In this thesis, adaptations were made on the Hybrid Cadaveric System to accommodate new testing ramifications. The tests simulated dynamic loading (jump landings) from a 1ft. height with various degrees of valgus (fixed hamstring and quadricep forces) and various Quadricep (Q) and Hamstring (H) forces (fixed degrees of valgus) to determine how the Anterior Cruciate Ligament (ACL) and Medial Collateral Ligament (MCL) behave. The tests performed included 0Q 0H, 100Q 0H, 300Q 0H, 300Q 100H, and 5°, 15°, 25° of valgus. To determine the strain behavior of the ACL and MCL a variety of equipment was used, including electromagnetic force plate to take impact reading, cables used to create loading on the quadriceps and hamstrings, and two Differential Variance Resistance Transducers (DVRTs). These ultimately generated ACL and MCL strain allowing for a variety of strain comparisons under various circumstances. It was concluded that in a few cases there were statistically significant differences in strain for the ACL and MCL when applying various quadricep and hamstring forces (fixed valgus). It was also found that only statistical significance was present in ACL strain when comparing degrees of valgus (fixed quadricep and hamstring forces). The research concluded that muscle activation reduces strain on the ACL and MCL in these testing scenarios. It was also established that degrees of valgus effects the ACL but is negligible for the MCL. However, due to complications and variables, further testing is needed to increase accuracy and supply more definitive results. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

The purpose of this study was to determine the effects of varying periods of immobilization on ligamentous healing and strength in a rat experimental model. Sixty-one mature male Wistar rats were used. The left knee medial collateral ligament was surgically exposed, divided, and repaired. The rats were randomly placed into one of four groups: Group A, no immobilization, Group B, 2 weeks' immobilization, Group C, 6 weeks' immobilization, and Group D, 10 weeks' immobilization of the operated limb. The right knee served as a control. The ligaments were studied histologically and biomechanically at 2 weeks, 6 weeks, 10 weeks and 20 weeks post-operatively. Histologic samples were objectively evaluated with the light microscope using a Maturity Index Score and Scale that were devised based on the numbers and orientation of the fibroblasts and the amount and orientation of the collagen fibres. Ligament-bone preparations were studied using an Instron material testing machine to determine the biomechanical properties of the ligament until failure. Utilizing the Maturity Index Score and Scale, it was shown that Group A, with no immobilization, matured more rapidly than the other groups, and achieved full maturity at 20 weeks post-operatively. The other groups all showed a retarded rate of healing while immobilized. The electron microscopic study supported this data by demonstrating the level of metabolic activity of the fibroblasts which decreased with increasing maturity and by demonstrating that the size, amount and orientation of the collagen fibers increased with mobilization. The biomechanical testing showed that at 2 weeks post-operative, Group A had achieved a strength which was 46% of controls while Group B was only 29% of controls (p = 0.055). At 6 weeks Group A was 65% of controls, Group B was 56% of controls and Group C was 39% of controls (p = 0.0004). At 20 weeks Group A was 83% of controls, Group B was 71% of controls, Group C was 66% of controls and Group D was 48% of controls (p = 0.0005). Group A was 71% stronger than Group D at this time, indicating that the healing medial collateral ligament attained a greater strength and histologically matured more rapidly if mobilization is begun immediately. / Science, Faculty of / Botany, Department of / Zoology, Department of / Graduate

Lam, Mak Ham. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 110-131). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Objetivo: Este trabalho tem como objetivo a avaliação dos resultados funcionais, e da incidência da instabilidade articular mecânica, resultantes do tratamento clínico das lesões ligamentares primárias, agudas e graves do tornozelo (associada a instabilidade articular). Esta lesão é extremamente frequente e acomete indivíduos jovens, economicamente e fisicamente ativos, causando prejuízos pessoais e econômicos importantes. Existe dificuldade no adequado diagnóstico e heterogeneidade na escolha da melhor forma de tratamento. Materiais e métodos: Foram incluídos neste estudo 186 pacientes portadores de lesão ligamentar aguda grave do tornozelo. A amostra foi randomizada em dois grupos de tratamento clínico. Os pacientes incluídos no grupo A foram tratados com uso de imobilização suro podálica imediata (RobofootR), carga permitida conforme tolerado, analgesia, gelo, elevação e mobilização leve da articulação do tornozelo por três semanas. Em seguida foram imobilizados com órtese curta funcional (AircastR esportivo) por mais três semanas, e encaminhado para programa de reabilitação fisioterápico. No grupo B os pacientes foram imobilizados no primeiro atendimento com órtese curta funcional (AircastR esportivo), a carga foi permitida conforme tolerado, analgesia, gelo, elevação e mobilização leve da articulação realizadas por três semanas, e em seguida foram encaminhados para programa de tratamento fisioterápico, como no grupo A. Os pacientes são avaliados clínica e radiograficamente para determinar a limitação funcional nas diversas fases do processo cicatricial, e a presença de instabilidade residual nos tornozelos. Resultados: Não encontramos diferença significativa com relação à evolução para instabilidade mecânica entre os grupos. Da mesma forma não houve diferença na incidência de dor, mas a avaliação através do método de pontuação da Associação Americana dos Cirurgiões de pé e tornozelo (AOFAS) mostrou melhores resultados nos pacientes submetidos ao tratamento com órtese funcional (grupo B). Conclusões: O tratamento das lesões ligamentares graves através do uso de órtese funcional tem melhores resultados do que o tratamento com órtese rígida. A incidência de instabilidade crônica foi muito pequena nos dois grupos / Objective: The objective of this study is to investigate functional results and the incidence of mechanical ankle instability, following conservative treatment of the first episode involving severe lateral ankle ligamentar lesions (with articular instability). This common lesion most often affects young, professional and physically active patients, causing serious personal and economic consequences. Adequate diagnosis is challenging and treatment alternatives for these lesions vary considerably. Methods and cases: 186 patients with severe lateral ankle ligamentar lesions were included in this study. Patients were randomized in two conservative treatment option groups. In group A, patients were treated with long ankle orthosis (RobofootR), comfortable weight bearing allowed, pain management, ice and elevation with restricted joint mobilization for three weeks. After this, they were placed in a short, functional orthosis (AircastR) for an additional three weeks period, with rehabilitation program commencing. In group B, patients were initially immobilized using a functional orthosis (sportive AircastR), and followed the above mentioned sequences for patients in group A. Patients were clinically and radiographically evaluated to determine the functional deficit in each phase, and the presence of ankle residual instability. Results: No significant differences were found in relation to the residual mechanical ankle instability between both groups. Additionally no differences were found in pain intensity, however, the functional evaluation using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot score system showed better results in the functional orthosis treatment group (group B). Conclusions: The treatment of severe lateral ankle ligamentar lesions, using functional orthosis, has shown better results over those treated with a rigid orthosis, and both methods presented a very low incidence of residual chronic instability

Objetivo: Este trabalho tem como objetivo a avaliação dos resultados funcionais, e da incidência da instabilidade articular mecânica, resultantes do tratamento clínico das lesões ligamentares primárias, agudas e graves do tornozelo (associada a instabilidade articular). Esta lesão é extremamente frequente e acomete indivíduos jovens, economicamente e fisicamente ativos, causando prejuízos pessoais e econômicos importantes. Existe dificuldade no adequado diagnóstico e heterogeneidade na escolha da melhor forma de tratamento. Materiais e métodos: Foram incluídos neste estudo 186 pacientes portadores de lesão ligamentar aguda grave do tornozelo. A amostra foi randomizada em dois grupos de tratamento clínico. Os pacientes incluídos no grupo A foram tratados com uso de imobilização suro podálica imediata (RobofootR), carga permitida conforme tolerado, analgesia, gelo, elevação e mobilização leve da articulação do tornozelo por três semanas. Em seguida foram imobilizados com órtese curta funcional (AircastR esportivo) por mais três semanas, e encaminhado para programa de reabilitação fisioterápico. No grupo B os pacientes foram imobilizados no primeiro atendimento com órtese curta funcional (AircastR esportivo), a carga foi permitida conforme tolerado, analgesia, gelo, elevação e mobilização leve da articulação realizadas por três semanas, e em seguida foram encaminhados para programa de tratamento fisioterápico, como no grupo A. Os pacientes são avaliados clínica e radiograficamente para determinar a limitação funcional nas diversas fases do processo cicatricial, e a presença de instabilidade residual nos tornozelos. Resultados: Não encontramos diferença significativa com relação à evolução para instabilidade mecânica entre os grupos. Da mesma forma não houve diferença na incidência de dor, mas a avaliação através do método de pontuação da Associação Americana dos Cirurgiões de pé e tornozelo (AOFAS) mostrou melhores resultados nos pacientes submetidos ao tratamento com órtese funcional (grupo B). Conclusões: O tratamento das lesões ligamentares graves através do uso de órtese funcional tem melhores resultados do que o tratamento com órtese rígida. A incidência de instabilidade crônica foi muito pequena nos dois grupos / Objective: The objective of this study is to investigate functional results and the incidence of mechanical ankle instability, following conservative treatment of the first episode involving severe lateral ankle ligamentar lesions (with articular instability). This common lesion most often affects young, professional and physically active patients, causing serious personal and economic consequences. Adequate diagnosis is challenging and treatment alternatives for these lesions vary considerably. Methods and cases: 186 patients with severe lateral ankle ligamentar lesions were included in this study. Patients were randomized in two conservative treatment option groups. In group A, patients were treated with long ankle orthosis (RobofootR), comfortable weight bearing allowed, pain management, ice and elevation with restricted joint mobilization for three weeks. After this, they were placed in a short, functional orthosis (AircastR) for an additional three weeks period, with rehabilitation program commencing. In group B, patients were initially immobilized using a functional orthosis (sportive AircastR), and followed the above mentioned sequences for patients in group A. Patients were clinically and radiographically evaluated to determine the functional deficit in each phase, and the presence of ankle residual instability. Results: No significant differences were found in relation to the residual mechanical ankle instability between both groups. Additionally no differences were found in pain intensity, however, the functional evaluation using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot score system showed better results in the functional orthosis treatment group (group B). Conclusions: The treatment of severe lateral ankle ligamentar lesions, using functional orthosis, has shown better results over those treated with a rigid orthosis, and both methods presented a very low incidence of residual chronic instability