In vivo anterior cruciate ligament strain behaviour during a rapid deceleration movement: case report

Abstract

The mechanism of anterior cruciate ligament (ACL) injury is still unclear. To gain this insight, knowledge of the mechanical behaviour of the healthy ACL during activities that may stress the ligament must be investigated in vivo. The goal of this research was to measure ACL strain in vivo during rapid deceleration, a sport type movement that has been previously shown to precede injuries to the ACL in healthy subjects. A young male subject with no previous knee joint injuries volunteered after informed consent. The strain gauge device (DVRT) was calibrated and surgically implanted in the antero-medial band of the intact ACL. The subject was then transported to the lab for data collection. The zero strain position of the ACL was determined using the slack-taut technique. The subject hopped as quickly as possible from a distance of 1.5 m to the target, an X taped at the centre of a force plate, landing with the instrumented left leg and stopping in the landed position. The entire collection window was five seconds at 1000 Hz. A total of three rapid deceleration trials were collected and averaged over the hop cycle. The slack-taut test was then repeated to ensure proper operation of the DVRT and the reliability of the results. The results showed an average peak strain of the ACL during the instrumented Lachman test of 2.00±0.17%. The average peak strain of the ACL during the rapid deceleration task was 5.47±0.28%. The data indicate that the RD task caused an increase in peak ACL strain that is much higher than during the instrumented Lachman test, and that the strain begins to increase during the flight phase, prior to landing, and reaches a peak that corresponds to the peak ground reaction force. This technique may be used in further sport-specific movements to gain insight into movement patterns associated with ACL injury mechanisms.