Volume 12, Issue 4 (2-2027)
J Sport Biomech 2027, 12(4): 854-881 |
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Zanguie H, Yousefi M, Azade M, Zivari S. Musculoskeletal Simulation Methods for Estimating Anterior Cruciate Ligament Loading during High-Risk Lower Extremity Tasks: A Systematic Review. , J Sport Biomech. 2027; 12 (4) :854-881
URL: http://biomechanics.iauh.ac.ir/article-1-571-en.html
URL: http://biomechanics.iauh.ac.ir/article-1-571-en.html
1- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and health, University of Tehran, Tehran, Iran.
2- Department of Sports Biomechanic, Faculty of Sports Sciences, University of Birjand, Birjand, Iran.
3- Department of Corrective Exercises and Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran.
4- Department of Sport Biomechanics, Faculty of Sport Sciences, Kharazmi University, Tehran, Iran.
2- Department of Sports Biomechanic, Faculty of Sports Sciences, University of Birjand, Birjand, Iran.
3- Department of Corrective Exercises and Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran.
4- Department of Sport Biomechanics, Faculty of Sport Sciences, Kharazmi University, Tehran, Iran.
Abstract: (48 Views)
Objective This systematic review evaluated musculoskeletal simulation approaches for estimating anterior cruciate ligament (ACL) loading during dynamic lower-limb tasks associated with injury risk, focusing on modeling methods, ACL representation, validation, and biomechanical determinants.
Methods MEDLINE/PubMed, Scopus, Web of Science, SPORTDiscus, and Google Scholar were searched for English-language studies published from 2010 to 2026. Eligible human studies used musculoskeletal, EMG-informed, or integrated musculoskeletal–finite element models to estimate ACL-related outcomes during landing, cutting, or change-of-direction tasks. Methodological quality was assessed using the Downs and Black checklist. The protocol was registered in PROSPERO (CRD420261486837).
Results Twelve studies were included. OpenSim was the most frequently used platform. Outcomes included model-estimated ACL force, strain, strain rate, and surrogate loading measures. Predicted ACL loading reflected interactions among muscle forces, external loads, multiplanar kinematics, and neuromuscular control. Knee valgus angle, knee abduction moment, and anterior tibial translation alone may be insufficient to characterize ACL loading. Evaluation methods varied, including comparisons with cadaveric data, experimental measurements, published findings, and sensitivity analyses; these methods do not provide equivalent evidence of validation.
Conclusion Musculoskeletal simulation provides a noninvasive approach to investigating ACL loading, but methodological heterogeneity and limited validation constrain the comparability of findings. Standardized methods, evaluation of subject-specific models, and independent experimental validation are needed to improve model reliability and applicability.
Methods MEDLINE/PubMed, Scopus, Web of Science, SPORTDiscus, and Google Scholar were searched for English-language studies published from 2010 to 2026. Eligible human studies used musculoskeletal, EMG-informed, or integrated musculoskeletal–finite element models to estimate ACL-related outcomes during landing, cutting, or change-of-direction tasks. Methodological quality was assessed using the Downs and Black checklist. The protocol was registered in PROSPERO (CRD420261486837).
Results Twelve studies were included. OpenSim was the most frequently used platform. Outcomes included model-estimated ACL force, strain, strain rate, and surrogate loading measures. Predicted ACL loading reflected interactions among muscle forces, external loads, multiplanar kinematics, and neuromuscular control. Knee valgus angle, knee abduction moment, and anterior tibial translation alone may be insufficient to characterize ACL loading. Evaluation methods varied, including comparisons with cadaveric data, experimental measurements, published findings, and sensitivity analyses; these methods do not provide equivalent evidence of validation.
Conclusion Musculoskeletal simulation provides a noninvasive approach to investigating ACL loading, but methodological heterogeneity and limited validation constrain the comparability of findings. Standardized methods, evaluation of subject-specific models, and independent experimental validation are needed to improve model reliability and applicability.
Type of Study: Research |
Subject:
Special
Received: 2026/08/26 | Accepted: 2026/10/12 | Published: 2026/10/31
Received: 2026/08/26 | Accepted: 2026/10/12 | Published: 2026/10/31
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