The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.
Effects of Applied Quadriceps and Hamstrings Muscle Loads on Forces in the Anterior and Posterior Cruciate Ligaments
Abstract
Background: Muscle contraction can subject healing knee ligament grafts to high loads. Purpose: To directly measure the effects of quadriceps and hamstrings muscle loads on forces in the anterior cruciate ligaments and posterior cruciate ligaments. Study Design: Controlled laboratory study. Methods: Thirteen cadaveric knee specimens had load cells installed to record resultant forces in both anterior and posterior cruciate ligaments under 5 loading conditions. Cruciate force measurements were repeated with a 100-N load applied to the quadriceps tendon and again with a combined 50-N biceps load and 50-N semimembranosus-semitendinosus load. Results: Applied quadriceps loads resulted in mean changes in anterior cruciate ligament and posterior cruciate ligament forces that were less than 20 N for all loading conditions. Hamstrings load significantly increased mean posterior cruciate ligament force between 30° and 105° of flexion with 100 N of applied posterior tibial force. Conclusions: At the muscle force levels used in this study, the hamstrings were more effective than the quadriceps in altering cruciate force levels, especially near 90° of flexion, where they have an excellent mechanical advantage for controlling anterior-posterior tibial translation. Clinical Relevance: Isolated hamstrings activity generally had little or no effect on anterior cruciate ligament forces but significantly increased forces in the posterior cruciate ligament beyond approximately 30° of flexion.
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“investigators have proposed a technique involving the isolation of the tibial attachment of the cruciate ligament by creating a bone plug and attaching a load sensor to measure the native ACL force in cadaveric knees [5, 6].”
In the citing paper
“This approach is limited to ex vivo applications.”
In the citing paper
“Another experimental study simulated active extension of the lower limb against gravity by loading the quadriceps musculature [6]. The result showed an increased load on the ACL from 0° to 45° of flexion.”
Citations
Cites
Combined knee loading states that generate high anterior cruciate ligament forces
Markolf, K. L., Burchfield, D. M., Shapiro, M. M., Shepard, M. F., Finerman, G. A. M., & Slauterbeck, J. L. (1995) · Journal of Orthopaedic Research® · doi:10.1002/jor.1100130618 · Cited by 1,038
Self-citationMarkolf, K. L., Gorek, J. F., Kabo, J. M., & Shapiro, M. S. (1990) · The Journal of Bone & Joint Surgery · doi:10.2106/00004623-199072040-00014 · Cited by 610 · cited 2×
“Details of load cell installation and bench testing can be found in our prior publications.(10,11,14,15) A modification to this test apparatus was made that allowed application of muscle loads as the knee was passively extended under the above tibial loading conditions.”
BackgroundMethodSelf-citationLi, G., Rudy, T. W., Sakane, M., Kanamori, A., Ma, C. B., & Woo, S. L. (1999) · Journal of Biomechanics · doi:10.1016/s0021-9290(98)00181-x · Cited by 581
Anterior Cruciate Ligament Strain Behavior During Rehabilitation Exercises In Vivo
Beynnon, B. D., Fleming, B. C., Johnson, R. J., Nichols, C. E., Renström, P. A. F. H., & Pope, M. H. (1995) · The American Journal of Sports Medicine · doi:10.1177/036354659502300105 · Cited by 471
The Strain Behavior of the Anterior Cruciate Ligament During Squatting and Active Flexion-Extension
Beynnon, B. D., Johnson, R. J., Fleming, B. C., Stankewich, C. J., Renström, P. A. F. H., & Nichols, C. E. (1997) · The American Journal of Sports Medicine · doi:10.1177/036354659702500616 · Cited by 270
Direct in vitro measurement of forces in the cruciate ligaments. Part I
Wascher, D. C., Markolf, K. L., Shapiro, M. S., & Finerman, G. A. M. (1993) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-199303000-00009 · Cited by 200
Self-citationIn‐vitro ligament tension pattern in the flexed knee in passive loading
Ahmed, A. M., Hyder, A., Burke, D. L., & Chan, K. H. (1987) · Journal of Orthopaedic Research® · doi:10.1002/jor.1100050208 · Cited by 150
Markolf, K. L., Burchfield, D. M., Shapiro, M. M., Davis, B. R., Finerman, G. A. M., & Slauterbeck, J. L. (1996) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-199611000-00013 · Cited by 118
Self-citationLewis, J. L., Lew, W. D., & Schmidt, J. (1982) · Journal of Biomechanical Engineering · doi:10.1115/1.3138325 · Cited by 107
A Biomechanical Study of Replacement of the Posterior Cruciate Ligament with a Graft. Part I
Markolf, K. L., Slauterbeck, J. R., Armstrong, K. L., Shapiro, M. S., & Finerman, G. A. M. (1997) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-199703000-00009 · Cited by 103
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Items 201–228 of 228
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Lehnert, M., Hůlka, K., Xaverová, Z., Maixnerová, E., Milichová, P., & Reich, P. (2017) · Studia Kinanthropologica · doi:10.32725/sk.2017.018
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Anterior Cruciate Ligament Strain Behavior During Rehabilitation Exercises
Kousa, P., Slauterbeck, J. R., & Beynnon, B. D. (2008) · Elsevier eBooks · doi:10.1016/b978-1-4160-3834-4.10064-2
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Nonoperative Management of Anterior Cruciate Ligament Deficient Patients
Tsepis, E., Vagenas, G., Giakas, G., Ristanis, S., & Georgoulis, A. D. (2008) · Elsevier eBooks · doi:10.1016/b978-1-4160-3834-4.10007-1
Medial collateral ligament and posteromedial corner repair and reconstruction
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Metadata
- Authors
- Markolf, K. L., O'Neill, G., Jackson, S. R., & McAllister, D. R.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- The American Journal of Sports Medicine
- Publisher
- SAGE Publications
- Published
- 2004-07
- Volume
- 32
- Issue
- 5
- Pages
- 1144-1149
- ISSN
- 0363-5465 (ISSN-L)
- 1552-3365
- OpenAlex
- W2118040773
- Cited by
- 229
- References
- 16
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 8 · 2023: 7 · 2022: 13 · 2021: 20 · 2020: 13 · 2019: 10 · 2018: 12 · 2017: 15 · 2016: 14 · 2015: 8 · 2014: 4 · 2013: 10 · 2012: 15
- FWCI
- 3.47
- 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
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Keywords
- anterior cruciate ligament, posterior cruciate ligament, knee flexion angle, tibial translation, ligament healing
- MeSH terms
- Adult, Aged, Biomechanical Phenomena, Cadaver, Female, Humans, Knee Joint, Male, Middle Aged, Tendons, Range of Motion, Articular, Anterior Cruciate Ligament, Posterior Cruciate Ligament, Weight-Bearing, Muscle, Skeletal, Torque
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