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. 2021 Jul 24:2021:2109348.
doi: 10.1155/2021/2109348. eCollection 2021.

Numerical Analysis of the ACL, with Sprains of Different Degrees after Trauma

Rodrigo Arturo Marquet-Rivera  1 , Guillermo Urriolagoitia-Sosa  1 , Beatriz Romero-Ángeles  1 , Rosa Alicia Hernández-Vázquez  2 , Octavio Alejandro Mastache-Miranda  3 , Salvador Cruz-López  1 , Arturo Torres-Yáñez  1 , Guillermo Urriolagoitia-Calderón  1
Affiliations

Numerical Analysis of the ACL, with Sprains of Different Degrees after Trauma

Rodrigo Arturo Marquet-Rivera et al. Comput Math Methods Med. .

Abstract

Nowadays, cruciate ligament injuries have increased in incidence, since practicing a sport or physical activity has become a trend in current societies. Although this lifestyle generates multiple benefits, as a consequence, injury has also increased. Due to its nature and complexity, the ligaments of the knee are those that are most frequently affected, mainly the ACL (anterior cruciate ligament). This tissue reacts to overexertion or movements out of range, either caused by the exercise itself or caused by trauma caused by the practice of physical activity, causing various degrees of sprain. Whatever the etiology of these injuries, they will require a therapy indicated for each degree of injury. This therapy initially entails immobilization of the affected area and later; physical therapy will be required to a lesser or greater degree. Commonly, in the physiotherapy of these injuries, rehabilitation exercises are prescribed, where the physiotherapist asks a patient to use equipment with an estimated weight. However, the effectiveness of a generalized therapy in this way does not always give the expected results. This is related to the fact that these therapies are standardized and do not consider some factors such as the remaining muscle fibres that are not directly affected by the sprain, which does not mean that they should not be considered. Therefore, in the present work, a biomodel of a human knee has been developed and used to evaluate numerically how the ACL acts under an external load, when there are different degrees of injuries, caused by trauma. Four case studies were considered: Case 1 (control case) where the ACL is healthy, Case 2 where the ACL presents a 1st-degree sprain, Case 3 where the ACL presents a 2nd-degree sprain, and finally Case 4 where the ACL presents a 3rd-sprain grade. After performing the analyses, in the control case, it was found that it presents a balance between tensile and compressive stresses. While in the 4th case, the most critical tensile stress decreases while compression stresses increase. This shows that the ligament, having considerable damage, no longer works as it should and can eventually damage the collateral structures. It was found that, when there was a sprain, where the continuity of the ligament is compromised, a second torsional moment occurs in the ACL which causes the tissue fibres not to act according to their normal physiology or in a healthy state. The results obtained from the present study provide the possibility of predicting where the following injuries will occur by considering the von Mises failure criterion. Likewise, they will allow to improve the therapeutic procedures considering not only the injured structure but also the system as a whole.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Biomodel of high biofidelity of the knee. (a) Cortical bone of the last third of the femur. (b) Cortical bone of the tibial plateau. (c) Anterior cruciate ligament (ACL). (d) Posterior cruciate ligament (PCL). (e) External lateral ligament (ELL). (f) Internal lateral ligament (ILL). (g) Meniscus.
Figure 2
Figure 2
Restriction of movement in the cortical bone of the last third of the femur.
Figure 3
Figure 3
Loading action (compression).
Figure 4
Figure 4
Normal stress presented in the X-axis in the control case.
Figure 5
Figure 5
Normal stress presented in the Y-axis in the control case.
Figure 6
Figure 6
Normal stress presented in the Z-axis in the control case.
Figure 7
Figure 7
von Mises stress presented in the control case.
Figure 8
Figure 8
Normal stress presented in the X-axis in Case 2.
Figure 9
Figure 9
Normal stress presented in the Y-axis in Case 2.
Figure 10
Figure 10
Normal stress presented in the Z-axis in Case 2.
Figure 11
Figure 11
von Mises stress presented in Case 2.
Figure 12
Figure 12
Normal stress presented in the X-axis in Case 3.
Figure 13
Figure 13
Normal stress presented in the Y-axis in Case 3.
Figure 14
Figure 14
Normal stress presented in the Z-axis in Case 3.
Figure 15
Figure 15
von Mises stress presented in Case 3.
Figure 16
Figure 16
Normal stress presented in the X-axis in Case 4.
Figure 17
Figure 17
Normal stress presented in the Y-axis in Case 4.
Figure 18
Figure 18
Normal stress presented in the Z-axis in Case 4.
Figure 19
Figure 19
von Mises stress presented in Case 4.
Figure 20
Figure 20
Comparison between compression stresses and tensile stresses (MPa) on the X-axis.
Figure 21
Figure 21
Comparison between compression stresses and tensile stresses (MPa) on the Y-axis.
Figure 22
Figure 22
Comparison between compression stresses and tensile stresses (MPa) on the Z-axis.
Figure 23
Figure 23
Example of torsion and flexion that occur in structures where there is no uniform structural continuity.
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