberrant mechanics; if so, in vivo measurements of mechanical function may, with continued development, facilitate diagnosis of pathological discs.
Listed In: Biomechanical Engineering

Even prior to walking slower, older adults walk with a diminished push-off – decreased propulsive forces (FP) accompanied by reduced ankle moment and power generation. The purpose of this study was to identify age-related differences in the joint-level modifications used to modulate FP generation during walking. We posit that there are two possibilities for older adults to enhance FP generation. First, older adults may increase ankle power generation and thereby alleviate compensatory demands at the hip. Alternatively, older adults may opt to exacerbate their distal to proximal redistribution by relying even more on the hip musculature. 10 healthy young adults and 16 healthy older adults participated in this study. Subjects walked at their preferred speed while watching a video monitor displaying their instantaneous FP while instructed to modify their FP to match target values representing normal and ±10% and ±20% of normal. For all trials, we estimated lower extremity joint kinematics and kinetics. During normal walking, older adults exerted smaller FP and ankle power than young adults. Enhancing FP via biofeedback alleviated mechanical power demands at the hip, without changes in ankle power. Further, older adults walked with increased FP without increasing their total positive joint work. Thus, given the same total requisite power generation, older adults got ‘more bang for their ankle power buck’ using biofeedback.
Listed In: Biomechanical Engineering, Biomechanics, Gait

Rugby is intrinsically an impact sport which results in concussions being a frequent injury within the game. Repeated concussion is linked to early-onset dementia and depression, and the rules for limiting repeated concussion are an ongoing controversy. Therefore a greater understanding of the dynamics of head impacts in rugby and the mechanism of concussion is required. Accordingly, this study focuses on assessing the use of Model Based Image Matching (MBIM) and multi-camera view video for measuring six degree of freedom head kinematics during an impact event in rugby union. The matching is performed on video evidence using 3-D animation software Poser 4. The surroundings are built in the virtual environment based on the real dimensions of the sport field. A skeleton model is then used to fit the player’s anthropometry for each video frame thus allowing player kinematics to be measured. The results from this initial study suggest that the MBIM method can be applied to head impact cases in rugby union. The head kinematics results from this case are similar to those reported in literature. The MBIM method should be applied to a number of head impact cases to establish thresholds for concussion injuries in rugby. The data gained from the MBIM method can allow for more reliable kinematic data to be inputted into finite element analysis and rigid body simulations of concussion impacts. This can allow multi-axis force measurements to be measured within the brain and neck. This can ultimately lead to an improvement in concussion injury prevention and management.
Listed In: Biomechanical Engineering, Biomechanics, Mechanical Engineering, Sports Science

Purpose: Anterior cruciate ligament (ACL) tear greatly increases the risk of knee osteoarthritis (OA), even when patients undergo ACL reconstruction surgery (ACLR). Changes to walking kinematics following ACLR have been suggested to play a role in this degenerative path to post-traumatic OA by shifting the location of repetitive joint contact loads that occur during walking to regions of cartilage not conditioned for altered loads. Recent work has shown that changes to the average knee center of rotation during walking (KCOR) between 2 and 4 years after ACLR are associated with long term changes in patient reported outcomes at 8 years. Changes to KCOR result in changes to contact patterns between the femur and the tibial plateau. However, it is unknown if changes to this kinematic measure are reflected by changes to cartilage as early as 2 years after surgery. Ultrashort TE-enhanced T2* (UTE-T2*) mapping has been shown to be sensitive to subsurface changes occurring in deep articular cartilage early after ACL injury and over 2 years after ACLR that were not detectable by standard morphological MRI. Thus, the purpose of this study was to test the hypothesis that side to side differences in KCOR correlate with side to side differences in UTE-T2* quantitative MRI (qMRI) in the central weight bearing regions of the medial and lateral tibial plateaus at 2 years following ACLR. Methods: Thirty-five human participants (18F, Age: 33.8±10.5 yrs, BMI: 24.1±3.3) with a history of unilateral ACL reconstruction (2.19±0.22 yrs post-surgery) and no other history of serious lower limb injury received bilateral examinations on a 3T MRI scanner. UTE-T2* maps were calculated via mono-exponential fitting on a series of T2*-weighted MR images acquired at eight TEs (32μs -16 ms, non-uniform echo spacing) using a radial out 3D cones acquisition. All subjects completed bilateral gait analysis. Medial-lateral (ML) and anterior-posterior (AP) coordinates of average KCOR during stance of walking were calculated for both knees. Side to side differences in KCOR were tested for correlations with side to side differences in mean full thickness UTE-T2* quantitative values in the central weight bearing regions of the medial and lateral tibial plateau using Pearson correlation coefficients. Results: There was a distribution in UTE-T2* values, with some subjects having higher UTE-T2* and some lower in the ACLR knee relative to the contralateral knee. A significant correlation (R=0.407, p=0.015, Figure 1A) was observed between UTE-T2* and the ML KCOR with a more lateral KCOR corresponding to higher values of UTE-T2* for the medial tibia. Similarly, for the lateral tibia, a lower UTE-T2* was correlated with a more posterior KCOR (R=0.363, p=0.032, Figure 1B). Significant correlations were not observed for UTE-T2* in the lateral tibia with the ML position of KCOR or for UTE-T2* in the medial tibia with the AP position of KCOR. Conclusions: The results of this study support the hypothesis that side to side differences in mean full thickness UTE-T2* qMRI correlate with side to side differences in knee kinematics at 2 years after ACLR. The finding that a more lateral KCOR in the ACLR knee correlates with UTE T2* values in the medial tibia that were higher than the contralateral side suggests that this kinematic change, which has been previously shown to result in more relative motion between the femur and tibia in the medial compartment, could be affecting subsurface matrix integrity, inducing changes detectable by UTE-T2* mapping. Additionally, the finding that a more posterior KCOR in the ACLR knee correlated with UTE-T2* values in the lateral tibia that were lower than the contralateral knee further suggests that the UTE-T2* metric may reflect early changes in cartilage health. When interpreted within the context of prior work showing that a posterior shift in KCOR from 2 to 4 years post-surgery correlated with improved clinical outcomes at 8 years, the observed lower UTE-T2* with a more posterior KCOR, which is reflective of improved quadriceps recruitment, suggests positive cartilage matrix properties. In spite of the limitations of this cross-sectional and exploratory study, and the difficulty accounting for changes in the contralateral knee, these results support future studies of the relationship between UTE-T2* and KCOR to provide new insight into predicting the risk for OA after ACLR.
Listed In: Biomechanical Engineering, Biomechanics, Gait, Mechanical Engineering, Orthopedic Research, Sports Science