In situ forces of the anterior and posterior cruciate ligaments in high knee flexion: An in vitro investigation

The function of the anterior and posterior cruciate ligaments (ACL and PCL) in the first 120° of flexion has been reported extensively, but little is known of their behavior at higher flexion angles. The aim of this investigation was to study the effects of muscle loads on the in situ forces in both ligaments at high knee flexion (> 120°). Eighteen fresh‐frozen human knee specimens were tested on a robotic testing system from full extension to 150° of flexion in response to quadriceps (400 N), hamstrings (200 N), and combined quadriceps and hamstrings (400 N/200 N) loads. The in situ forces in the ACL and PCL were measured using the principle of superposition. The force in the ACL peaked at 30° of flexion (71.7 ± 27.9 N in response to the quadriceps load, 52.3 ± 24.4 N in response to the combined muscle load, 32.3 ± 20.9 N in response to the hamstrings load). At 150°, the ACL force was approximately 30 N in response to the quadriceps load and 20 N in response to the combined muscle load and isolated hamstring load. The PCL force peaked at 90° (34.0 ± 15.3 N in response to the quadriceps load, 88.6 ± 23.7 N in response to the combined muscle load, 99.8 ± 24.0 N in response to the hamstrings load) and decreased to around 35 N at 150° in response to each of the loads.

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