Determination of the in situ loads on the human anterior cruciate ligament

A noncontact, kinematic method was used to determine the lengths and in situ loads borne by portions of the human anterior cruciate ligament (ACL) by the combination of kinematic data from the intact knee and load-length curves of the isolated ACL. Specimens from knees of cadavers of young people were tested in passive flexion and extension as well as with 100 N of anterior tibial drawer at 0, 30, 45, and 90° of flexion. The results showed that the in situ load on the whole ACL (as much as 129 N) can exceed the magnitude of the applied anterior tibial drawer. The load distribution within the ligament changes with flexion of the knee. The anterior and posterior portions share the anterior drawer force equally toward full extension. However, at flexion >45°, the anterior portion supports 90–95% of the load. This information is important for the determination of the function of the entire ACL and of its subportions in response to external loading of the intact knee. In particular, the preferential loading found for one of the portions of the ACL demonstrates that successful operative reconstruction of this ligament may not be achieved simply by reproduction of its gross anatomy; consideration of the role of the ligament in the overall kinematics of the knee is necessary.