RESEARCH ARTICLE


Anterior Cruciate Ligament Injury: Compensation during Gait using Hamstring Muscle Activity



Paola Formento Catalfamo*, Gerardo Aguiar, Jorge Curi, Ariel Braidot
Department of Biomechanics, School of Engineering, National University of Entre Rios, Argentina


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Creative Commons License
© Catalfamo et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Biomechanics, School of Engineering, National University of Entre Ríos, Ruta 11. Km 10, Oro Verde, Argentina, Tel: 0054-343-4975100 ext: 121; Fax: 0054-343 – 4975100 ext: 108; Email: pcatalfamo@bioingenieria.edu.ar


Abstract

Previous research has shown that an increase in hamstring activation may compensate for anterior tibial transalation (ATT) in patients with anterior cruciate ligament deficient knee (ACLd); however, the effects of this compensation still remain unclear. The goals of this study were to quantify the activation of the hamstring muscles needed to compensate the ATT in ACLd knee during the complete gait cycle and to evaluate the effect of this compensation on quadriceps activation and joint contact forces. A two dimensional model of the knee was used, which included the tibiofemoral and patellofemoral joints, knee ligaments, the medial capsule and two muscles units. Simulations were conducted to determine the ATT in healthy and ACLd knee and the hamstring activation needed to correct the abnormal ATT to normal levels (100% compensation) and to 50% compensation. Then, the quadriceps activation and the joint contact forces were calculated. Results showed that 100% compensation would require hamstring and quadriceps activations larger than their maximum isometric force, and would generate an increment in the peak contact force at the tibiofemoral (115%) and patellofemoral (48%) joint with respect to the healthy knee. On the other hand, 50% compensation would require less force generated by the muscles (less than 0.85 of maximum isometric force) and smaller contact forces (peak tibiofemoral contact force increased 23% and peak patellofemoral contact force decreased 7.5% with respect to the healthy knee). Total compensation of ATT by means of increased hamstring activity is possible; however, partial compensation represents a less deleterious strategy.

Keywords:: Anterior cruciate ligament, tibial translation, hamstring..