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The Relationship Between Anterior Tibial Acceleration, Tibial Slope, and ACL Strain During a Simulated Jump Landing Task
Scott G. McLean, PhD1; Youkeun K. Oh, B.Eng2; Mark L. Palmer, MD, PhD1; Sarah M. Lucey, BSc1; Dustin G. Lucarelli, BSc1; James A. Ashton-Miller, PhD2; Edward M. Wojtys, MD3
1 School of Kinesiology, The University of Michigan, 401 Washtenaw Avenue, Ann Arbor, MI 48109. E-mail address for S.G. McLean: mcleansc@umich.edu
2 3208 GGB (George G. Brown Laboratory), 2350 Hayward, Ann Arbor, MI 48109
3 Domino's Farms-Ann Arbor, 24 Frank Lloyd Wright Drive, Reception: Lobby A, Ann Arbor, MI 48105
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Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by the authors of this work are available with the online version of this article at jbjs.org.

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Investigation performed at the School of Kinesiology and Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Jul 20;93(14):1310-1317. doi: 10.2106/JBJS.J.00259
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Knee joint morphology contributions to anterior cruciate ligament (ACL) loading are rarely considered in the injury prevention model. This may be problematic as the knee mechanical response may be influenced by these underlying morphological factors. The goal of the present study was to explore the relationship between posterior tibial slope (which has been recently postulated to influence knee and ACL loading), impact-induced anterior tibial acceleration, and resultant ACL strain during a simulated single-leg landing.


Eleven lower limb cadaveric specimens from female donors who had had a mean age (and standard deviation) of 65 ± 10.5 years at the time of death were mounted in a testing apparatus to simulate single-limb landings in the presence of pre-impact knee muscle forces. After preconditioning, specimens underwent five impact trials (mean impact force, 1297.9 ± 210.6 N) while synchronous three-dimensional joint kinetics, kinematics, and relative anteromedial bundle strain data were recorded. Mean peak tibial acceleration and anteromedial bundle strain were quantified over the first 200 ms after impact. These values, along with radiographically defined posterior tibial slope measurements, were submitted to individual and stepwise linear regression analyses.


The mean peak anteromedial bundle strain (3.35% ± 1.71%) was significantly correlated (r = 0.79; p = 0.004; β = 0.791) with anterior tibial acceleration (8.31 ± 2.77 m/s-2), with the times to respective peaks (66 ± 7 ms and 66 ± 4 ms) also being significantly correlated (r = 0.82; p = 0.001; β = 0.818). Posterior tibial slope (mean, 7.6° ± 2.1°) was significantly correlated with both peak anterior tibial acceleration (r = 0.75; p = 0.004; β = 0.786) and peak anteromedial bundle strain (r = 0.76; p = 0.007; β = 0.759).


Impact-induced ACL strain is directly proportional to anterior tibial acceleration, with this relationship being moderately dependent on the posterior slope of the tibial plateau.

Clinical Relevance: 

Anterior tibial acceleration is associated with anteromedial bundle strain during simulated landings. The magnitude of the impact-induced accelerations governing the strain response is additionally correlated with the posterior slope of the tibial plateau. Additional exploration of the effect of other knee morphological variables on ACL strain during simulated high-risk landings appears warranted.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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