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Effects of Anterior-Posterior Constraint on Injury Patterns in the Human Knee During Tibial-Femoral Joint Loading from Axial Forces through the Tibia
Published November 01, 2001 by The Stapp Association in United States
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Event: STAPP Car Crash Conference
According to the National Accident Sampling System (NASS), 10% of all automobile accident injuries involve the knee. These injuries involve bone fracture and/or “soft tissue” injury. Previous investigators have determined the tibial-femoral (TF) joint failure load for an experimentally constrained human knee at 90° flexion. In these experiments bone fractures have been documented. During TF joint compression, however, anterior motion of the tibia has been noted by others. It was therefore the objectives of this study to document effects of flexion angle and anterior-posterior joint constraint on the nature and severity of knee injury during TF compression loading via axial loads in the tibia.
The effect of flexion angle was examined using 10 unconstrained human knees from 5 cadavers aged 73.2±9.4 years. The tibial-femoral joint was loaded in compression as a result of axial loading along the tibia using a servo-hydraulic testing machine until gross failure with the knee flexed 60° or 120°. Pressure sensitive film measured the distribution of internal TF joint loads. Both 60° and 120° flexed preparations failed by rupture of the anterior cruciate ligament (ACL) at 4.6±1.2 kN, and the internal joint loads were significantly higher (2.6±1.5 kN) on the medial versus the lateral (0.4±0.5 kN) aspect of the tibial plateau.
The effect of anterior-posterior (AP) constraint of the femur along the longitudinal axis of the femur was investigated in a second series of tests using the same TF joint loading protocol on 6 pairs of human joints (74.3±10.5 years) flexed at 90°. The primary mode of failure for the AP constrained joints was fracture of bone via the femoral condyle at a maximum load of 9.2±2.6 kN. The mode of failure for unconstrained joints was primarily due to rupture of the ACL at a maximum load of 5.8±2.9 kN. Again, the pressure film indicated an unequal internal TF load distribution for the unconstrained knee (medial plateau 4.1±1.9 kN versus lateral plateau 0.8±0.8 kN). However, there was a more equal distribution of internal loads between the medial (4.4±1.8 kN) and lateral (2.8±1.9 kN) aspects of the tibial plateau in the constrained joints.
This study showed that the mechanism of tibial-femoral knee joint injury and internal TF joint load distribution depends on the degree of AP constraint offered by the test apparatus. Flexion angle did not significantly affect failure load or the mechanism of failure for the unconstrained knee. The findings from this study may be useful in understanding the complex failure mechanisms for an unconstrained knee under axial compression loads in the tibia during automobile crashes.
- Vijay M. Jayaraman - Orthopaedic Biomechanics Laboratories, Michigan State University
- Eric T. Sevensma - Orthopaedic Biomechanics Laboratories, Michigan State University
- Masaya Kitagawa - Orthopaedic Biomechanics Laboratories, Michigan State University
- Roger C. Haut - Orthopaedic Biomechanics Laboratories, Michigan State University
CitationJayaraman, V., Sevensma, E., Kitagawa, M., and Haut, R., "Effects of Anterior-Posterior Constraint on Injury Patterns in the Human Knee During Tibial-Femoral Joint Loading from Axial Forces through the Tibia," SAE Technical Paper 2001-22-0021, 2001, https://doi.org/10.4271/2001-22-0021.
- Atkinson P.J., Newberry W.N. Atkinson T.S., Haut R.C. 1998a A method to increase the sensitive range of pressure sensitive film Journal of Biomechanics 31 855 859
- Atkinson P.J. Atkinson T.S. Haut R.C. Eusebi, C. Maripudi, V. Hill, T. Sambatur, K 1998b Development of injury criteria for human surrogates to address current trends in knees to instrument panel injuries SAE, 983146 13 31
- Atkinson T Atkinson P 2000 Knee injuries in motor vehicle collisions: a study of the national accident sampling system database for the years 1979–1995 Accid. Anat. and Prev. 32 6 779 786
- Banglmaier, R. Dvoracek-Driksna, D. Oniang’o, T. Haut, R 1999 Axial compressive load response of the 90° flexed human tibiofemoral joint Proc. 43 rd Stapp Car Crash Conference 127 140 Society of Automotive Engineers Wareendale, PA
- Bedewi, P.G. Digges, K.H. 1999 Investigating Ankle Injury Mechanisms in Offset Frontal Collisions Utilizing Computer Modeling and Case-Study Data Proc. 43 rd Stapp Car Crash Conference 217 242 Society of Automotive Engineers Wareendale, PA
- Daniel D.M., Stone M.L. Dobson B.E., Fithian D.C. Rossman D.J., Kaufman K.R. 1994 Fate of the ACL injured patient: a prospective outcome study The American Journal of Sports Medicine 22 632 644
- Ewers, B. Jayaraman, V. Banglmaier, R. Haut, R. 2000 The effect of loading rate on the degree of acute injury and chronic conditions in the knee after blunt impact Stapp Car Crash Conference Journal 44 299 314
- Fildes B. Lane L. Vulcan P. Seyer K 1997 Lower limb injuries to passenger car occupant Accid. Anat. and Prev. 29 6 785 791
- Fleming B., Renstrom P. Beynnon B., et al. 2001 The effect of weight-bearing and external loading on anterior cruciate ligament strain Journal of Biomechanics 34 163 170
- Haut R. 1983 The influence of superficial tissue on response of the primate knee to traumatic tibial drawer Journal of Biomechanics 16 465 472
- Hirsch G. Sullivan L. 1965 Experimental knee-joint fractures Acta Orthopaedica Scandinavia 36 391 399
- Kennedy J.C. Bailey W.H. 1968 Experimental tibial-plateau fractures: studies of the mechanism and a classification Journal of Bone and Joint Surgery 50 A 1522 1534
- Li G., Rudy T. Allen C. 1998 Effect of combined axial compressive and anterior tibial loads on in situ forces in the anterior cruciate ligament: a porcine study Journal of Orthopaedic Research 16 122 127
- MacKenzie E., Siegel J. 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
- Markolf K.L., Bargar W.L. Shoemaker S.C., Amstutz H.C. 1981 The role of joint load in knee stability Journal of Bone and Joint Surgery [AM] 63 570 585
- Mertz H.J. 1993 Anthropomorphic test devices Accidental Injury. Biomechanics and Prevention Nahum, A.M. Melvin, J.W. 66 84 Springer-Verlag New York Inc. New York
- Miller T. Martin P. Crandell J.R. 1995 Cost of lower limb injuries in highway crashes Proc. International Conference on Pelvic and Lower Extremity Injuries 47 57
- States J 1970 Traumatic arthritis-A medical and legal dilemma Proc. 14 th Annual Conference of the American Association for Automotive Medicine 21 28
- Torzilli P., Deng, X., Warren, R. 1994 The effect of joint-compression load and quadreceps muscle force on knee motion in the intact and the anterior cruciate ligament-sectioned knee The American Journal of Sports Medicine 22 105 112
- Viano D. Culver C. Haut R. Melvin J. Bender M. Culver R. Levine R 1978 Bolster impacts to the knee and tibia of human cadavers and an anthropomorphic dummy Proc. 22 nd Stapp Car Crash Conference 403 428 Society of Automotive Engineers Warrendale, PA
- Zhang D., Weinbaum S. Cowin S. 1998 Estimates of the peak pressures in bone pore water Journal of Biomechanical Engineering 120 697 703