Model prediction of anterior cruciate ligament force during drop-landings

Purpose: The aim of this study was to calculate and explain the pattern of force transmitted to the anterior cruciate ligament during soft-style drop-landings. We hypothesized that peak ACL loading is due to the anterior pull of the quadriceps on the tibia, as these muscles develop large eccentric forces upon impact. Methods: A three-dimensional model of the body was used to simulate drop-landing. The simulation was performed by entering into the model muscle excitation patterns based on experimental EMG. The input excitation patterns were modified to create a performance response of the model that matched experimental data. Joint angles, ground reaction forces, and muscle forces obtained from the landing simulation were then applied to a model of the lower limb that incorporated a three-dimensional model of the knee. Results: The model ACL was loaded only in the first 25% of the landing phase. Peak ACL force (similar to 0.4 BW) resulted from a complex interaction between the patellar tendon force, the compressive force acting at the tibiofemoral joint, and the force applied by the ground to the lower leg. The patellar tendon force and tibiofemoral contact force both applied significant anterior shear forces to the shank throughout the landing phase. These effects were modulated by another significant posterior shear force applied by the ground reaction, which served to limit the maximum force transmitted to the ACL. Conclusion: The pattern of ACL force in drop-landing cannot be explained by the anterior pull of the quadriceps force alone.