Patellofemoral joint loads in ACL reconstructed elite athletes during running at time of return to sport

Background: Patellofemoral joint pain and degeneration is common in patients who undergo ACL reconstruction (ACLR). The presence of patellofemoral joint pain significantly impacts on the ability to continue to participate in sport and may even have a bearing on participation in activities of daily living. What is currently unclear is the mechanisms behind this process, previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear if this process is occurring following ACLR. Hypothesis/Purpose: To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to non-injured knee and matched control knees. Study Design: Cohort study Methods: Thirty four elite sports practitioners who had undergone ACLR and thirty four age and sex matched controls participated in the study. The participants had their running gait assessed using 3D motion capture, and knee loads and forces calculated using inverse dynamics. Results: There was a significance difference in knee extensor moment, knee flexion angles, patellofemoral contact force (around 23% greater), and patellofemoral contact pressure (around 27% greater) between the ACLR and non-injured limb (p≤0.04) and the ACLR and control limb (p≤0.04), with no significant difference between the non-injured and control limbs (p≥0.44). Conclusion: Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared to the non-injured and control knees. Clinical Relevance: Altered levels of patellofemoral stress in the ACLR knee during running may predispose these individuals to patellofemoral joint pain

Review of current knee biomechanical modeling techniques

In this paper we are going to present an essential modification of an existing analytical model. The model creation normally starts with a simplified, less complex analytical model, where the phenomena can be easily interpreted, checked and controlled. If this model is available and valid – with its certain simplifications – then as a following step, it can be either extended by taking into account earlier neglected factors or a similar but more advanced computational model has to be created in order to broaden the investigated factors. The accent will be set on a neglected factor, the moving center of gravity (COG), in this paper, and the obtained results will be compared with some external data from other authors

Running Injuries Due to Strike Patterns

Running is a very repetitive activity that can lead to surmountable stresses to the body over time that could lead to injury. Running biomechanics can influence the effects that the body will experience. This paper will discuss the biomechanical effects that relate to two different strike patterns: rearfoot and forefoot. Research will be examined as to how the strike patterns can influence the major lower extremity joints: ankle, knee, and hip. Common injuries during running as related to strike pattern are also discussed through conclusions based on research studies

Gender differences in limb and joint stiffness during the fencing lunge

The aim of the current investigation was to examine gender differences in limb and joint stiffness characteristics during the fencing lunge. Ten male and ten female fencers completed simulated lunge movements. Lower limb kinematics were collected using an eight camera optoelectric motion capture system which operated at 250 Hz. Measures of limb and joint stiffness were calculated as a function of limb length and joint moments divided by the extent of limb and joint excursion. Gender differences in limb joint stiffness parameters were examined statistically using independent samples t-tests. The results showed firstly that both limb (male = 64.22 ±19.12, female = 75.09 ±22.15 N.kg.m) and hip stiffness (male = 10.50 ±6.00, female = 25.89 ±15.01 Nm.kg.rad) were significantly greater in female fencers. In addition it was also demonstrated that knee moment (male = 1.64 ±0.23, female = 2.00 ±0.75 Nm.kg) was significantly larger in females. On the basis of these observations, the findings from the current investigation may provide further insight into the aetiology of the distinct injury patterns observed between genders in relation to fencing

Effects of new military footwear on knee loading during running

Military recruits are known to be susceptible to chronic injuries. The knee is the most common injury site and patellofemoral pain has been demonstrated as the leading mechanism for medical military discharge. Military boots have been cited as a key mechanism responsible for the high incidence of chronic injuries. The British Army has therefore introduced two new footwears – a cross-trainer and running shoe to reduce the incidence of chronic injuries. The aim of this study was to compare knee joint kinetics of the cross-trainer and running shoe in relation to conventional military boots. Twelve male participants ran at 4.0 m s−1 in each footwear condition. Knee joint kinetics was obtained and contrasted using repeated-measures ANOVAs. The results showed that patellofemoral load was significantly greater in the military boots. However, peak knee abduction moment was significantly greater in the running shoes. On the basis of the findings from this study, it is recommended that recruits who are susceptible to injuries mediated through excessive knee loads select the cross-trainer for their running activities

Comparison of lower body segment alignment of elite level hockey players to age-matched non-hockey players

Master's Project (M.A.) University of Alaska Fairbanks, 2015Lower body overuse and insidious onset injuries are thought to have an underlying biomechanical component which may be predisposing to injury. The purpose of this study was to compare lower body biomechanical characteristics for elite hockey players to matched controls. I hypothesize that elite hockey players have a greater degree of anterior pelvic tilt, greater varus knee angle, a higher foot arch and feet held in parallel more during gait than a matched non-skating population. Measures were taken of elite level, college aged, male hockey players and compared to cross country runners (ten subjects in each group) who served as controls for trunk angle, pelvic tilt angle, knee alignment, (varus/valgus angle), foot angle, arch index (arch height), hip, center of range of motion, hip external rotation, hip internal rotation, hip total range of motion (ROM), knee transverse plane ROM, and step width. The results obtained support the hypothesis for anterior pelvic tilt and foot angle during gait. Although knee angle was in the expected varus direction it was not significant and no differences were observed in the foot arch between the groups. All other measurements not directly related to the hypothesis were not significantly different with the exception of mean step width. The obtained results are important as recent literature describes a lower body posture of medial collapse into "dynamic valgus" as being predisposing to injury. Results show, on the spectrum from lower body varus to lower body valgus, hockey players are on the varus side of the spectrum in all attributes except arch height, which was similar in both populations. Since lower body alignment is thought to be coupled, this inconsistency appears contrary to the "medial collapse into dynamic valgus" model and may explain why foot orthotics and athletic shoes used as an injury intervention often fail

Standardisation of the description of patellofemoral motion and comparison between different techniques.

Accepted versio

Hip and knee joint loading during vertical jumping and push jerking

BACKGROUND: The internal joint contact forces experienced at the lower limb have been frequently studied in activities of daily living and rehabilitation activities. In contrast, the forces experienced during more dynamic activities are not well understood, and those studies that do exist suggest very high degrees of joint loading. METHODS: In this study a biomechanical model of the right lower limb was used to calculate the internal joint forces experienced by the lower limb during vertical jumping, landing and push jerking (an explosive exercise derived from the sport of Olympic weightlifting), with a particular emphasis on the forces experienced by the knee. FINDINGS: The knee experienced mean peak loadings of 2.4-4.6×body weight at the patellofemoral joint, 6.9-9.0×body weight at the tibiofemoral joint, 0.3-1.4×body weight anterior tibial shear and 1.0-3.1×body weight posterior tibial shear. The hip experienced a mean peak loading of 5.5-8.4×body weight and the ankle 8.9-10.0×body weight. INTERPRETATION: The magnitudes of the total (resultant) joint contact forces at the patellofemoral joint, tibiofemoral joint and hip are greater than those reported in activities of daily living and less dynamic rehabilitation exercises. The information in this study is of importance for medical professionals, coaches and biomedical researchers in improving the understanding of acute and chronic injuries, understanding the performance of prosthetic implants and materials, evaluating the appropriateness of jumping and weightlifting for patient populations and informing the training programmes of healthy populations. Copyright © 2012 Elsevier Ltd. All rights reserved

Effects of Isolated Hip Abductor Fatigue on Frontal Plane Knee Mechanics

Purpose: Anterior cruciate ligament injuries and patellofemoral pain syndrome are both common and significant injuries to the knee that have been associated with hip weakness. Prospective studies have linked the risk of experiencing either injury to alterations in the frontal plane knee angle and moment during activity. These components of knee mechanics are theorized to be affected by hip abductor weakness. The purpose of this study was to identify the effects of isolated hip abductor fatigue-induced weakness on lower extremity kinematics and kinetics in recreationally active women

Analytical and computational estimation of patellofemoral forces in the knee under squatting and isometric motion

This study presents an intermediate step in prosthesis design, by introducing a newly developed two-dimensional mathematical, and a three-dimensional computational knee model. The analytical model is derived from Newton’s law with respect to the equilibrium equations, thus based on theoretical assumptions, and experimentally obtained parameter. The numeric model is built from an existing prosthesis, involving three parts as patella, femur and tibia, and currently it is under development. The models are capable to predict – with their standard deviation – the patellofemoral (numerically tibiofemoral as well) forces in the knee joint during squatting motion. The reason why the squatting is investigated is due to its relative simplicity and the fact, that during the movement the forces reach extremity in the knee joint. The obtained forces – as a function of flexion angle – are used firstly as fundaments to the knee design method, and secondly to extend the results related to the existing isometric kinetics, where one of the newly obtained functions appears as an essential – and so far missing – input function. Most results are compared and validated to the ones found in the relevant literature and put into a dimensionless form in order to have more general meaning