Functional knee bracing provides protection to the anterior cruciate ligament in response to rotatory loads

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106405

Sene K. Polamalu , Ehab M. Nazzal , Emre Anil Ozbek , Gian Andrea Lucidi , Luke T. Mattar , Andrew L. Sprague , Volker Musahl , Richard E. Debski

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引用次数: 0

Abstract

Background

The aim of the study was to quantify the effect of functional knee bracing on native knee kinematics and the in-situ force in the ACL in response to external loading.

Methods

A robotic testing system was used to apply three external loads from full extension to 60° of flexion to eight fresh frozen human cadaveric knees: 1) a 134 N anterior load, 2) a combined 5-Nm internal rotation +5-Nm valgus torque, and 3) a combined 5-Nm external rotation +5-Nm valgus torque. For native and braced states, kinematics were recorded and the in-situ force in the ACL was determined.

Findings

In response to the combined internal + valgus torque, ideal bracing significantly reduced internal rotation at each flexion angle and valgus rotation at 60° of flexion and reduced the in-situ force in the ACL at full extension and 30° of flexion. In response to the combined external + valgus torque, ideal bracing significantly reduced external rotation at each flexion angle and the in-situ force in the ACL at full extension. Ideal bracing had no effect on kinematics in the other degrees of freedom or on the in-situ force in the ACL in response to a 134 N anterior load.

Interpretation

Ideal knee bracing provided a protective effect on the ACL in response to a combined 5-Nm internal rotation +5-Nm valgus torque but had minimal impact in response to anterior loading and valgus torque. Therefore, ideal functional knee bracing may improve rotatory stability and provide protection to the ACL.

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功能性膝支具提供保护前交叉韧带响应旋转负荷。

背景：本研究的目的是量化功能性膝关节支架对膝关节运动学和前交叉韧带响应外部载荷的原位力的影响。方法：利用机器人测试系统对8个新鲜冷冻人体膝关节施加从完全伸展到屈60°的三种外部载荷：1)134 N前向载荷，2)5 nm内旋+5 nm外翻扭矩，3)5 nm外旋+5 nm外翻扭矩。对于原生状态和支撑状态，记录了运动学并确定了ACL的原位力。结果：理想支具对内+外翻扭矩的联合响应，显著降低了每个屈曲角度的内旋和60°屈曲时的外翻旋转，降低了ACL完全伸展和30°屈曲时的原位力。理想支具可显著降低每个屈曲角度的外旋和ACL完全伸展时的原位力。理想支具对其他自由度的运动学或前交叉韧带在134 N前负荷下的原位力没有影响。解释：理想的膝关节支具在5 nm内旋+5 nm外翻扭矩时对ACL有保护作用，但在前负荷和外翻扭矩时影响最小。因此，理想的功能性膝支具可以提高旋转稳定性，并为前交叉韧带提供保护。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.