Limited benefit of hamstrings forces for the anterior cruciate ligament-deficient knee: An in vitro study

John Joseph Elias, Marcus S. Kirkpatrick, Matthew J. Stonestreet, Kushal S. Shah, Caroline E. Frampton, Melanie A. Morscher, Kerwyn C. Jones

Research output: Contribution to journalArticle


The hamstrings are considered stabilizers of the anterior cruciate ligament-deficient knee; however, anterior cruciate ligament injury primarily influences tibiofemoral kinematics near full extension, where the hamstrings have the least influence on kinematics. Ten knees were tested at multiple flexion angles in vitro to directly compare the influence of anterior cruciate ligament injury and hamstrings activation on tibiofemoral kinematics. Tibiofemoral kinematics were measured for three testing conditions: (1) anterior cruciate ligament intact, with forces applied through the quadriceps muscles (596 N), (2) anterior cruciate ligament cut, with forces applied through the quadriceps, and (3) anterior cruciate ligament cut, with forces applied through the quadriceps and hamstrings (200 N). Based on repeated measures comparisons performed at each flexion angle, cutting the anterior cruciate ligament significantly (p <0.05) increased tibial anterior translation, medial translation, and internal rotation at 0 and 15 of flexion by approximately 2.5 mm, 1 mm, and 2 , respectively. Internal rotation also increased significantly at 30. With the anterior cruciate ligament cut, loading the hamstrings significantly decreased anterior translation, medial translation, and internal rotation at 45 , by approximately 2 mm, 2 mm, and 4 , respectively. Loading the hamstrings caused kinematic changes in the opposite direction of the anterior cruciate ligament injury, but the changes occurred at deeper flexion angles than those at which anterior cruciate ligament injury influenced tibiofemoral kinematics.

Original languageEnglish (US)
Pages (from-to)752-758
Number of pages7
JournalProceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Issue number10
Publication statusPublished - Oct 2012
Externally publishedYes



  • anterior cruciate ligament injury
  • hamstrings
  • kinematics
  • Knee

ASJC Scopus subject areas

  • Mechanical Engineering
  • Medicine(all)

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