Empirical Based Modeling for the Assessment of Dynamic Knee Stability: Implications for Anterior Cruciate Ligament Injury Risk

Anterior cruciate ligament (ACL) injuries are common sports injuries, costing the U.S. roughly $1 billion annually. To better understand the underlying injury mechanism, Nyquist and Bode stability criteria were applied to assess frontal plane dynamic knee stability among male Australian Football players during the weight-acceptance phase of single-leg jump landing. Out of 30 landings, 19 were classified as stable and 11 as unstable. Medial and lateral vasti, hamstring and gastrocnemii muscle activation waveforms were analyzed in parallel to determine if individuals with stable and unstable frontal plane joint biomechanics possessed different lower limb neuromuscular strategies. The total quadriceps muscle activation during the stable landings were significantly higher (p=0.02) than during the unstable landings. Additionally, the vasti exhibited a medial dominance during the stable landings compared to the unstable (p=0.06). These results suggest that individuals with unstable frontal plane knee landing mechanics may have reduced recruitment of the muscles crossing the knee; specifically, the medial muscles, which could limit their ability to compress and support the joint. The stability criteria were able to classify stable and unstable knee mechanics. And the differences in muscle activation during these stable and unstable landings provided new insights towards the ACL injury mechanism and possible injury prevention countermeasures.