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Research Papers

The Effect of the Shoe-Surface Interface in the Development of Anterior Cruciate Ligament Strain

[+] Author and Article Information
Mark C. Drakos1

Sports Medicine and Shoulder Service and the Department of Biomechanical Engineering, Hospital for Special Surgery, New York, NY 10021mdrakos@yahoo.com

Howard Hillstrom, James E. Voos, Anna N. Miller, Andrew P. Kraszewski, Thomas L. Wickiewicz, Russell F. Warren, Answorth A. Allen, Stephen J. O’Brien

Sports Medicine and Shoulder Service and the Department of Biomechanical Engineering, Hospital for Special Surgery, New York, NY 10021

1

Corresponding author.

J Biomech Eng 132(1), 011003 (Dec 08, 2009) (7 pages) doi:10.1115/1.4000118 History: Received December 19, 2008; Revised May 23, 2009; Posted September 01, 2009; Published December 08, 2009; Online December 08, 2009

Abstract

The shoe-surface interface has been implicated as a possible risk factor for anterior cruciate ligament (ACL) injuries. The purpose of this study is to develop a biomechanical, cadaveric model to evaluate the effect of various shoe-surface interfaces on ACL strain. There will be a significant difference in ACL strain between different shoe-surface combinations when a standardized rotational moment (a simulated cutting movement) is applied to an axially loaded lower extremity. The study design was a controlled laboratory study. Eight fresh-frozen cadaveric lower extremities were thawed and the femurs were potted with the knee in 30 deg of flexion. Each specimen was placed in a custom-made testing apparatus, which allowed axial loading and tibial rotation but prevented femoral rotation. For each specimen, a 500 N axial load and a 1.5 Nm internal rotation moment were placed for four different shoe-surface combinations: group I (AstroTurf-turf shoes), group II (modern playing turf-turf shoes), group III (modern playing turf-cleats), and group IV (natural grass-cleats). Maximum strain, initial axial force and moment, and maximum axial force and moment were calculated by a strain gauge and a six component force plate. The preliminary trials confirmed a linear relationship between strain and both the moment and the axial force for our testing configuration. In the experimental trials, the average maximum strain was 3.90, 3.19, 3.14, and 2.16 for groups I–IV, respectively. Group IV had significantly less maximum strain $(p<0.05)$ than each of the other groups. This model can reproducibly create a detectable strain in the anteromedial bundle of the ACL in response to a given axial load and internal rotation moment. Within the elastic range of the stress-strain curve, the natural grass and cleat combination produced less strain in the ACL than the other combinations. The favorable biomechanical properties of the cleat-grass interface may result in fewer noncontact ACL injuries.

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Figures

Figure 1

Graphic depiction of the novel testing device: (1) Unistrut (steel) is the supporting beam of the testing device; (2) testing cube allows superior and inferior translation while preventing axial rotation; (3) turn screw allows the application of an axial load; (4) turf box houses the different athletic surfaces; (5) six component force plate, which calculate forces and moments in the x, y, and z planes; (6) lazy susan/potentiometer allows axial rotation of the surface and calculates the angle; and (7) pulley with weights, which creates a moment about the shoe-surface interface

Figure 2

Testing device

Figure 3

A Microstrain DVRT is inserted into the anteromedial bundle of the ACL

Figure 4

Figure 5

Schematic drawing of the experiment: A shoe is placed on the potted cadaver and loaded into the testing assembly, an axial load is then placed followed by a moment about the axial plane and the ACL strain is recorded

Figure 6

Graph of strain (%) versus axial load: Note that at approximately 500 N the strain plateaus

Figure 7

Graph of strain (%) versus moment: Note that as moment increases so does ACL strain in a linear type pattern

Figure 8

Graph of the mean maximum strain in the ACL versus the shoe-surface interface: The red star indicates a statistically significant difference (p<0.05)

Figure 9

Graph of the mean maximum load on the force plate versus the shoe-surface interface: The red star indicates a statistically significant difference (p<0.05)

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