The DOI matches its Crossref record.
Direct measurement of resultant forces in the anterior cruciate ligament. An in vitro study performed with a new experimental technique.
Abstract
A new technique was used to measure the resultant forces in the anterior cruciate ligament during a series of loading experiments on seventeen fresh-frozen cadaver specimens. The base of the ligament's tibial attachment was mechanically isolated with a coring cutter, and a specially designed load-transducer was fixed to the bone-plug that contained the ligament's tibial insertion so that the resultant forces were directly measured by the load-cell. Although the magnitudes of values for forces varied considerably between specimens for a given test condition, the patterns of loading with respect to direction of loading and the angle of flexion of the knee were remarkably consistent. Passive extension of the knee generated forces in the ligament only during the last 10 degrees of extension; at 5 degrees of hyperextension, the forces ranged from fifty to 240 newtons (mean, 118 newtons). When a 200-newton pull of the quadriceps tendon was applied to extend a knee slowly against tibial resistance, however, the force in the ligament increased at all angles of flexion of the knee. Internal tibial torque always generated greater forces in the ligament than did external tibial torque; higher forces were recorded as the knee was extended. The greatest forces (133 to 370 newtons) were generated when ten newton-meters of internal tibial torque was applied to a hyperextended knee. Fifteen newton-meters of applied varus moment generated forces of ninety-four to 177 newtons at full extension; fifteen newton-meters of applied valgus moment generated a mean force of fifty-six newtons, which remained unchanged with flexion of the knee. The force during straight anterior translation of the tibia was approximately equal to the anterior force applied to the tibia. The application of 925 newtons of tibiofemoral contact force reduced the mean force in the ligament that was generated by 200 newtons of anterior pull on the tibia by 36 per cent at full extension and 46 per cent at 20 degrees of flexion.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“This approach is limited to ex vivo applications.”
In the citing paper
“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
“studies demonstrated that passive flexion–extension motions do not load the ACL [5, 30]”
Citations
Cited by
Sorted by citations
Items 101–200 of 610
Biomechanical Function of the human anterior cruciate ligament
Takeda, Y., Xerogeanes, J. W., Livesay, G. A., et al. (1994) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/s0749-8063(05)80081-7 · Cited by 104
Biomechanical Studies of Double-Bundle Posterior Cruciate Ligament Reconstructions
Markolf, K. L., Feeley, B. T., Jackson, S. R., et al. (2006) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.e.00427 · Cited by 104
Self-citationMarouane, H., Shirazi-Adl, A., Adouni, M., et al. (2014) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2014.01.055 · Cited by 103
“It is recognized that the anterior cruciate ligament (ACL) plays an important biomechanical role in the knee joint response under loads in particular in the anterior–posterior (A–P) and internal– external (I–E) movements (Amis, 2012; Markolf et al., 1990).”
BackgroundJonsson, H., & Kärrholm, J. (1994) · Journal of Orthopaedic Research® · doi:10.1002/jor.1100120604 · Cited by 102
Training Affects Knee Kinematics and Kinetics in Cutting Maneuvers in Sport
Wilkie, J. C., Lloyd, D. G., Besier, T. F., Elliott, B. C., Doyle, T. L. A., & Ackland, T. R. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181d03ba0 · Cited by 101
“The quadriceps cause anterior tibial translation (7,32) with the ACL being the main restraint in knee postures from 30flexion to full extension (25,30,31).”
BackgroundInfluentialBiomechanical Analysis of Tibial Torque and Knee Flexion Angle
Senter, C., & Hame, S. L. (2006) · Sports Medicine · doi:10.2165/00007256-200636080-00001 · Cited by 100
Gender Comparison of Patellar Tendon Tibial Shaft Angle with Weight Bearing
Nunley, R. M., Wright, D. L., Renner, J. B., Yu, B., & Garrett, W. E. J. (2003) · Research in Sports Medicine · doi:10.1080/15438620390231193 · Cited by 100
DeVita, P., & Hortobágyi, T. (2001) · Journal of Applied Biomechanics · doi:10.1123/jab.17.4.297 · Cited by 100
Preferential Loading of the ACL Compared With the MCL During Landing
Quatman, C. E., Kiapour, A. M., Demetropoulos, C. K., Kiapour, A., Wordeman, S. C., Levine, J. W., Goel, V. K., & Hewett, T. E. (2013) · The American Journal of Sports Medicine · doi:10.1177/0363546513506558 · Cited by 98
Dos’Santos, T., THOMAS, C. R., Comfort, P., & Jones, P. A. (2019) · Sports Medicine · doi:10.1007/s40279-019-01171-0 · Cited by 94
Anticipatory effects on anterior cruciate ligament loading during sidestep cutting
Weinhandl, J. T., Earl-Boehm, J. E., Ebersole, K. T., Huddleston, W. E., Armstrong, B., & O’Connor, K. M. (2013) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2013.06.001 · Cited by 95
“Over the years much has been learned regarding ACL mechanics through in vitro (Markolf et al., 1990; Markolf et al., 1995) and in vivo (Beynnon et al.”
BackgroundMethodInfluentialThe measurement of elongation of anterior cruciate-ligament grafts in vivo.
Beynnon, B. D., Johnson, R. J., Fleming, B. C., Renström, P. A. F. H., Nichols, C. E., Pope, M. H., & Haugh, L. D. (1994) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-199404000-00006 · Cited by 94
Fleming, B. C., Beynnon, B. D., Howe, J. G., et al. (1992) · Journal of Orthopaedic Research® · doi:10.1002/jor.1100100204 · Cited by 94
Differences in normal and perturbed walking kinematics between male and female athletes
Hurd, W. J., Chmielewski, T. L., Axe, M. J., DAVIS, I. M., & Snyder‐Mackler, L. (2004) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2004.01.013 · Cited by 93
“Markolf and colleagues in 1990 (Markolf et al., 1990) and 1995 (Markolf et al.”
BackgroundLoading mechanisms of the anterior cruciate ligament
Beaulieu, M. L., Ashton‐Miller, J. A., & Wojtys, E. M. (2021) · Sports Biomechanics · doi:10.1080/14763141.2021.1916578 · Cited by 92
“…one of the studies that measured ACL loading in response to quasi-statically applied internal tibial torque reported a significant increase in ACL strain (Fleming et al., 2001; Kennedy et al., 1977; Markolf et al., 1990; Shin et al., 2011) or ACL force (Hame et al., 2002; T. Miyasaka et al., 2002).”
BackgroundInfluentialYamanaka, M., Yasuda, K., Tohyama, H., et al. (1999) · The American Journal of Sports Medicine · doi:10.1177/03635465990270061401 · Cited by 92
Markolf, K. L., Park, S., Jackson, S. R., et al. (2008) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.g.01272 · Cited by 91
Self-citationShimokochi, Y., Lee, S. Y., Shultz, S. J., & Schmitz, R. J. (2009) · Journal of Athletic Training · doi:10.4085/1062-6050-44.1.33 · Cited by 91
A Sagittal Plane Model of the Knee and Cruciate Ligaments With Application of a Sensitivity Analysis
Beynnon, B. D., Yu, J. Y., Huston, D. R., et al. (1996) · Journal of Biomechanical Engineering · doi:10.1115/1.2795965 · Cited by 89
Biomechanics of knee ligament healing, repair and reconstruction
Woo, S. L., Saw, S. S. C., & Yamaji, T. (1997) · Journal of Biomechanics · doi:10.1016/s0021-9290(96)00168-6 · Cited by 88
Aga, C., Rasmussen, M. T., Smith, S. D., et al. (2013) · The American Journal of Sports Medicine · doi:10.1177/0363546512474968 · Cited by 87
“This simulated the reported forces in the ACL during passive extension while walking and the early rehabilitation protocol of flexion-extension loading on the reconstructed graft.(19) After the cyclic loading protocol, grafts were further displaced at 50 mm/min until failure(16) to simulate a sudden overload event at…”
MethodOakes, D. A., Markolf, K. L., McWilliams, J. P., Young, C. R., & McAllister, D. R. (2002) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-200206000-00007 · Cited by 86
Self-citationA Novel Robotic System for Joint Biomechanical Tests: Application to the Human Knee Joint
Fujie, H., Sekito, T., & Orita, A. (2004) · Journal of Biomechanical Engineering · doi:10.1115/1.1644567 · Cited by 85
Branch, T. P., Browne, J. E., Campbell, J., et al. (2009) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-009-1010-y · Cited by 85
A deficient anterior cruciate ligament does not lead to quadriceps avoidance gait
Roberts, C. S., Rash, G. S., Honaker, J. T., et al. (1999) · Gait & Posture · doi:10.1016/s0966-6362(99)00038-7 · Cited by 85
Walsh, M. P., Wijdicks, C. A., Parker, J., et al. (2008) · The American Journal of Sports Medicine · doi:10.1177/0363546508323747 · Cited by 82
Anterior cruciate ligament injury risk factors in football
Bisciotti, G. N., Chamari, K., Cena, E., Bisciotti, A., Bisciotti, A., Corsini, A., & Volpi, P. (2019) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.19.09563-x · Cited by 80
Limbert, G., Taylor, M., & Middleton, J. (2004) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2004.01.030 · Cited by 81
“, 1985), displacements (Markolf et al., 1990; Renstrom et al., 1986), buckle transducers (Barry and Ahmed, 1986) or optical”
BackgroundMethodThe Effects of Compressive Load and Knee Joint Torque on Peak Anterior Cruciate Ligament Strains
Fleming, B. C., Ohlén, G., Renström, A., Peura, G. D., Beynnon, B. D., & Badger, G. J. (2003) · The American Journal of Sports Medicine · doi:10.1177/03635465030310051101 · Cited by 81
“This result would be expected, because the quadriceps muscles, which are antagonistic to the ACL, are dominant during extensor exercise.(5,13,14,20,22,29,32,34,36)”
BackgroundJagodzinski, M., Foerstemann, T., Mall, G., Krettek, C., Bosch, U., & Paessler, H. H. (2005) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2004.03.021 · Cited by 79
“The analysis of ACL tension with a load transducer reports 118 (50–240N) for knee extension of 5 (Markolf et al., 1990).”
BackgroundMethodGender differences in passive knee biomechanical properties in tibial rotation
Park, H., Wilson, N. A., & Zhang, L. (2008) · Journal of Orthopaedic Research® · doi:10.1002/jor.20576 · Cited by 79
“However, ACL injuries also occur with the tibia in external rotation.(27,28,37,38) Furthermore, recent studies showed that the ACL may impinge against the lateral wall of the intercondylar notch during excessive external rotation and abduction.”
BackgroundBiomechanics of the ACL: Measurements of in situ force in the ACL and knee kinematics
Woo, S. L., Fox, R. J., Sakane, M., Livesay, G. A., Rudy, T. W., & Fu, F. H. (1998) · The Knee · doi:10.1016/s0968-0160(98)00014-3 · Cited by 79
Cyclic Pull-Out Strength of Hamstring Tendon Graft Fixation with Soft Tissue Interference Screws
Stadelmaier, D. M., Lowe, W. R., Ilahi, O. A., et al. (1999) · The American Journal of Sports Medicine · doi:10.1177/03635465990270061501 · Cited by 79
“Previous work had indicated that the forces exerted on the graft fixation site during different activities typically encountered in the early postoperative period range from 152 to 450 N.(21,24) In our study, cyclic load testing initiated “slippage” of the graft as the amplitude of the loading increased with each cycl…”
BackgroundManiar, N., Schache, A. G., Sritharan, P., & Opar, D. A. (2018) · Scientific Reports · doi:10.1038/s41598-017-19098-9 · Cited by 77
Fleming, B. C., Renström, P. A. F. H., Beynnon, B. D., et al. (2000) · The American Journal of Sports Medicine · doi:10.1177/03635465000280060901 · Cited by 77
The University of North Carolina at Chapel Hill University Libraries (2020) · Europe PMC (PubMed Central) · doi:10.17615/3vqb-v766 · Cited by 79
Evaluation of the Single-Incision Arthroscopic Technique for Anterior Cruciate Ligament Replacement
Howell, S. M., Wallace, M. P., Hull, M. L., et al. (1999) · The American Journal of Sports Medicine · doi:10.1177/03635465990270030301 · Cited by 77
“Free placement may be clinically important because the placement of the femoral tunnel determines the forces in the graft.(4,15,16,18,20) A femoral tunnel positioned too anterior or distal causes abnormal increases in graft tension with flexion(15,17,19) that may result in graft failure, loss of fixation, or limited m…”
BackgroundAnterior tibial post impingement in a posterior stabilized total knee arthroplasty
Li, G., Papannagari, R., Most, E., et al. (2004) · Journal of Orthopaedic Research® · doi:10.1016/j.orthres.2004.09.005 · Cited by 76
Brady, M. F., Bradley, M. P., Fleming, B. C., Fadale, P. D., Hulstyn, M. J., & Banerjee, R. K. (2007) · The American Journal of Sports Medicine · doi:10.1177/0363546506294363 · Cited by 75
“The focus on anterior-posterior laxity is motivated by the fact that a primary role of the ACL is to oppose anterior translation of the tibia,(18) although the ACL is also a restraint to axial rotation.(27,48) More recent cadaveric studies evaluating the relationship between initial graft tension and axial rotation ha…”
BackgroundBiomechanics of passive knee joint in drawer: load transmission in intact and ACL-deficient joints
Moglo, K. E., & Shirazi-Adl, A. (2002) · The Knee · doi:10.1016/s0968-0160(02)00135-7 · Cited by 75
Changes in Lower Extremity Biomechanics Due to a Short-Term Fatigue Protocol
Cortés, N., Greska, E., Kollock, R. O., Ambegaonkar, J. P., & Oñate, J. A. (2013) · Journal of Athletic Training · doi:10.4085/1062-6050-48.2.03 · Cited by 76
Ligament Healing: Current Knowledge and Clinical Applications
Frank, C. (1996) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/00124635-199603000-00002 · Cited by 75
Dos’Santos, T., THOMAS, C. R., Comfort, P., & Jones, P. A. (2018) · Strength and conditioning journal · doi:10.1519/ssc.0000000000000395 · Cited by 78
Yu, B., Herman, D. C., Preston, J. J., et al. (2004) · The American Journal of Sports Medicine · doi:10.1177/0363546503262204 · Cited by 74
“Studies repeatedly have shown that the anterior shear force applied on the tibia through the patellar tendon is a function of the knee flexion angle.(4,13,23,28,31) The anterior shear force applied on the tibia through the patellar tendon decreases as the patellar tendon–tibia shaft angle decreases, whereas the patell…”
BackgroundAlmonroeder, T. G., Garcia, E., & Kurt, M. (2015) · PubMed Central · Cited by 74
Numazaki, H., Tohyama, H., Nakano, H., Kikuchi, S., & Yasuda, K. (2002) · The American Journal of Sports Medicine · doi:10.1177/03635465020300060801 · Cited by 72
“Therefore, even tension between 80 and 140 N does not appear to be too high, according to the in situ force of the ACL reported by Markolf et al.(7) In addition, our results showed that an increase in the initial graft tension up to 140 N did not affect the linear stiffness, the ultimate failure load, or the mode of f…”
BackgroundInfluentialA Dynamic Model of the Knee and Lower Limb for Simulating Rising Movements
Shelburne, K. B., & Pandy, M. G. (2002) · Computer Methods in Biomechanics & Biomedical Engineering · doi:10.1080/10255840290010265 · Cited by 72
“Since external tibial rotation increases the force produced in the ACL [38], the model calculations represent an upper-bound for ligament forces in the real knee.”
BackgroundTerauchi, M., Hatayama, K., Yanagisawa, S., Saito, K., & Takagishi, K. (2011) · The American Journal of Sports Medicine · doi:10.1177/0363546510393305 · Cited by 71
Weinhandl, J. T., Earl-Boehm, J. E., Ebersole, K. T., Huddleston, W. E., Armstrong, B., & O’Connor, K. M. (2014) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2014.05.013 · Cited by 70
“Once Flig was determined, sagittal plane ACL loading (FACL-SP) was estimated as a proportion of Flig based on cadaveric knee measurements (Markolf et al., 1995; Markolf et al., 1990):”
BackgroundMethodNoonan, B. C., Dines, J. S., Allen, A. A., Altchek, D. W., & Bedi, A. (2016) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/j.arthro.2016.02.010 · Cited by 71
“We felt that initial tensioning to 250 N was reasonable as forces up to 370 N can be generated in a reconstructed ACL when hyperextension and internal rotation of the tibia are performed.(12) While this level of force may be difficult to obtain manually by simply pulling on a graft, the ability to establish both tibia…”
BackgroundBiomechanical Comparison of Cutting Techniques: A Review and Practical Applications
Dos’Santos, T., McBurnie, A. J., THOMAS, C. R., Comfort, P., & Jones, P. A. (2019) · Strength and conditioning journal · doi:10.1519/ssc.0000000000000461 · Cited by 70
“Specifically, side-step techniques with a wide lateral foot plant (20,37,45,57), greater hip abduction angles (95), increased internal foot progression angles (initial posture) (47,95), increased hip internal rotation angles (initial posture) (37,66,94,95), greater peak knee valgus angles (45,47,57,66,94), greater lat…”
BackgroundAnterior Cruciate Ligament Reconstruction with Patellar Tendon
Graf, B. K., Henry, J. S., Rothenberg, M., et al. (1994) · The American Journal of Sports Medicine · doi:10.1177/036354659402200120 · Cited by 70
Evaluating cost function criteria in predicting healthy gait
Veerkamp, K., Waterval, N. F. J., Geijtenbeek, T., Carty, C. P., Lloyd, D. G., Harlaar, J., & van der Krogt, M. M. (2021) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2021.110530 · Cited by 70
A review of systematic reviews on anterior cruciate ligament reconstruction rehabilitation
Lobb, R., Tumilty, S., & Claydon, L. S. (2012) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2012.05.001 · Cited by 82
Kiapour, A. M., Quatman, C. E., Goel, V. K., Wordeman, S. C., Hewett, T. E., & Demetropoulos, C. K. (2013) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2013.10.017 · Cited by 69
“The choice to place a single DVRT on the ACL AM-bundle was based on a previous work that found AM-bundle strain to be a good representation of overall ACL strain (Markolf et al., 1990).”
Altered knee kinematics in ACL‐deficient non‐copers: A comparison using dynamic MRI
Barrance, P. J., Williams, G. N., Snyder‐Mackler, L., et al. (2005) · Journal of Orthopaedic Research® · doi:10.1002/jor.20016 · Cited by 68
Functional Tissue Engineering Parameters toward Designing Repair and Replacement Strategies
Butler, D. L., Shearn, J. T., Juncosa, N., et al. (2004) · Clinical Orthopaedics and Related Research · doi:10.1097/01.blo.0000144858.65450.d2 · Cited by 67
“The cruciate ligaments exhibit nonparallel fiber orientations that can complicate the loading of the tissue and even create small axial torques.(10,40,63) These angled bundles further tilt the orientation of the resultant force and create combined reaction loads (tension and torsion) at the insertion sites (Fig 4).”
BackgroundMechanism of Injury and Risk Factors for Anterior Cruciate Ligament Injury
Wetters, N. G., Weber, A. E., Wuerz, T. H., Schub, D. L., & Mandelbaum, B. R. (2015) · Operative Techniques in Sports Medicine · doi:10.1053/j.otsm.2015.09.001 · Cited by 66
High tibial osteotomy in the ACL-deficient knee with medial compartment osteoarthritis
Herman, B. V., & Giffin, J. R. (2016) · Journal of Orthopaedics and Traumatology · doi:10.1007/s10195-016-0413-z · Cited by 67
Cronström, A., Creaby, M. W., & Ageberg, E. (2020) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03552-3 · Cited by 74
Effect of Plyometric Training on Neural and Mechanical Properties of the Knee Extensor Muscles
Behrens, M., Mau‐Moeller, A., & Bruhn, S. (2013) · International Journal of Sports Medicine · doi:10.1055/s-0033-1343401 · Cited by 65
Three-Dimensional Knee Joint Kinetics During a Golf Swing
Gatt, C. J., Pavol, M. J., Parker, R. D., et al. (1998) · The American Journal of Sports Medicine · doi:10.1177/03635465980260022101 · Cited by 65
Wallace, M. P., Howell, S. M., & Hull, M. L. (1997) · Journal of Orthopaedic Research® · doi:10.1002/jor.1100150409 · Cited by 65
“Furthermore, the range of maximum total tension of the double-looped hamstring graft (78-296 N) was similar to that of the normal anterior cruciate liga-ment (50-240 N) during passive motion (13).”
BackgroundPadua, D., & DiStefano, L. J. (2009) · Sports health · doi:10.1177/1941738108330971 · Cited by 74
“Anterior tibial shear (sagittal plane) is considered the most direct loading mechanism.(21,22) Decreasing anterior tibial shear through ACL injury prevention programs is one method to minimize ACL loading and thereby reduce injury risk.”
BackgroundMuneta, T., Yamamoto, H., Sakai, H., Ishibashi, T., & Furuya, K. (1993) · The American Journal of Sports Medicine · doi:10.1177/036354659302100222 · Cited by 61
Biomechanical response of the passive human knee joint under anterior-posterior forces
Bendjaballah, M. Z., Shirazi-Adl, A., & Zukor, D. J. (1998) · Clinical Biomechanics · doi:10.1016/s0268-0033(98)00035-7 · Cited by 63
Yanagawa, T., Shelburne, K. B., Serpas, F., et al. (2002) · Clinical Biomechanics · doi:10.1016/s0268-0033(02)00104-3 · Cited by 63
“[29] (see Fig.”
Markolf, K. L., Jackson, S. R., Foster, B. D., et al. (2013) · Journal of Orthopaedic Research® · doi:10.1002/jor.22476 · Cited by 62
Self-citationRole of kinetic chain in sports performance and injury risk: a narrative review
Nuhmani, S., Almansoof, H. S., & Muaidi, Q. I. (2023) · Journal of Medicine and Life · doi:10.25122/jml-2023-0087 · Cited by 63
“This alteration in kinetic chain muscle activities can increase the risk of anterior cruciate ligament (ACL) injuries [10].”
BackgroundNeuromuscular contributions to anterior cruciate ligament injuries in females
Lephart, S. M., Abt, J. P., & Ferris, C. M. (2002) · Current Opinion in Rheumatology · doi:10.1097/00002281-200203000-00014 · Cited by 62
Injury to the Anterior Cruciate Ligament during Alpine Skiing
Hame, S. L., Oakes, D. A., & Markolf, K. L. (2002) · The American Journal of Sports Medicine · doi:10.1177/03635465020300041301 · Cited by 62
“Details of specimen preparation and the ACL bone cap isolation technique can be found in a prior publication.(8) Testing was performed with the knee at 0° of flexion (as defined by application of a 2-N m extension moment), 90° of flexion, full manual flexion, and at forced hyperflexion (as determined by hanging an app…”
MethodSelf-citationFleming, B. C., Beynnon, B. D., Nichols, C. E., et al. (1993) · Journal of Biomechanics · doi:10.1016/0021-9290(93)90612-i · Cited by 62
Abt, J. P., Sell, T. C., Crawford, K., Lovalekar, M. T., Nagai, T., Deluzio, J. B., Smalley, B. W., McGrail, M. A., Rowe, R. S., Cardin, S., et al. (2010) · Journal of Special Operations Medicine · doi:10.55460/42ci-elhp · Cited by 61
Effects of Fatigue and Recovery on Knee Mechanics during Side-Step Cutting
Tsai, L., Sigward, S. M., Pollard, C. D., FLETCHER, M. J., & Powers, C. M. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181a4b266 · Cited by 62
Kiapour, A. M., Kiapour, A., Goel, V. K., Quatman, C. E., Wordeman, S. C., Hewett, T. E., & Demetropoulos, C. K. (2015) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2015.05.017 · Cited by 61
“Journal of Biomechanics (2 AM-bundle was based on previous work that found AM-bundle strain to be representative of overall ACL strain (Markolf et al., 1990).”
Key developments that impacted the field of mechanobiology and mechanotransduction
Wall, M. E., Butler, D. L., Haj, A. J. E., Bodle, J. C., Loboa, E. G., & Banes, A. J. (2017) · Journal of Orthopaedic Research® · doi:10.1002/jor.23707 · Cited by 61
Houck, D. A., Kraeutler, M. J., McCarty, E. C., & Bravman, J. T. (2018) · Orthopaedic Journal of Sports Medicine · doi:10.1177/2325967118801762 · Cited by 61
“This study also defined biomechanical failure as 3 mm of device lengthening.19 Data Extraction Data extracted for this review included displacement during cyclic loading, ultimate load to failure, and mode of failure of the different cortical suspension devices for ACLR.”
BackgroundInfluentialA New Load Application System for In Vitro Study of Ligamentous Injuries to the Human Knee Joint
Bach, J. M., & Hull, M. L. (1995) · Journal of Biomechanical Engineering · doi:10.1115/1.2794195 · Cited by 61
Isometric versus tension measurements
Fleming, B. C., Beynnon, B. D., Johnson, R. J., et al. (1993) · The American Journal of Sports Medicine · doi:10.1177/036354659302100115 · Cited by 61
Shirazi, R., & Shirazi-Adl, A. (2009) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2009.07.005 · Cited by 60
Suzuki, T., Shino, K., Otsubo, H., Suzuki, D., Mae, T., Fujimiya, M., Yamashita, T., & Fujie, H. (2014) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/j.arthro.2014.05.027 · Cited by 61
Rubinstein, R. A., Shelbourne, K. D., VanMeter, C. D., et al. (1995) · The American Journal of Sports Medicine · doi:10.1177/036354659502300321 · Cited by 58
Roth, J. D., Howell, S. M., & Hull, M. L. (2017) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-017-4670-z · Cited by 57
Southam, B. R., Colosimo, A. J., & Grawe, B. M. (2018) · Orthopaedic Journal of Sports Medicine · doi:10.1177/2325967117751689 · Cited by 57
“Cadaveric studies have demonstrated that higher tension forces are observed in the ACL when varus torque is applied to the extended knee.(71,72,79,122) Furthermore, several studies have identified that knees with varus thrust that undergo ACLR may be more likely to fail if the varus alignment is not addressed at the t…”
BackgroundJoint position sense is not changed after acute disruption of the anterior cruciate ligament
Good, L., Roos, H. P., Gottlieb, D. J., et al. (1999) · Acta Orthopaedica Scandinavica · doi:10.3109/17453679909011261 · Cited by 57
A Model of Human Knee Ligaments in the Sagittal Plane: Part 2: Fibre Recruitment under Load
Zavatsky, A. B., & O'Connor, J. J. (1992) · Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine · doi:10.1243/pime_proc_1992_206_281_02 · Cited by 57
Hame, S. L., Markolf, K. L., Hunter, D. M., Oakes, D. A., & Zoric, B. (2003) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1053/jars.2003.50040 · Cited by 56
Self-citationLloyd, D. G. (2021) · Sports Biomechanics · doi:10.1080/14763141.2021.1959947 · Cited by 56
“Our research group has used all these approaches, except the cadaveric studies, preferring to use the results of other groups cadaveric investigations to inform our studies (e.g., Elias et al., 2003; Markolf et al., 1995, 1990; E. G. Meyer & Haut, 2005).”
Markolf, K. L., Jackson, S. R., & McAllister, D. R. (2010) · The American Journal of Sports Medicine · doi:10.1177/0363546509358321 · Cited by 55
“The ACL’s tibial insertion site was mechanically isolated using a cylindrical coring cutter, and a cap of bone containing the entire tibial footprint was attached to a load cell.(9) First, the bone cap was disconnected from the load cell to create an ACL-deficient condition.”
MethodSelf-citationMarkolf, K. L., Jackson, S. R., & McAllister, D. R. (2013) · Foot & Ankle International · doi:10.1177/1071100713478923 · Cited by 55
Self-citationThe Relationship Between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity
Shultz, S. J., Nguyen, A., & Levine, B. J. (2009) · Sports Health A Multidisciplinary Approach · doi:10.1177/1941738108326702 · Cited by 55
“Higher ACL loads have been reported when internal rotation torques were applied along with the knee hyperextended.(26,27) This is consistent with our findings that the combination of greater navicular drop (resulting in tibial internal rotation) and genu recurvatum (resulting in knee hyperextension) were related to gr…”
ResultInherent differences in the laxity and stability between the intact knee and total knee replacements
Luger, E. J., Sathasivam, S., & Walker, P. S. (1997) · The Knee · doi:10.1016/s0968-0160(96)00224-4 · Cited by 55
Markolf, K. L., Willems, M. J., Jackson, S. R., & Finerman, G. A. M. (1998) · Journal of Orthopaedic Research® · doi:10.1002/jor.1100160411 · Cited by 55
Self-citationKiapour, A. M., Wordeman, S. C., Paterno, M. V., Quatman, C. E., Levine, J. W., Goel, V. K., Demetropoulos, C. K., & Hewett, T. E. (2013) · The American Journal of Sports Medicine · doi:10.1177/0363546513509961 · Cited by 53
“The choice to place a single DVRT on the ACL’s AM bundle was based on previous work that found the AM bundle’s strain to be a good representation of overall ACL strain.(18) Finally, the utilized cadaveric model of landing was associated with a number of assumptions and simplifications including, but not limited to, st…”
Male-Female Differences in Knee Laxity and Stiffness
Boguszewski, D. V., Cheung, E. C., Joshi, N. B., et al. (2015) · The American Journal of Sports Medicine · doi:10.1177/0363546515608478 · Cited by 54
Self-citationGeometric Risk Factors Associated With Noncontact Anterior Cruciate Ligament Graft Rupture
Levins, J. G., Sturnick, D. R., Argentieri, E. C., et al. (2016) · The American Journal of Sports Medicine · doi:10.1177/0363546516657525 · Cited by 54
“This contradictory finding may be explained by the observation that an anteriordirected slope of the tibial plateau has been associated with increased genu recurvatum,(9) a risk factor for ACL injury,(6) and has been shown to increase ACL strain values.(29) In addition, Terauchi et al(48) found that, in females, eithe…”
BackgroundBone-Patellar Tendon-Bone Grafts for Anterior Cruciate Ligament Reconstruction
Honl, M., Carrero, V., Hille, E., et al. (2002) · The American Journal of Sports Medicine · doi:10.1177/03635465020300041501 · Cited by 53
“The in vivo forces sustained by the ACL have been estimated by many authors.(22,25,36,37,47,59) A sinusoidal force between 30 and 300 N was used in the cyclic tests, which is in the upper range of the forces that are estimated to occur during normal daily activities.”
MethodMiyasaka, T., Matsumoto, H., Suda, Y., et al. (2002) · Journal of Orthopaedic Science · doi:10.1007/s007760200058 · Cited by 53
Kinematics of the Anterior Cruciate Ligament During Gait
Wu, J., Hosseini, A., Kozánek, M., Gadikota, H. R., Gill, T. J., & Li, G. (2010) · The American Journal of Sports Medicine · doi:10.1177/0363546510364240 · Cited by 53
Rupp, S., Hopf, T., Hess, T. H., et al. (1999) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1053/ar.1999.v15.0150171 · Cited by 52
Metadata
- Authors
- Markolf, K. L., Gorek, J. F., Kabo, J. M., & Shapiro, M. S.
- Affiliations
- University of California, Los Angeles (US)
- ORCID
- Markolf, K L
- Venue
- The Journal of Bone & Joint Surgery
- Published
- 1990-04
- Volume
- 72
- Issue
- 4
- Pages
- 557-567
- ISSN
- 0021-9355 (ISSN-L)
- OpenAlex
- W181468102
- Cited by
- 610
- References
- 0
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 9 · 2023: 15 · 2022: 11 · 2021: 24 · 2020: 15 · 2019: 22 · 2018: 22 · 2017: 20 · 2016: 32 · 2015: 17 · 2014: 20 · 2013: 21 · 2012: 20
- FWCI
- 11.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Bone and Joint Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ar037037-03)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01-AR37037)
- 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, tibial attachment, knee hyperextension, tibiofemoral contact forces, anterior tibial translation, knee flexion angle
- MeSH terms
- Aged, Biomechanical Phenomena, Humans, Knee Joint, Ligaments, Articular, Middle Aged, Movement, In Vitro Techniques
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.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
