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SPORT INJURIES AND SPORT INJURIES AND BIOMECHANICS BIOMECHANICS ACL RUPTURE
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SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

Jan 11, 2016

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Page 1: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

SPORT INJURIES AND SPORT INJURIES AND BIOMECHANICSBIOMECHANICS

ACL RUPTURE

Page 2: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

ANATOMYANATOMY

Intra capsular knee joint structureLength 38mm( 25 to 41mm)Width 10mm (7 to 12mm)Made up multiple collagen fibersSurrounded by synovial membrane

envelope

Page 3: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 4: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 5: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 6: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

ANATOMYANATOMY

Femoral proximal attachment :postero- lateral corner of inter condylar notch

Tibial distal attachment : front and lateral of anterior tibial spine

Two bands: small anteromedial and a larger posterolateral portion

Page 7: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 8: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

BIOMECHANICSBIOMECHANICS

Posterolateral bulky portion is tight in extension

Anteromedial bundle is tight in flexionUltimate tensile load :2160 +/- 157 NApprox 85% resistance to anterior tibial

displasment

Page 9: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

Maximum laxity in 30 deg Maximum laxity in 30 deg flexionflexion

Page 10: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

Biomechanical characteristicsBiomechanical characteristics

ACL does not remain an isometric or constant length structure

Unsectioned ACL :2-5mm anterior translation at full extension 5-8 mm at 30 deg flexion by application 100N anterior force

Page 11: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 12: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

ACL ruptureACL rupture

Common and severe injury particularly in compact sports as rugby

Usual mechanism of injury knee hyperextension or external rotation in flexion

Page 13: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 14: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 15: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 16: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 17: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 18: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 19: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

AP instabilityAP instability

7-9 mm of increased translation (100N anterior force)

Supporting structures in ACL rupture: iliotibial band 24% medial capsule 22% lateral capsule 20% MCL 16% LCL 12%

Quadriceps and hamstrings in a certain degree alsoBaratta et al 1988

Page 20: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 21: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

Moment vs. time. Examples of quadriceps avoidanceDevita et all 1998 Timony et all 1993

Page 22: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 23: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

Matt Gaudet 2000Matt Gaudet 2000

1

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50

100

150

200

250

300

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subjects

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Page 24: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

Load deformation curveLoad deformation curve

Deformation

Load

Elastic Region

Plastic Region

Yield Point Ultimate

Failure

Point

Page 25: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 26: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.
Page 27: SPORT INJURIES AND BIOMECHANICS ACL RUPTURE. ANATOMY Intra capsular knee joint structure Length 38mm( 25 to 41mm) Width 10mm (7 to 12mm) Made up multiple.

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