Theoretical analysis of ligament and extensor-mechanism function in the ACL-deficient knee
Theoretical analysis of ligament and extensor-mechanism function in the ACL-deficient knee
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DOI：
10.1016/s0268-0033(97)00055-7
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发表时间：
1998-03-01
影响因子：
1.8
通讯作者：
Shelburne, KB
中科院分区：
文献类型：
--
作者：
Pandy, MG;Shelburne, KB
Objective.目的：研究ACL缺陷膝关节的韧带和伸肌机制功能。膝关节肌肉、韧带和骨骼的数学建模。许多实验已经证明ACL缺陷膝关节的胫骨前平移（ATT）增加，但其对膝关节伸肌机制功能的影响尚未完全了解。膝关节韧带之间的负荷分配也是未知的，因为韧带力难以在体内Po测量。模型骨骼的几何形状是根据尸体数据改编的。11个弹性元件描述了韧带和关节囊的几何和机械特性。该模型由11个肌腱单元驱动。通过求解模型的静力平衡方程，模拟直前牵引和最大等长伸展。在完整和ACL缺陷模型中，伸肌机制的力臂和膝关节处的扭矩几乎相等。ACL缺陷模型的膝关节韧带力低于完整模型。韧带力较低，因为当模型ACL被移除时，施加到胫骨的剪切力减小。膝关节伸肌机制的功能不会因ACL丧失而改变。MCL是ACL缺损膝关节前抽屉的主要约束，当ACL缺失时，MCL的深层纤维支配韧带之间的负荷分配。
Objective. To study ligament and extensor-mechanism function in the ACL-deficient knee.Design. Mathematical modeling of the muscles, ligaments, and bones at the knee.Background. Numerous experiments have documented an increase in anterior tibial translation (ATT) in the ACL-deficient knee, but its effect on the function of the knee-extensor mechanism is not fully understood. The load sharing between the knee ligaments is also unknown since ligament forces are difficult Po measure in vivo.Methods. The geometry of the model bones is adapted from cadaver data. Eleven elastic elements describe the geometric and mechanical properties of the ligaments and joint capsule. The model is actuated by eleven musculotendinous units. Straight, anterior drawer and maximum, isometric extension are simulated by solving the equations for static equilibrium of the model.Results. The moment arm of the extensor mechanism and the torque at the knee are nearly equal in the intact and ACL-deficient model. Knee-ligament forces are lower in the ACL-deficient model than in the intact model. Ligament forces are lower because the shear force applied to the tibia decreases when the model ACL is removed.Conclusions. Function of the knee-extensor mechanism is not altered by loss of the ACL. The MCL is the primary restraint to anterior drawer in the ACL-deficient knee, The deep fibers of the MCL dominate the load sharing between the ligaments when the ACL is absent.