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. 2020 Feb 20;10:3026. doi: 10.1038/s41598-020-59602-2

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Contact areas between femoral and tibial cartilage with different pre-strains of ACL, PCL, LCL, and MCL bundles. The blue shaded areas (with crosslines) show the total contact area (left axis) and the red shaded areas (diagonal lines) show the medial cartilage to lateral cartilage ratio of contact area (right axes). The cartilage-to-cartilage contact area on the lateral side of the knee was close to zero in the FE models with 5–10% increased pre-strains in the MCL (at 40% to 90% of the stance phase). Thus, the medial to lateral contact area ratio goes out of range.