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Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump.

Publication ,  Journal Article
Englander, ZA; Lau, BC; Wittstein, JR; Goode, AP; DeFrate, LE
Published in: Orthop J Sports Med
March 2021

BACKGROUND: There is little in vivo data that describe the relationships between patellar tendon orientation, patellar tendon strain, and anterior cruciate ligament (ACL) strain during dynamic activities. Quantifying how the quadriceps load the ACL via the patellar tendon is important for understanding ACL injury mechanisms. HYPOTHESIS: We hypothesized that flexion angle, patellar tendon orientation, and patellar tendon strain influence ACL strain during a single-leg jump. Specifically, we hypothesized that patellar tendon and ACL strains would increase concurrently when the knee is positioned near extension during the jump. STUDY DESIGN: Descriptive laboratory study. METHODS: Models of the femur, tibia, ACL, patellar tendon, and quadriceps tendon attachment sites of 8 male participants were generated from magnetic resonance imaging (MRI). High-speed biplanar radiographs during a single-leg jump were obtained. The bone models were registered to the radiographs, thereby reproducing the in vivo positions of the bones, ligament, and tendon attachment sites. Flexion angle, patellar tendon orientation, patellar tendon strain, and ACL strain were measured from the registered models. ACL and patellar tendon strains were approximated by normalizing their length at each knee position to their length at the time of MRI. Two separate bivariate linear regression models were used to assess relationships between flexion angle and patellar tendon orientation and between ACL strain and patellar tendon strain. A multivariate linear regression model was used to assess whether flexion angle and patellar tendon strain were significant predictors of ACL strain during the inflight and landing portions of the jump. RESULTS: Both flexion angle and patellar tendon strain were significant predictors (P < .05) of ACL strain. These results indicate that elevated ACL and patellar tendon strains were observed concurrently when the knee was positioned near extension. CONCLUSION: Concurrent increases in patellar tendon and ACL strains indicate that the quadriceps load the ACL via the patellar tendon when the knee is positioned near extension. CLINICAL RELEVANCE: Increased ACL strain when the knee is positioned near extension before landing may be due to quadriceps contraction. Thus, landing with unanticipated timing on an extended knee may increase vulnerability to ACL injury as a taut ligament is more likely to fail.

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Published In

Orthop J Sports Med

DOI

ISSN

2325-9671

Publication Date

March 2021

Volume

9

Issue

3

Start / End Page

2325967121991054

Location

United States

Related Subject Headings

  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
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Englander, Z. A., Lau, B. C., Wittstein, J. R., Goode, A. P., & DeFrate, L. E. (2021). Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump. Orthop J Sports Med, 9(3), 2325967121991054. https://doi.org/10.1177/2325967121991054
Englander, Zoë A., Brian C. Lau, Jocelyn R. Wittstein, Adam P. Goode, and Louis E. DeFrate. “Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump.Orthop J Sports Med 9, no. 3 (March 2021): 2325967121991054. https://doi.org/10.1177/2325967121991054.
Englander ZA, Lau BC, Wittstein JR, Goode AP, DeFrate LE. Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump. Orthop J Sports Med. 2021 Mar;9(3):2325967121991054.
Englander, Zoë A., et al. “Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump.Orthop J Sports Med, vol. 9, no. 3, Mar. 2021, p. 2325967121991054. Pubmed, doi:10.1177/2325967121991054.
Englander ZA, Lau BC, Wittstein JR, Goode AP, DeFrate LE. Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump. Orthop J Sports Med. 2021 Mar;9(3):2325967121991054.
Journal cover image

Published In

Orthop J Sports Med

DOI

ISSN

2325-9671

Publication Date

March 2021

Volume

9

Issue

3

Start / End Page

2325967121991054

Location

United States

Related Subject Headings

  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences