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First published on May 18, 2004, doi:10.1177/0363546503262198
This version was published on July 1, 2004
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The American Journal of Sports Medicine 32:1144-1149 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Effects of Applied Quadriceps and Hamstrings Muscle Loads on Forces in the Anterior and Posterior Cruciate Ligaments

Keith L. Markolf, PhD*, Geoffery O’Neill*, Steven R. Jackson* and David R. McAllister, MD{dagger},{ddagger}

From the * Biomechanices Research Section, Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, and the {ddagger} Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California

{dagger} Address correspondence to David R. McAllister, MD, Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, CHS, Box 956902, Los Angeles, CA 90095-6902.

Background: Muscle contraction can subject healing knee ligament grafts to high loads.

Purpose: To directly measure the effects of quadriceps and hamstrings muscle loads on forces in the anterior cruciate ligaments and posterior cruciate ligaments.

Study Design: Controlled laboratory study.

Methods: Thirteen cadaveric knee specimens had load cells installed to record resultant forces in both anterior and posterior cruciate ligaments under 5 loading conditions. Cruciate force measurements were repeated with a 100-N load applied to the quadriceps tendon and again with a combined 50-N biceps load and 50-N semimembranosus-semitendinosus load.

Results: Applied quadriceps loads resulted in mean changes in anterior cruciate ligament and posterior cruciate ligament forces that were less than 20 N for all loading conditions. Hamstrings load significantly increased mean posterior cruciate ligament force between 30° and 105° of flexion with 100 N of applied posterior tibial force.

Conclusions: At the muscle force levels used in this study, the hamstrings were more effective than the quadriceps in altering cruciate force levels, especially near 90° of flexion, where they have an excellent mechanical advantage for controlling anterior-posterior tibial translation.

Clinical Relevance: Isolated hamstrings activity generally had little or no effect on anterior cruciate ligament forces but significantly increased forces in the posterior cruciate ligament beyond approximately 30° of flexion.

Key Words: anterior cruciate ligament (ACL) • posterior cruciate ligament (PCL) • biomechanics • quadriceps • hamstrings




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