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Quadriceps Muscle Contraction Protects the Anterior Cruciate Ligament During Anterior Tibial Translation

Martina Hansens Hospital, Institute for Surgical Research, The National Hospital, University of Oslo, Oslo, Norway

Patrick W. Cawley, OPA, RT

Smith & Nephew Donjoy Inc., Carlsbad, California

Arne Ekeland, MD, PhD

Martina Hansens Hospital, Institute for Surgical Research, The National Hospital, University of Oslo, Oslo, Norway

The proposed skiing injury mechanism that suggests a quadriceps muscle contraction can contribute to ante rior cruciate ligament rupture was biomechanically in vestigated. The effect of quadriceps muscle force on a knee specimen loaded to anterior cruciate ligament failure during anterior tibial translation was studied in a human cadaveric model. In both knees from six do nors, average age 41 years (range, 31 to 65), the joint capsule and ligaments, except the anterior cruciate ligament, were cut. The quadriceps tendon, patella, patellar tendon, and menisci were left intact. One knee from each pair was randomly selected to undergo de structive testing of the anterior cruciate ligament by anterior tibial translation at a displacement rate of 30 mm/sec with a simultaneously applied 889 N quadri ceps muscle force. The knee flexion during testing was 30°. As a control, the contralateral knee was loaded correspondingly, but only 5 N of quadriceps muscle force was applied. The ultimate load for the knee to anterior cruciate ligament failure when tested with 889 N quadriceps muscle force was 22% ± 18% higher than that of knees tested with 5 N of force. The linear stiffness increased by 43% ± 30%. These results did not support the speculation that a quadriceps muscle contraction contributes to anterior cruciate ligament failure. In this model, the quadriceps muscle force protected the anterior cruciate ligament from injury during anterior tibial translation.

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