ArticleJournal of the mechanical behavior of biomedical materials2018
Femoral entheseal shape and attachment angle as potential risk factors for anterior cruciate ligament injury.
Article in Journal of the mechanical behavior of biomedical materials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Anterior cruciate ligament overuse increases collagen fibril compliance: collagen unraveling and elevated glycosaminoglycan activity in a murine model.Acta biomaterialia · 2026Article
- Effect of Internal Tibial Torque on ACL Tear at the Femoral Enthesis.Annals of biomedical engineering · 2026Article
- Spatially resolved structure-function mapping of the anterior cruciate ligament-bone interface : regional variation in microarchitecture, tensile properties, and stress distribution.Bone & joint research · 2025Article
- Anatomical Tissue Engineering of the Anterior Cruciate Ligament Entheses.International journal of molecular sciences · 2023Review
- Fatigue-driven compliance increase and collagen unravelling in mechanically tested anterior cruciate ligament.Communications biology · 2023Article
- Construction of a physical fitness evaluation index system and model for high-level freestyle skiing aerials athletes in China.PloS one · 2023Article
- Eight weeks of core stability training improves landing kinetics for freestyle skiing aerials athletes.Frontiers in physiology · 2022Article
- Enthesis strength, toughness and stiffness: an image-based model comparing tendon insertions with varying bony attachment geometries.Journal of the Royal Society, Interface · 2021Article
- Femoral Intercondylar Notch: Gross Anatomy and Histology of the Connective Tissue Lining of its Roof: A Pilot Study.Surgical and radiologic anatomy : SRA · 2021Observational
- An Anterior Cruciate Ligament Failure Mechanism.The American journal of sports medicine · 2019Article
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Authors and funding
4 authors at 1 institution in 1 country.
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Abstract
Although non-contact human ACL tears are a common knee injury, little is known about why they usually fail near the femoral enthesis. Recent histological studies have identified a range of characteristic femoral enthesis tidemark profiles and ligament attachment angles. We tested the effect of the tidemark profile and attachment angle on the distribution of strain across the enthesis, under a ligament stretch of 1.1. We employed a 2D analytical model followed by 3D finite element models using three constitutive forms and solved with ABAQUS/Standard. The results show that the maximum equivalent strain was located in the most distal region of the ACL femoral enthesis. It is noteworthy that this strain was markedly increased by a concave (with respect to bone) entheseal profile in that region as well as by a smaller attachment angle, both of which are features more commonly found in females. Although the magnitude of the maximum equivalent strain predicted was not consistent among the constitutive models used, it did not affect the relationship observed between entheseal shape and maximum equivalent strain. We conclude that a concave tidemark profile and acute attachment angle at the femoral ACL enthesis increase the risk for ACL failure, and that failure is most likely to begin in the most distal region of that enthesis.
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