Three orthogonal components of the tibiofemoral and patellofemoral forces were measured simultaneously for knees with intact cruciate ligaments (nine knees), following anterior cruciate ligament resection (six knees), and subsequent posterior cruciate ligament resection (six knees). The knees were loaded using an experimental protocol that modeled static double-leg squat. The mean compressive tibial force increased with flexion angle. The mean anteroposterior tibial shear force acted posteriorly on the tibia below 50 deg flexion and anteriorly above 55 deg. Mediolateral shear forces were low compared to the other force components and tended to be directed medially on both the patella and tibia. The mean value of the ratio of the resultant tibial force divided by the quadriceps force decreased with increasing flexion angle and was between 0.6 and 0.7 above 70 deg flexion. The mean value of the ratio of the resultant tibiofemoral contact force divided by the resultant patellofemoral contact force decreased with increasing flexion and was between 0.8 and 1.0 above 55 deg flexion. Cruciate ligament resection resulted in no significant changes in the patellar contact forces. Following resection of the anterior cruciate ligament, the tibial anteroposterior shear force was directed anteriorly over all flexion angles tested. Subsequent resection of the posterior cruciate ligament resulted in an approximately 10 percent increase in the quadriceps tendon and tibial compressive force.

1.
Ahmed
A. M.
, and
Burke
D. L.
,
1983
, “
In-vitro measurement of static pressure distribution in synovial joints—Part 1: Tibial surface of the knee
,”
ASME JOURNAL OF BIOMECHANICAL ENGINEERING
,
105
,
216
225
.
2.
Ahmed
A. M.
,
Burke
D. L.
, and
Yu
A.
,
1983
, “
In-vitro measurement of static pressure distribution in synovial joints—Part II: Retropatellar surface
,”
ASME JOURNAL OF BIOMECHANICAL ENGINEERING
,
105
,
226
236
.
3.
Andriacchi
T. P.
,
1993
, “
Functional analysis of pre and post-knee surgery: Total knee arthroplasty and ACL reconstruction
,”
ASME JOURNAL OF BIOMECHANICAL ENGINEERING
,
115
,
575
581
.
4.
Arms
S. W.
,
Pope
M. H.
,
Johnson
R. J.
,
Fischer
R. A.
,
Arvidsson
I.
, and
Eriksson
E.
,
1984
, “
The biomechanics of anterior cruciate ligament rehabilitation and reconstruction
,”
Amer. J. Sports Med.
,
12
,
8
18
.
5.
Baltzopoulos
V.
,
1995
, “
Muscular and tibiofemoral joint forces during isokinetic concentric knee extension
,”
Clin. Biomechanics
,
10
,
208
214
.
6.
Beynnon
B. D.
,
Johnson
R. J.
,
Fleming
B. C.
,
Stankewich
C. J.
,
Renstro¨m
P. A.
, and
Nichols
C. E.
,
1997
, “
The strain behavior of the anterior cruciate ligament during squatting and active flexion-extension
,”
Amer. J. Sports Med.
,
25
,
823
829
.
7.
Berchuck
M.
,
Andriacchi
T. P.
,
Bach
B. R.
, and
Reider
B.
,
1990
, “
Gait adaptations by patients who have a deficient anterior cruciate ligament
,”
J. Bone Jt. Surg.
,
72-A
,
871
877
.
8.
Brand
R. A.
,
Pedersen
D. R.
,
Davy
D. T.
,
Kotzar
G. M.
,
Heiple
K. G.
, and
Goldberg
V. M.
,
1994
, “
Comparison of hip force calculations and measurements in the same patient
,”
J. Arthroplasty
,
9
,
45
51
.
9.
Carmines
D. V.
, and
MacMahon
E. B.
,
1991
, “
Measurement of the center of pressure beneath the tibial plateaus
,”
Trans. Orthop. Res. Soc.
,
37
,
578
578
.
10.
Castle
T. H.
,
Noyes
F. R.
, and
Grood
E. S.
,
1992
, “
Posterior tibial subluxation of the posterior cruciate-deficient knee
,”
Clin. Orthop. Rel. Res.
,
284
,
193
202
.
11.
Clement
B.
,
Drouin
G.
,
Shorrock
G.
, and
Gely
P.
,
1989
, “
Statistical analysis of knee ligament lengths
,”
J. Biomech.
,
22
,
767
774
.
12.
Daniel
D. M.
,
Stone
M. L.
,
Barnett
P.
, and
Sachs
R.
,
1988
, “
Use of the quadriceps active test to diagnose posterior cruciate-ligament disruption and measure posterior laxity of the knee
,”
J. Bone Jt. Surg.
,
70-A
,
386
391
.
13.
Denham
R. A.
, and
Bishop
R. E. D.
,
1978
, “
Mechanics of the knee and problems in reconstructive surgery
,”
J. Bone Jt. Surg.
,
60-B
,
345
352
.
14.
Draganich
L. F.
, and
Vahey
J. W.
,
1990
, “
An in vitro study of anterior cruciate ligament strain induced by quadriceps and hamstrings forces
,”
J. Orthop. Res.
,
8
,
57
63
.
15.
Eijden
T. M. G. J.
,
van Kouwenhoven
E.
,
Verburg
J.
, and
Weijs
W. A.
,
1986
, “
A mathematical model of the patellofemoral joint
,”
J. Biomech.
,
19
,
219
229
.
16.
Ellis
M. I.
,
Seedhom
B. B.
, and
Wright
V.
,
1984
, “
Forces in the knee joint whilst rising from a seated position
,”
J. Biomed. Engng.
,
6
,
113
120
.
17.
Ericson
M. O.
, and
Nisell
R.
,
1986
, “
Tibiofemoral joint forces during ergometer cycling
,”
Amer. J. Sports Med.
,
14
,
285
290
.
18.
Ferguson
A. B.
,
Brown
T. D.
,
Fu
F. H.
, and
Rutkowski
R.
,
1979
, “
Relief of patellofemoral contact stress by anterior displacement of the tibial tubercle
,”
J. Bone Jt. Surg.
,
61-A
,
159
166
.
19.
Grady-Benson
J. C.
,
Kaufman
K. R.
,
Irby
S. E.
, and
Colwell
C. W.
,
1992
a, “
The effect of posterior tibial slope on tibiofemoral forces after total knee arthroplasty
,”
Trans. Orthop. Res. Soc.
,
38
,
270
270
.
20.
Grady-Benson
J. C.
,
Kaufman
K. R.
,
Irby
S. E.
, and
Colwell
C. W.
,
1992
b, “
The influence of joint line location on tibiofemoral forces after total knee arthroplasty
,”
Trans. Orthop. Res. Soc.
,
38
,
324
324
.
21.
Hirokawa
S.
,
1991
, “
Three-dimensional mathematical model analysis of the patellofemoral joint
,”
J. Biomech.
,
24
,
659
671
.
22.
Hirokawa
S.
,
Solomonow
M.
,
Lu
Y.
,
Lou
Z.-P.
, and
D’Ambrosia
R.
,
1992
, “
Anterior-posterior and rotational displacement of the tibia elicited by quadriceps contraction
,”
Am. J. Sports Medicine
,
20
,
299
306
.
23.
Huberti
H. H.
, and
Hayes
W. C.
,
1984
, “
Patellofemoral contact pressures. The influence of Q-angle and tendofemoral contact
,”
J. Bone Jt. Surg.
,
66-A
,
715
724
.
24.
Jacobsen
K.
,
1977
, “
Osteoarthrosis following insufficiency of the cruciate ligaments in man
,”
Acta Orthop. Scandin.
,
48
,
520
526
.
25.
Kaufman
K. R.
,
An
K.-N.
,
Litchy
W. J.
,
Morrey
B. F.
, and
Chao
E. Y. S.
,
1991
, “
Dynamic joint forces during knee isokinetic exercise
,”
Am. J. Sports Med.
,
19
,
305
316
.
26.
Kaufman
K. R.
,
Kovacevic
N.
,
Irby
S. E.
, and
Colwell
C. W.
,
1996
, “
Instrumented implant for measuring tibiofemoral forces
,”
J. Biomechanics
,
29
,
667
671
.
27.
Ladin
Z.
, and
Wu
G.
,
1991
, “
Combining position and acceleration measurements for joint force estimation
,”
J. Biomechanics
,
24
,
1173
1187
.
28.
Lewallen
D. G.
,
Riegger
C. L.
,
Myers
E. R.
, and
Hayes
W. C.
,
1990
, “
Effects of retinacular release and tibial tubercle clevation in patellofemoral degenerative joint disease
,”
J. Orthop. Res.
,
8
,
856
862
.
29.
Lewis
J. L.
,
Lew
W. D.
, and
Schmidt
J.
,
1982
, “
A note on the application and evaluation of the buckle transducer for knee ligament force measurement
,”
ASME JOURNAL OF BIOMECHANICAL ENGINEERING
,
104
,
125
128
.
30.
Luo
Z. P.
,
Hsu
H. C.
,
Rand
J. A.
,
An
K. N.
,
1996
, “
Importance of soft tissue integrity on biomechanical studies of the patella after TKA
,”
ASME JOURNAL OF BIOMECHANICAL ENGINEERING
,
118
,
130
132
.
31.
Lutz
G. E.
,
Palmitier
R. A.
,
An
K. N.
, and
Chao
E. Y. S.
,
1993
, “
Comparison of tibiofemoral joint forces during open-kinetic-chain and closed-kinetic-chain exercises
,”
J. Bone Jt. Surg.
,
75-A
,
732
739
.
32.
Morrison
J. B.
,
1968
, “
Bioengineering analysis of force actions transmitted by the knee joint
,”
Bio-Med. Engng.
,
3
,
164
170
.
33.
Morrison
J. B.
,
1969
, “
Function of the knee joint in various activities
,”
Bio-Med. Engng.
,
4
,
573
580
.
34.
Neter, J., Wasserman, W., and Kutner, M. H., 1985, “Inferences in regression analysis,” in: Applied Linear Statistical Models, 2nd ed., pp. 60–108. Irwin, Homewood, IL.
35.
Nisell
R.
,
1985
, “
Mechanics of the knee. A study of joint and muscle load with clinical applications
,”
Acta Ortho. Scandinavica
, Supplementum
216
,
56
56
.
36.
Nisell
R.
,
Ericson
M. O.
,
Ne´meth
G.
, and
Ekholm
J.
,
1989
, “
Tibiofemoral joint forces during isokinetic knee extension
,”
Amer. J. Sports Med.
,
17
,
49
54
.
37.
Nissan
M.
,
1980
, “
Review of some basic assumptions in knee biomechanics
,”
J. Biomechanics
,
13
,
375
381
.
38.
Osternig
L. R.
,
Hamill
J.
,
Corcos
D. M.
, and
Lander
J.
,
1984
, “
Electromyo-graphic patterns accompanying isokinetic exercise under varying speed and sequencing conditions
,”
Am. J. Physical Med.
,
63
,
289
297
.
39.
Perry
J.
,
Antonelli
D.
, and
Ford
W.
,
1975
, “
Analysis of knee-joint forces during flexed-knee stance
,”
J. Bone Jt. Surg.
,
57-A
,
961
967
.
40.
Renstro¨m
P.
,
Arms
S. W.
,
Stanwyck
T. S.
,
Johnson
R. J.
, and
Pope
M. H.
,
1986
, “
Strain within the anterior cruciate ligament during hamstring and quadriceps activity
,”
Amer. J. Sports Med.
,
14
,
83
87
.
41.
Salmons
S.
,
1969
, “
The eighth international conference on medical and biological engineering
,”
Biomed. Engng.
,
4
,
467
474
.
42.
Singerman
R.
,
Berilla
J.
,
Kotzar
G.
,
Daly
J.
, and
Davy
D. T.
,
1994
a, “
A six-degree-of-freedom transducer for in vitro measurement of patellofemoral contact forces
,”
J. Biomechanics
,
27
,
233
238
.
43.
Singerman
R.
,
Davy
D. T.
, and
Goldberg
V. M.
,
1994
b, “
Effects of patella alta and patella infera on patellofemoral contact forces
,”
J. Biomechanics
,
27
,
1059
1065
.
44.
Singerman
R.
,
Berilla
J.
, and
Davy
D. T.
,
1995
, “
Direct in vitro determination of the patellofemoral contact force for normal knees
,”
ASME JOURNAL OF BIOMECHANICAL ENGINEERING
,
117
,
8
14
.
45.
Solomonow
M.
,
Baratta
R.
,
Zhou
B. H.
,
Shoji
H.
,
Bose
W.
,
Beck
C.
, and
D’Ambrosia
R.
,
1987
, “
The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability
,”
Am. J. Sports Med.
,
15
,
207
213
.
46.
Wismans
J.
,
Veldpaus
F.
,
Janssen
J.
,
Huson
A.
, and
Struben
P.
,
1980
, “
A three-dimensional mathematical model of the knee-joint
,”
J. Biomech.
,
13
,
677
685
.
47.
Yamaguchi
G. T.
, and
Zajac
F. E.
,
1989
, “
A planar model of the knee joint to characterize the knee extensor mechanism
,”
J. Biomech.
,
22
,
1
10
.
48.
Yasuda
K.
, and
Sasaki
T.
,
1987
a, “
Muscle exercise after anterior cruciate ligament reconstruction. Biomechanics of the simultaneous isometric contraction of the quadriceps and the hamstrings
,”
Clin. Orthop. Rel. Res.
,
220
,
266
274
.
49.
Yasuda
K.
, and
Sasaki
T.
,
1987
b, “
Exercise after anterior cruciate ligament reconstruction. The force exerted on the tibia by the separate isometric contractions of the quadriceps or the hamstrings
,”
Clin. Orthop. Rel. Res.
,
220
,
275
283
.
This content is only available via PDF.
You do not currently have access to this content.