ACL; skeletal growth; 6DOF robotics; knee

Flexion Angle Dependent Differences in Joint Kinematics and ACL Force In Response to Applied Loads Are Conserved Throughout Skeletal Growth in the Porcine Stifle Joint

The anterior cruciate ligament (ACL) stabilizes the lower limb against translational and rotational loads while the knee is is multiple postures. Surgical reconstruction, the most common treatment for ACL tears, is intended to replicate the biomechanical function of the native ACL in the postures and activities related to daily living and high-impact activities. In order to improve outcomes from ACL reconstructions in patients in pediatric and adolescent age groups, we need to improve our understanding of the knee posture dependent biomechanical function of the ACL. As such, the objective of this study was to quantify flexion angle dependent changes in the response of the ACL and the total knee to applied loads in the anterior-posterior and varus-valgus directions using a skeletally immature porcine model. To do this, we collected stifle (knee) joints from female Yorkshire-cross pigs at ages ranging from 1.5 to 18 months (n=30 total). The joints were tested using a 6 degree-of-freedom universal force sensing robotic system under applied anterior-posterior loads and varus-valgus moments at 40° and 60° of flexion. Studied parameters included anterior-posterior tibial translation (APTT), varus-valgus rotation (VVR), and anterior force carried by the ACL and its anteromedial and posterolateral bundles. We found increased knee laxity (APTT and VVR) was associated with both younger age and increased knee flexion. Greater anterior force carried in the ACL, and specifically in the anteromedial bundle, was associated with increased flexion, regardless of age. These findings have implications in intraoperative graft assessment and biomechanical models.
Listed In: Biomechanical Engineering, Biomechanics, Orthopedic Research, Sports Science