Numerical Simulations to Assess Different Rehabilitation Strategies After ACL Rupture in a Skier

Objective: In this study a numerical model of a skier was developed to investigate the effect of different rehabilitation strategies after anterior cruciate ligament (ACL) rupture. Methods: A computer model using a combined fine-element and multibody approach was established. The model includes a detailed representation of the knee structures, as well as all major leg muscles. Using this model. different strategies after ACL rupture were analyzed. Results: The benefit of muscle training to compensate for a loss of the ACL was shown. The results indicate that in increase of 10% of the physiological cross-sectional area has a positive effect Without subjecting other knee Structures to critical loads. Simulating the use of a hamstring graft indicated increasing knee loads. A patellar-tendon graft resulted in an increase of the stress on the lateral collateral ligament. Conclusion: Muscle training of both extensors and flexors is beneficial in medical rehabilitation of ACL-deficient and ACL-reconstructed knees.