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The Journal of Bone and Joint Surgery, Vol 64, Issue 2 208-216, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
In vivo rotatory knee stability. Ligamentous and muscular contributions
SC Shoemaker and KL Markolf
Active and passive components of torsional stability of the knee were
measured with an instrumented clinical knee-testing apparatus.
Torque-versus-rotation response curves were recorded in the
non-weight-bearing condition with muscles relaxed for twenty normal
subjects who were tested at 20 and 90 degrees of knee flexion with the hips
flexed and extended. At applied torque levels as high as +/-10
newton-meters, tibial rotation averaged approximately one-half the foot
rotation. The mean algebraic right-left rotation difference for the group
was nearly zero; however, sizable standard deviations for this difference
indicated considerable right-left variations between individuals in the
test group. Maximum isometrically generated tibial torques were measured by
asking the subjects to twist with an explosive effort against a locked
torque-cell. No significant differences in generated torque were measured
between preferred and non-preferred lower limbs, with only one minor
exception. Subjects generally were able to generate greater internal torque
than external torque. When the foot was locked in a position of internal or
external rotation, an individual was able to generate increased tibial
torque in the direction that would tend to return the foot to the neutral
position. Flexion of the knee from 20 to 90 degrees increased externally
generated torque, while internal torque was affected to a lesser degree.
Flexion of the hip had little effect on generated torque. Six cadaver knees
without menisci that were tested to failure in external rotation showed
torque levels for ligament failure to be similar in magnitude to the
maximum generated isometric torque that acts to protect the knee ligaments.
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