ANTERIOR CRUCIATE LIGAMENT SECTIONING ALTERS CENTER OF PRESSURE WITHIN THE TIBIOFEMORAL JOINT: AN IN VITRO STUDY

Abstract

Anterior cruciate ligament (ACL) injuries often lead to secondary injuries, joint degradation, and were linked to osteoarthritis. There is little known about how ACL rupture affects the loading and contact characteristics within the tibiofemoral joint. The objective of this study was to evaluate changes in tibiofemoral joint contact pressure and center of pressure (COP) during dynamic motion before and after ACL sectioning in vitro. Six intact cadaveric knees were manipulated through three full cycles of motion ranging from 30∘ to 120∘ of flexion in a custom-built device. A pressure sensor inserted in the tibiofemoral joint measured contact pressure of the medial and lateral compartments as well as COP characteristics of the whole joint before and after the ACL was sectioned. There was a significant decrease in lateral-compartment peak pressure, medial and lateral mean pressure, and total contact area after the ACL was sectioned. In both intact and ACL deficient knees, a posterior-lateral shift in COP was observed during flexion and a medial-anterior shift when returning to extension. Plotting the COP trajectory through the flexion-extension cycle resulted in a distinct hysteresis curve due to the viscoelastic soft tissue properties. Following sectioning, the COP trajectory had a diminished area compared to the intact condition. The diminished area of contact pressure may be more problematic than the overall magnitude when the integrity of the ACL is compromised. The centralized pressure distribution to a smaller surface area over time may cause focal damage to the cartilage leading to osteoarthritis.