Knee joint mechanics under quadriceps-hamstrings muscle forces are influenced by tibial restraint

Background. To investigate the role of quadriceps and hamstrings muscle recruitments on knee joint mechanics, measurement studies constrain the tibial anterior posterior translation at a point away from the joint. This generates a restraining force perpendicular to the tibia thus introducing an artefact shear force that likely alters joint mechanics and forces in cruciate ligaments. Methods. A 3D nonlinear finite element model of the entire knee joint, including tibiofemoral and patellofemoral joints, was used to investigate joint mechanics in flexion (0 degrees-90 degrees) under isolated and combined hamstrings and quadriceps activation. The effect of tibial restraint at two locations on results was studied and compared with the reference boundary condition of tibia constrained by pure moments. Findings. Tibial restraint by a force rather than a pure moment substantially influences the joint response. For identical forces, hamstrings have much greater moment generating capacity at larger flexion angles while quadriceps are more effective at smaller angles. Interpretation. Tibial constraint by a restraining force rather than a pure moment causes an artefact force on the joint that vary with muscle forces and restraining location. These artefact shear forces, especially when placed closer to the joint, considerably reduce forces in cruciate ligaments; in anterior cruciate ligament at near full extension and in posterior cruciate ligament at larger flexion angles. The beneficial effects of muscle co-contraction in reducing anterior cruciate ligament forces at near full extension and in posterior cruciate ligament forces at near 90 degrees, however, disappear as the restraint on the tibia approaches the joint. The artefact forces could distort results and their interpretations. (c) 2006 Elsevier Ltd. All rights reserved.