Kl. Markolf et al., IN-SITU CALIBRATION OF MINIATURE SENSORS IMPLANTED INTO THE ANTERIOR CRUCIATE LIGAMENT PART II - FORCE PROBE MEASUREMENTS, Journal of orthopaedic research, 16(4), 1998, pp. 464-471
The arthroscopically implantable force probe transducer. which measure
s the effects of local ligament fiber tension, was inserted into the a
nteromedial band of the anterior cruciate ligament after measurements
with the differential variable reluctance transducer were completed in
Part I of this study. The overall goals in Part II remained the same,
with additional experiments included to determine the sensitivity of
output voltage from the transducer to medial-lateral placement of the
device within the anteromedial band and to depth of placement within a
given insertion hole. Calibration curves of output voltage from the a
rthroscopically implantable force probe transducer versus resultant fo
rce in the ligament were generated during a separate series of knee-lo
ading experiments identical to those performed in Part I. The output v
oltage for a given probe placement was highly sensitive to the depth o
f implantation into the anteromedial band. When the probe was complete
ly buried within the ligament, voltage outputs were often sporadic or
absent even though surface fibers had clearly developed tension. When
the probe was only partially inserted into the hole, such that the end
of the probe was slightly proud to the surface, voltage output was si
gnificantly higher as the device measured tension in the superficial f
ibers. Voltage outputs for proud placement were always significantly h
igher than corresponding voltages for deep placements for all test con
ditions. With proud placements, voltage outputs were not sensitive to
small deviations in medial-lateral position within the anteromedial ba
nd. Mean coefficients of variation for output voltage (four repeated p
lacements of the probe into the same central hole) ranged from 0.156 t
o 0.359 (deep and proud insertions). Output voltage from the probe gen
erally followed the pattern of resultant force in the ligament during
passive knee extension. For anterior tibial loading, the contribution
of deep fibers to resultant force did not depend on the knee flexion a
ngle at which the test was conducted: the contribution of superficial
fibers was greatest beyond 45 degrees of flexion and least at full ext
ension. The contributions of the anteromedial band to resultant force
in the ligament were not significantly different between the three mod
es of loading (anterior tibial force, internal tibia torque, and varus
moment) at either 0 or 10 degrees of flexion; this was true for both
superficial and deep fibers. We found it necessary to secure the probe
within the insertion site using a suture (for both deep and proud pla
cements) to obtain repeatable readings. Puncturing the anteromedial ba
nd clearly produced tissue damage; the insertion hole often produced a
permanent plane of cleavage in the anteromedial band. However, this t
issue damage did not alter the overall ability of the ligament to gene
rate resultant force.