MEASUREMENT OF KNEE STIFFNESS AND LAXITY IN PATIENTS WITH DOCUMENTED ABSENCE OF THE ANTERIOR CRUCIATE LIGAMENT
MEASUREMENT OF KNEE STIFFNESS AND LAXITY IN PATIENTS WITH DOCUMENTED ABSENCE OF THE ANTERIOR CRUCIATE LIGAMENT
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DOI：
10.2106/00004623-198466020-00011
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发表时间：
1984-01-01
影响因子：
5.3
通讯作者：
AMSTUTZ, HC
中科院分区：
文献类型：
--
作者：
MARKOLF, KL;KOCHAN, A;AMSTUTZ, HC
在装有仪器的临床膝关节测试设备上测试有记录的前十字韧带缺失的患者（35），并测量以下测试模式的响应曲线：前-后力与完全伸展和20 °时的位移。90度。屈曲;内翻-外翻力矩与完全伸展和20 °时的成角。以及胫骨扭矩与20 °旋转的关系。弯曲。这些受伤的膝关节的僵硬度和松弛度以及左右差异的绝对值与先前测量的49名没有膝关节损伤治疗史的正常受试者的对照人群的相同数量进行了比较。对于未受伤的膝盖和没有前十字韧带的膝盖，在20 °。90度。在屈曲时，前后松弛度在大约15 °处最大。脚的外旋。与未受伤的膝关节相比，在所有测试位置的脚和膝关节，受伤的膝关节表现出显着增加总的前后松弛和减少前刚度。该组患者在. ±.时受伤膝关节的成对前后松弛度平均增加。施加200 N的前后力，在完全伸展时为3.1 mm（+39%），在20 °时为5.5 mm（+57%）。90 °时为2.5mm（+34%）。弯曲。在20 °时，受伤膝关节前刚度的平均降低也最大（-54%）。膝关节屈曲。在20 °时测量到后部刚度仅轻微降低（-16%）。这可能反映了存在相关的关节囊和关节突损伤。在前交叉韧带缺陷膝关节组中，内侧半月板缺失的患者在所有3个膝关节屈曲位置的总前后松弛度均大于半月板完整或撕裂的患者。损伤膝关节在完全伸展时的内翻-外翻松弛度平均增加1.7度（+36%），而内翻和外翻刚度分别降低21%和24%。内侧半月板的缺失（在前十字韧带缺失的膝关节中）增加了0 °和20 °时的内翻-外翻松弛。弯曲。无前交叉韧带的膝关节扭转松弛度平均增加10%，内旋刚度降低16%。受伤和未受伤膝关节的内外侧等长扭矩产生能力没有差异。
Patients (35) with documented absence of the anterior cruciate ligament were tested on instrumented clinical knee-testing apparatus and the response curves were measured for the following testing modes: anterior-posterior force vs. displacement at full extension and at 20.degree. and 90.degree. of flexion; varus-valgus moment vs. angulation at full extension and 20.degree. of flexion; and tibial torque vs. rotation at 20.degree. of flexion. Absolute values of stiffness and laxity and right-left differences for these injured knees were compared with identical quantities measured previously for a control population of 49 normal subjects with no history of treatment for injury to the knee. For both the uninjured knees and the knees without an anterior cruciate ligament, at 20.degree. and 90.degree. of flexion the anterior-posterior laxity was greatest at approximately 15.degree. of external rotation of the foot. The injured knees demonstrated significantly increased total anterior-posterior laxity and decreased anterior stiffness when compared with the uninjured knees in all tested positions of the foot and knee. The mean increase in paired anterior-posterior laxity for the injured knees in this group of patients at .+-. 200 N of applied anterior-posterior force was 3.1 mm (+39%) at full extension, 5.5 mm (+57%) at 20.degree. of flexion, and 2.5 mm (+34%) at 90.degree. of flexion. The mean reduction in anterior stiffness for injured knees was also greatest (-54%) at 20.degree. of knee flexion. Only slight reduction in posterior stiffness (-16%) was measured at 20.degree. of flexion, and this probably reflected the presence of associated capsular and meniscal injuries. In the group of anterior cruciate-deficient knees, the patients with an absent medial meniscus showed greater total anterior-posterior laxity in all 3 positions of knee flexion than did the patients with an intact or torn meniscus. Varus-valgus laxity at full extension increased an average of 1.7 degrees (+36%) for the injured knees, while varus and valgus stiffness decreased 21 and 24%. Absence of the medial meniscus (in a knee with absence of the anterior cruciate ligament) increased varus-valgus laxity at 0 and 20.degree. of flexion. Torsional laxity increased by an average of 10% in knees without an anterior cruciate ligament and internal rotation stiffness decreased 16%. There was no difference in internal and external isometric torque-generating capacity between the injured and uninjured knees.