The attachment locations of anterior cruciate ligament (ACL) grafts during reconstruction have been reported to influence knee joint function. However, there are controversial opinions on femoral ACL attachment locations for restoring normal knee kinematics. The knee stability and ACL force by different ACL attachment locations could be predicted using the musculoskeletal model simulation. The objectives of this study are to develop a detailed musculoskeletal knee model and to quantify the effect of ACL graft attachment locations on knee kinematics and graft force. Five normal subjects walked at a self-selected speed, and motion data were captured. A detailed knee model including 14 ligaments was developed for dynamics simulation using cadaveric specimen data, which were previously published and are open to public access. The ACL bundles of the model were removed and replaced with ACL grafts to develop anatomical and isometric ACL-reconstructed knee models; the femoral anatomical footprint and isometric locations were used, respectively. After the knee models were embedded in a full-body template model from the AnyBody Managed Model Repository, the full-body musculoskeletal model was simulated using the measured gait data. The isometric reconstruction model had significantly large anterior translation and internal rotation than the intact and anatomical reconstruction model. The average differences between the isometric reconstruction and intact models were 4.5 mm and 3.0° for tibial anterior translation and internal rotation, respectively. The ACL tensional force in the isometric reconstruction model was significantly lower than that in the intact model. Anatomical reconstruction could closely restore the normal knee kinematics.

据报道，重建过程中前十字韧带（ACL）移植物的附着位置会影响膝关节功能。但是，关于股骨ACL附着位置恢复正常膝关节运动学方面存在争议。可以使用肌肉骨骼模型仿真预测不同ACL附着位置的膝盖稳定性和ACL力。这项研究的目的是建立详细的肌肉骨骼膝盖模型，并量化ACL移植物附着位置对膝盖运动学和移植力的影响。五名正常对象以自行选择的速度行走，并捕获了运动数据。使用尸体标本数据开发了包括14条韧带的详细膝关节模型，用于动力学仿真，该数据先前已发布并向公众开放。移除模型的ACL束并替换为ACL移植物，以开发解剖和等距ACL重建的膝盖模型；分别使用了股骨解剖足迹和等距位置。将膝盖模型嵌入到AnyBody Managed Model Repository的全身模板模型中之后，使用测得的步态数据模拟全身肌肉骨骼模型。等轴重建模型的前移和内旋比完整和解剖重建模型大得多。等距重建模型和完整模型之间的平均差异分别为胫骨前移和内旋分别为4.5 mm和3.0°。等距重建模型中的ACL张力明显低于完整模型中的ACL张力。