In Vivo Elongation of the Anterior Cruciate Ligament and Posterior Cruciate Ligament during Knee Flexion
Abstract
Background: Most knowledge regarding cruciate ligament function is based on in vitro experiments. Purpose: To investigate the in vivo elongation of the functional bundles of the anterior cruciate ligament and posterior cruciate ligament during weightbearing flexion. Hypothesis: The biomechanical role of functional bundles of the anterior cruciate ligament and posterior cruciate ligament under in vivo loading is different from that measured in cadavers. Study Design: In vivo biomechanical study. Methods: Elongation of the anterior cruciate ligament and posterior cruciate ligament was measured during a quasi-static lunge using imaging and 3-dimensional computer-modeling techniques. Results: The anterior-medial bundle of the anterior cruciate ligament had a relatively constant length from full extension to 90° of flexion. The posterior-lateral bundle of the anterior cruciate ligament decreased in length with flexion. Both bundles of the posterior cruciate ligament had increased lengths with flexion. Conclusion: The data did not demonstrate the reciprocal function of the 2 bundles of the anterior cruciate ligament or the posterior cruciate ligament with flexion observed in previous studies. Instead, the data suggest that there is a reciprocal function between the anterior cruciate ligament and posterior cruciate ligament with flexion. The anterior cruciate ligament plays a more important role in low-flexion angles, whereas the posterior cruciate ligament plays a more important role in high flexion. Clinical Relevance: Understanding the biomechanical role of the knee ligaments in vivo is essential to reproduce the structural behavior of the ligament after injury (especially for 2-bundle reconstructions) and thus improve surgical outcomes.
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Recent in vivo measurements showed that both ACL bundles are longest at full knee extension.
“Recent in vivo measurements showed that both bundles are longest at full 224 knee extension [7, 8, 9, 10].”
From Computational study of kinematics of the anterior cruciate ligament double-bundle structure during passive knee flexion-extension (2020) · cites this paper as [7]
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- Authors
- Li, G., DeFrate, L. E., Sun, H., & Gill, T. J.
- Affiliations
- Harvard University (US)
- Corresponding author
- Li, Guoan
- Venue
- The American Journal of Sports Medicine
- Publisher
- SAGE Publications
- Published
- 2004-09
- Volume
- 32
- Issue
- 6
- Pages
- 1415-1420
- ISSN
- 0363-5465 (ISSN-L)
- 1552-3365
- OpenAlex
- W2050751779
- Cited by
- 182
- References
- 33
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 8 · 2023: 8 · 2022: 7 · 2021: 11 · 2020: 10 · 2019: 12 · 2018: 8 · 2017: 6 · 2016: 8 · 2015: 2 · 2014: 10 · 2013: 11 · 2012: 10
- FWCI
- 9.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- anterior cruciate ligament, posterior cruciate ligament, ligament elongation, knee flexion, lunge, knee biomechanics, ligament injury, ligament reconstruction
- MeSH terms
- Adult, Biomechanical Phenomena, Computer Simulation, Humans, Knee Injuries, Knee Joint, Magnetic Resonance Imaging, Movement, Anterior Cruciate Ligament, Posterior Cruciate Ligament, Weight-Bearing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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