Impact of knee modeling approach on indicators and classification of anterior cruciate ligament injury risk.

INTRODUCTION The aim of this study was to determine whether using a direct kinematic (DK) or inverse kinematic (IK) modeling approach could influence the estimation of knee joint kinematics, kinetics, and ACL injury risk classification during unanticipated side cutting. METHODS The three-dimensional motion and force data of 34 amateur Australian rules footballers conducting unanticipated side-cutting maneuvers were collected. The model used during the DK modeling approach was an eight-segment lower body model with the hip, knee, and ankle free to move in six degrees of freedom. During the IK modeling approach, the same eight-segment model was used; however, translational constraints were imposed on the hip, knee, and ankle joints. The similarity between kinematic and kinetic waveforms was evaluated using the root mean square difference (RMSD) and the one-dimensional statistical parametric mapping (SPM1D). The classification of an athlete's ACL injury risk was determined by correlating their peak knee moments with a predefined injury risk threshold. RESULTS The greatest RMSD occurred in the frontal plane joint angles (RMSD = 10.86°) and moments (RMSD = 0.67 ± 0.18 N·m·kg(-1)), which were also shown to be significantly different throughout the stance phase in the SPM1D analysis. Both DK and IK modeling approaches classified the same athletes as being at risk of ACL injury. CONCLUSIONS The choice of a DK or an IK modeling approach affected frontal plane estimates of knee joint angles and peak knee moments during the weight acceptance phase of unanticipated side cutting. However, both modeling approaches were similar in their classification of an athlete's ACL injury risk.

[1]  D G Lloyd,et al.  Optimizing whole-body kinematics to minimize valgus knee loading during sidestepping: implications for ACL injury risk. , 2012, Journal of biomechanics.

[2]  T. Krosshaug,et al.  Mechanisms for Noncontact Anterior Cruciate Ligament Injuries , 2010, The American journal of sports medicine.

[3]  Jill S Higginson,et al.  Static and dynamic correlates of the knee adduction moment in healthy knees ranging from normal to varus-aligned. , 2009, Clinical biomechanics.

[4]  Kevin R Ford,et al.  Letter to the editor regarding "Effect of low pass filtering on joint moments from inverse dynamics: implications for injury prevention". , 2012, Journal of biomechanics.

[5]  A Leardini,et al.  Does medio-lateral motion occur in the normal knee? An in-vitro study in passive motion. , 2011, Journal of biomechanics.

[6]  Caroline F. Finch,et al.  An Anterior Cruciate Ligament Injury Prevention Framework: Incorporating the Recent Evidence , 2012, Research in sports medicine.

[7]  D. Lloyd,et al.  External loading of the knee joint during running and cutting maneuvers. , 2001, Medicine and science in sports and exercise.

[8]  T. Hewett,et al.  Relationship Between Hip and Knee Kinematics in Athletic Women During Cutting Maneuvers: A Possible Link to Noncontact Anterior Cruciate Ligament Injury and Prevention , 2009, Journal of strength and conditioning research.

[9]  A J van den Bogert,et al.  Evaluation of a two dimensional analysis method as a screening and evaluation tool for anterior cruciate ligament injury , 2005, British Journal of Sports Medicine.

[10]  Thomas D. Collins,et al.  A six degrees-of-freedom marker set for gait analysis: repeatability and comparison with a modified Helen Hayes set. , 2009, Gait & posture.

[11]  T. Hewett,et al.  Biomechanics laboratory-based prediction algorithm to identify female athletes with high knee loads that increase risk of ACL injury , 2010, British Journal of Sports Medicine.

[12]  Antonie J van den Bogert,et al.  Investigating isolated neuromuscular control contributions to non-contact anterior cruciate ligament injury risk via computer simulation methods. , 2008, Clinical biomechanics.

[13]  A Leardini,et al.  Position and orientation in space of bones during movement: experimental artefacts. , 1996, Clinical biomechanics.

[14]  Todd C. Pataky,et al.  One-dimensional statistical parametric mapping in Python , 2012, Computer methods in biomechanics and biomedical engineering.

[15]  T. Hewett,et al.  Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes: A Prospective Study , 2005, The American journal of sports medicine.

[16]  Aurelio Cappozzo,et al.  Propagation of the hip joint centre location error to the estimate of femur vs pelvis orientation using a constrained or an unconstrained approach. , 2007, Journal of biomechanics.

[17]  Ali Hosseini,et al.  Kinematics of the Anterior Cruciate Ligament During Gait , 2010, The American journal of sports medicine.

[18]  Ayman Habib,et al.  OpenSim: Open-Source Software to Create and Analyze Dynamic Simulations of Movement , 2007, IEEE Transactions on Biomedical Engineering.

[19]  David G Lloyd,et al.  The effect of technique change on knee loads during sidestep cutting. , 2007, Medicine and science in sports and exercise.

[20]  Jos Vanrenterghem,et al.  The effect of running speed on knee mechanical loading in females during side cutting. , 2012, Journal of biomechanics.

[21]  W. T. Dempster,et al.  SPACE REQUIREMENTS OF THE SEATED OPERATOR, GEOMETRICAL, KINEMATIC, AND MECHANICAL ASPECTS OF THE BODY WITH SPECIAL REFERENCE TO THE LIMBS , 1955 .

[22]  Kristian M O'Connor,et al.  Fatigue-related changes in stance leg mechanics during sidestep cutting maneuvers. , 2008, Clinical biomechanics.

[23]  S. McLean,et al.  Sagittal plane biomechanics cannot injure the ACL during sidestep cutting. , 2004, Clinical biomechanics.

[24]  David G Lloyd,et al.  Repeatability of gait data using a functional hip joint centre and a mean helical knee axis. , 2003, Journal of biomechanics.

[25]  Joseph J Crisco,et al.  Kinematic differences between optical motion capture and biplanar videoradiography during a jump-cut maneuver. , 2013, Journal of biomechanics.

[26]  Antonie J. van den Bogert,et al.  Authors' reply regarding "Effect of low pass filtering on joint moments from inverse dynamics: Implications for injury prevention" , 2012 .

[27]  B. Elliott,et al.  Sports injury experiences from the Western Australian sports injury cohort study , 2002, Australian and New Zealand journal of public health.

[28]  A. J. van den Bogert,et al.  Effect of skin movement on the analysis of skeletal knee joint motion during running. , 1997, Journal of biomechanics.

[29]  Ernest P Hanavan,et al.  A mathematical model of the human body , 1964 .

[30]  M. Morris,et al.  The reliability of three-dimensional kinematic gait measurements: a systematic review. , 2009, Gait & posture.

[31]  Susanne W. Lipfert,et al.  Effect of gender and defensive opponent on the biomechanics of sidestep cutting. , 2004, Medicine and science in sports and exercise.

[32]  Ajay Seth,et al.  Muscle contributions to propulsion and support during running. , 2010, Journal of biomechanics.

[33]  A. Cappozzo,et al.  Human movement analysis using stereophotogrammetry. Part 3. Soft tissue artifact assessment and compensation. , 2005, Gait & posture.

[34]  Joseph Hamill,et al.  Influence of gender on hip and knee mechanics during a randomly cued cutting maneuver. , 2004, Clinical biomechanics.

[35]  Antonie J van den Bogert,et al.  Association between lower extremity posture at contact and peak knee valgus moment during sidestepping: implications for ACL injury. , 2005, Clinical biomechanics.

[36]  Susan M Sigward,et al.  The influence of gender on knee kinematics, kinetics and muscle activation patterns during side-step cutting. , 2006, Clinical biomechanics.

[37]  J J O'Connor,et al.  Bone position estimation from skin marker co-ordinates using global optimisation with joint constraints. , 1999, Journal of biomechanics.

[38]  David G Lloyd,et al.  Changes in knee joint biomechanics following balance and technique training and a season of Australian football , 2012, British Journal of Sports Medicine.

[39]  Jos Vanrenterghem,et al.  An evaluation of anatomical and functional knee axis definition in the context of side-cutting. , 2012, Journal of biomechanics.

[40]  D. Lloyd,et al.  Muscle activation strategies at the knee during running and cutting maneuvers. , 2003, Medicine and science in sports and exercise.