This content is not included in
your SAE MOBILUS subscription, or you are not logged in.
The Influence of Impact Interface on Human Knee Injury: Implications for Instrument Panel Design and the Lower Extremity Injury Criterion
Annotation ability available
Sector:
Language:
English
Abstract
Injury to the lower extremity during an automotive crash is a significant problem. While the introduction of safety features (i.e. seat belts, air bags) has significantly reduced fatalities, lower extremity injury now occurs more frequently, probably for a variety of reasons. Lower extremity trauma is currently based on a bone fracture criterion derived from human cadaver impact experiments. These impact experiments, conducted in the 1960's and 70's, typically used a rigid impact interface to deliver a blunt insult to the 90° flexed knee. The resulting criterion states that 10 kN is the maximum load allowed at the knee during an automotive crash when certifying new automobiles using anthropomorphic dummies. However, clinical studies suggest that subfracture loading can cause osteochondral microdamage which can progress to a chronic and debilitating joint disease. Additional studies suggest that the stiffness of the impact interface influences knee injury modalities resulting from impact loading. In the current study, a single impact at 27 J of energy with a rigid interface was delivered to one knee of isolated joint preparations of six cadavers resulting in an average peak load of 5 kN. Contralateral knees were impacted with a padded interface at an additional level of energy at approximately the same load. All rigid impact experiments resulted in some form of injury to the patella including occult microcracking and gross fracture of the patella. No injuries were detected in the knees from the padded experiments. Math modeling of the patellae showed significantly reduced tensile and shear stresses in the bone with padding. This study suggests that the current lower extremity injury criterion, based solely on load, may not be sufficiently conservative. Increasing contact area over the knee reduces stresses in the bone and prevents both gross bone fracture and bone and cartilage microdamage. Such data may be useful in future instrument panel designs and might suggest revision to the current lower extremity injury criterion.
Recommended Content
Authors
Citation
Atkinson, P., Garcia, J., Altiero, N., and Haut, R., "The Influence of Impact Interface on Human Knee Injury: Implications for Instrument Panel Design and the Lower Extremity Injury Criterion," SAE Technical Paper 973327, 1997, https://doi.org/10.4271/973327.Also In
References
- Nagel D States J 1977 Dashboard and bumper knee-will arthritis develop? AAAM proceedings 21 272 278
- Hartemann F Thomas C Henry C Foret-Bruno J Faverjon G Tarriere C Got C Patel A 1977 Belted or not belted: The only difference between two matched samples of 200 car occupants 21st Stapp Car Crash Conference 97 150
- Bourret P Corbelli S Cavallero C 1977 Injury agents and impact mechanisms in frontal crashes about 350 in the field accidents 21st Stapp Car Crash Conference 215 258
- Huelke D O'Day J States J 1982 Lower Extremity Injuries in Automobile Crashes Accid Anal & Prev 14 95 106
- Pattimore D Ward E Thomas P Bradford M 1991 The nature and cause of lower limb injuries in car crashes 35th Stapp Car Crash Conference 177 188
- Hayashi S Choi H Levine R Yang K King A 1996 Experimental and analytical study of knee fracture mechanisms in a frontal knee impact 40th Stapp Car Crash Conference 161 171
- Radin E Paul I Rose R 1972 Role of Mechanical Factors in Pathogenesis of Primary Osteoarthritis The Lancet 3 519 522
- Upadhyay S Moulton A Srikrishnamurthy K 1983 An analysis of the late effects of traumatic posterior dislocation of the hip without fractures The Journal of Bone and Joint Surgery 65-B 2 150 152
- Radin E Parker H Pugh J Steinberg R Paul I Rose R 1973 Response of joints to impact loading-III relationship between trabecular microfractures and cartilage degeneration Journal of Biomechanics 6 51 57
- Radin E Ehrlich M Chernack R Abernethy P Paul I Rose R 1978 Effect of repetitive impulsive loading on the knee joints of rabbits Clinical Orthopaedics and Related Research 131 288 293
- Donchue MJ Buss D Oegema T Thompson R 1983 The Effects of Indirect Blunt Trauma on Adult Canine Articular Cartilage The Journal of Bone and Joint Surgery 65-A 7 948 957
- Nyquist G King A 1985 Lower extremities Rev Biomech Impact Res Inj Auto Env 6 163 201
- Thompson R Oegema T Lewis J Wallace L 1991 Osteoarthritis changes following acute transarticular load an animal model 1 18
- Vellet AD Marks PH Fowler PJ Munro TG 1991 Occult posttraumatic osteochondral lesions of the knee: Prevalence, Classification, and short-term sequelae evaluated with MR imaging Radiology 178 1 271 276
- Donahue JM Buss D Oegema TR Thompson RC 1983 The effects of indirect blunt trauma on adult canine articular cartilage The Journal of Bone and Joint Surgery 65 948 957
- Gardner DL 1994 Problems and paradigms in joint pathology J Anat 184 465 476
- Volpin G Dowd G Stein H Bentley G 1990 Degenerative arthritis after intra-articular fractures of the knee. Long-term results J Bone Joint Surg Br 72 634 638
- Upadhyay S Moulton A Srikrishnamurthy K 1983 An analysis of the late effects of traumatic posterior dislocation of the hip without fractures J Bone Joint Surg 65 150 152
- Chapchal G 1978 Posttraumatic Osteoarthritis after Injury of the Knee and Hip Joint Reconstr Surg Traumat 16 87 94
- Arnoldi C 1991 Patellar Pain Acta Orthop Scand 62 1 29
- Nagel D Burton D Manning J 1977 The dashboard knee injury Clin Orthop 126 203 208
- Viano DC Stalnaker RL 1980 Mechanisms of Femoral Fracture Journal Biomechanics 13 701 715
- Melvin J Stalnaker R Alem N Benson J Mohan D 1975 Impact Response and Tolerance of the Lower Extremities Stapp Car Crash Conf 19 543 559
- Patrick L Kroell C Mertz H 1965 Forces on tehehuman body in simulated Crashes Stapp Car Crash Conf 9 237 259
- Powell W Ojala S Advani S Martin R 1975 Cadaver Femur Responses to Longitudinal impacts Stapp Car Crash Conf 19 561 579
- Viano D 1977 Considerations for a femur injury criterion 21st Stapp Car Crash Conference 445 473
- Siegal J Mason-Gonzales S Dischinger P Cushing B Read K Robinson R Smialek J Heatfield B Hill W Bents F Jackson J Livingston D Clark C 1993 Safety belt restraintsand compartment intrusions in frontal and lateral motor vehicle crashes: mechanisms of injuries, complications and acute care costs J Trauma 34 736 759
- Morgan R Eppinger R Hennessey B 1991 Ankle joint injury mechanism for adults in frontal automitve impact 35th Staoo Car Crash Conference 189 198
- Thomas P Charles J Fay P 1995 Lower limb injuries-the effect of intrusion, crash severity and the pedals on injury risk and injury type in frontal collisions 39th Stapp Car Crash Conference 265 280
- Otte D 1996 Biomechanics of lower limb injuries of belted car drivers and the influence of intrusion and accident severity 40th Stapp Car Crash Conference 193 206
- Lund A Ferguson S 1995 Driver Fatalities in 1985-1993 Cars with Airbags Journal of Trauma 38 469 475
- Mackay G Hill J 1995 The limitations of current seatbelts in Europe - some population considerations J Trauma 38 533 537
- Crandall J Kuhlmann T Pilkey W 1995 Air and knee bolster restraint system: laboratory sled tests with human cadavers and the Hybrid III dummy J Trauma 38 517 520
- King A Viano D Mizeres N States J 1995 Humanitarian benefits of cadaver research on injury prevention J Trauma 38 564 569
- Malliaris A Hitchcock R Hedlund J 1982 A search for priorities in crash protection Proceedings of the 1982 SAE International Congress and Exposition 959 991
- States J 1986 Adult occupant injuries of the lower limb Biomechanics and medical aspects of lower limb injuries Warrendale, PA SAE 97 107
- MacKenzie EJ Siegel JH Shapiro S et.al. 1988 Functional Recovery and Medical Costs of Trauma: An analysis by Type and Severity of Injury Journal of Trauma 28 281 298
- States J 1970 Traumatic Arthritis-- A Medical and Legal Dilemma Ann Conf of the Amer Assoc for Automotive Med 14 21 28
- Hamerman D 1989 The Biology of Osteoarthritis New England Journal of Medicine 320 20 1323 1330
- Thompson RC Oegema TR Lewis JL Wallace L 1991 Osteoarthritic changes after acute transarticular load The Journal of Bone and Joint Surgery 73-A 7 990 1001
- Shimizu M Tsuji H Matsui H Katoh Y Sano A 1993 Morphometric Analysis of Subchondral Bone of the Tibial Condyle in Osteoarthrosis Clin Orthop 229 239
- Vellet A Marks P Fowler P Munro T 1991 Occult Posttraumatic Osteochondral Lesions of the Knee: Prevalence, Classification, and Short Term Sequelae Evaluated with MR Imaging Radiology 271 276
- Kapelov R Teresi L Bradley W Bucciarelli N Murakami D Mullin W Jordan J 1993 Bone Contusions of the knee;lncreased Lesion Detection with fast Spin-Echo MR Imaging with Spectroscope Fat Saturation Radiology 901 904
- Davis M Ettinger W Neuhaus J Cho S Hauck W 1989 The Association of Knee Injury and Obestiy with Unilateral and Bilateral Osteoarthritis of the Knee American Journal of Epidemiology 130 2 278 288
- Kellgren J Lawrence J 1958 Osteoarthritis and disk degeneration in the urban population Annals of Rheumatory Diseases 17 386 396
- Johnson-Nurse C Dandy D 1985 Fracture-Separation of Articular Cartilage in the Adult Knee The Journal of Bone and Joint Surgery 67-B 10 42 43
- Atkinson PJ Haut RC 1995 Subfracture Insult to the Human Cadaver Patellofemoral Joint Produces Occult Injury Journal of Orthopaedic Research 13 936 944
- Atkinson P Haut R 1995 Insult to the human cadaver patellofemoral joint: effects of age on fracture tolerance and occult injury 39th Stapp Car Crash Conference 281 294
- LI, X Haut R Altiero N 1995 An analytic model to study blunt impact response of the rabbit P-F joint Journal of Biomechanical Engineering
- Atkinson P Newberry W Staton T Garcia J Altiero N Haut R 1996 Animal and human studies on injury mechanisms during blunt insult to the knee 6th CDC Injury Prevention Through Biomechanics 137 160
- Newberry W Haut R 1996 The effects of subfracture impact loading on the patellofemoral joint in a rabbit model 40th Stapp Car Crash Conference 149 159
- Hering W Patrick L 1977 Response Comparisons of the Human Cadaver Knee and a Part 572 Dummy Knee to Impacts by Crushable Materials Twenty-First Stapp Car Crash Conference 21 1015 1053
- Grelsamer R Proctor C Bazos A 1994 Evaluation of patellar shape in the sagittal plane: A clinical analysis Amer J Sports Med 22 61 66
- Haut R 1989 Contact Pressures in the Patellofemoral Joint during Impact Loading on the Human Flexed Knee Journal of Orthopaedic Research 7 272 280
- Huberti H Hayes W Stone J Shybut G 1984 Force ratios in the quadriceps tendon and ligamentum patellae Journal of Orthopaedic Research 2 49 54
- Atkinson P Haut R 1997 A method for determining regions of diarthrodial joint contact during dynamic loading of the human knee Trans Orthop Res Soc 656
- Setton L Zhu W Mow V 1990 Biphasic poroviscoelastic behavior of articular cartilage First World Congress of Biomechanics 17
- Mow V Holmes M Lai W 1984 Fluid transport and mechanical properties of articular cartilage a review Journal of Biomechanics 17 377 394
- Anderson DD Brown TD Yang KH Radin EL 1990 A dynamic finite element analysis of impulsive loading of the extension-splinted rabbit knee Journal of Biomechanical Engineering 112 119 128
- Anderson D Brown T Radin E 1991 Stress wave effects in a finite element analysis of an impulsively loaded articular joint MechE, Part H: J Eng Med 205 27 34
- Hayes W 1991 Biomechanics of cortical and trabecular bone: implications for assessment of fracture risk Basic orthopaedic biomechanics Mow Hayes 93 142
- Minns RJ Birnie AJM Abernethy PJ 1979 A stress analysis of the patella, and how it relates to patellar articular cartilage lesions J Biomechanics 12 699 711
- Minns R Bremble G Campbell J 1975 The geometric properties of the human tibia Journal of Biomechanics 8 253 255
- Mcleod W Moschi A Andrews J Hughston J 1977 Tibial plateau topography The American Journal of Sports Medicine 5 1 13 18
- Eckstein F Muller-Gerbl M Putz R 1992 Distribution of subchondral bone density and cartilage thickness in the human patella Journal of Anatomy 180 425 433
- Ateshian G Kwak S Soslowsky L Mow, V 1994 A stereophotographic method for determining in situ contact areas in diarthrodial joints, and a comparison with other methods Journal of Biomechanics 27 1 111 124
- Blankevoort L Kuiper JH Huiskes R Grootenboer HJ 1991 Articular contact in a three dimensional model of the knee J Biomechanics 24 1019 1031
- Ateshian GA Soslowsky LJ Mow VC 1991 Quantitation of articular surface topography and cartilage thickness in knee joints using stereophotogrammetry Journal of Biomechanics 24 8 761 776
- Shelp D Newberry W LI, X Dalimonte R DeCamp C Altiero N Haut R 1994 Tissue damage resulting from blunt impact on the knee: animal and cadaver studies 4th Inj prevention through biomechanics symposium 4 43 62
- Newberry W Shelp D Coles A Haut R 1995 Chronic alterations in the physiologically relevant properties of cartilage after mechanical insult Proceedings 41st Meeting of the Orthopaedic Research Society
- Haut R Shelp D LI, X Altiero N 1993 Studies on the impact response of articular cartilage to blunt impact Symposium Proceedings: Centers for Disease Control 3 177 200
- Newberry W Atkinson P Li X DeCamp C Altiero N Haut R 1995 Tissue injuries resulting from blunt impact on the knee 5th Injury prevention through biomechanics symposium
- Newberry WN Zukosky DK Walsh JC Haut RC 1996 Blunt trauma to a joint produces surface damage to cartilage with subsequent changes in subchondral bone 749
- Wilson W 1969 Evaluating knee-to-instrument panel impacts Stapp Car Crash Conference 13 134 148