Muscle balance at the knee--moment arms for the normal knee and the ACL-minus knee.
Muscle balance at the knee--moment arms for the normal knee and the ACL-minus knee.
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DOI：
10.1109/86.650292
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发表时间：
1997-12-01
期刊：
影响因子：
--
通讯作者：
Stewart, A A
中科院分区：
文献类型：
--
作者：
Buford, W L Jr;Ivey, F M Jr;Stewart, A A
膝盖处的力、力矩和应力取决于外部和内部载荷因素，包括肌肉力、节段位置和速度、承载的载荷以及肌肉肌腱单元的力臂（机械优势）。预测力和力矩的必要条件是详细了解整个膝关节运动范围 (ROM) 的有效力臂。现有的膝盖肌肉模型基于仅对少数保存标本进行的有限静态研究。本报告的目的是对正常膝关节和前交叉韧带 (ACL) 膝关节在屈曲-伸展运动过程中的肌肉肌腱力臂进行全面描述。最近的研究结果描述了膝盖的两个非正交、不相交的运动轴——一个描述屈曲伸展（FE），另一个描述纵向旋转（LR，相当于内旋-外旋）。在 15 个新鲜的半骨盆尸体标本中，相对于 FE 轴开发了穿过膝盖的肌肉的有效屈伸力臂。 13 块肌肉加上髌腱的正常力臂在整个 ROM 中表现出可变但可重复且可识别的模式。对于大多数肌肉来说，正常力臂和无 ACL 力臂之间没有显着差异。结果为更准确地预测关节反作用力和力矩提供了基础，并为从业者和治疗师提供了有用的知识，以协助评估受伤、修复和整个康复过程中膝盖的肌肉平衡。
Forces, moments and stresses at the knee are dependent upon external and internal loading factors including muscle forces, segmental position and velocity, load carried, and the moment arms (mechanical advantage) of the muscle-tendon units. Requisite to prediction of forces and moments is a detailed understanding of effective moment arms throughout the knee range-of-motion (ROM). Existing muscle models for the knee are based upon limited static studies of only a few preserved specimens. The objectives of this report are to develop a comprehensive description of muscle-tendon moment arms for the normal knee and the anterior cruciate ligament (ACL)-minus knee during flexion-extension motion. Recent research results describe two nonorthogonal, nonintersecting axes of motion for the knee--one describing flexion-extension (FE) and the other longitudinal rotation (LR, equivalent to internal-external rotation). The effective flexion-extension moment arms of the muscles crossing the knee were developed with respect to the FE axis in 15 fresh, hemi-pelvis cadaver specimens. The normal moment arms for each of 13 muscles plus the patellar tendon exhibited variable, yet repeatable and recognizable patterns throughout the ROM. For most muscles there was no significant difference between the normal and ACL-minus moment arms. The results provide a basis for more accurate predictions of joint reaction forces and moments as well as useful knowledge for practitioners and therapists to assist in the assessment of muscle balance at the knee following injury, repair, and throughout rehabilitation.