In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads
In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads
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DOI：
10.1002/jor.1100150219
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发表时间：
1997-03-01
影响因子：
2.8
通讯作者：
Fu, FH
中科院分区：
文献类型：
--
作者：
Sakane, M;Fox, RJ;Fu, FH
前十字韧带具有复杂的纤维解剖结构，不被认为是均匀的结构。目前的前交叉韧带重建成功地稳定了膝关节，但它们既不能完全恢复正常的膝关节运动学，也不能再现正常的韧带功能。为了改善重建结果，可能有必要在替代移植物中重现完整前十字韧带的复杂功能。我们检查了九个人类前十字韧带的原位力，以及韧带前内侧束和后外侧束之间的力分布，以响应在膝关节屈曲角度为 0-90 度时施加的 22 至 110 N 的前胫骨载荷。该分析是使用机器人操纵器与通用力-力矩传感器结合进行的。现场力是在韧带上没有连接任何装置的情况下确定的，同时允许膝盖自由移动以响应所施加的载荷。我们发现，前十字韧带中的原位力范围为：在膝关节屈曲 90 度时施加 22 N 的前胫骨载荷下，该力为 12.8 +/- 7.3 N；在膝关节屈曲 15 度时，在施加 110 N 的载荷下，前十字韧带中的原位力为 110.6 +/- 14.8 N。在膝关节屈曲角度0~45°时，后外侧束的原位力大小大于前内侧束，在胫骨前载荷110N的情况下，膝关节屈曲15°时，后外侧束的原位力大小达到最大值75.2+/-18.3N。膝关节屈曲角度和胫骨前载荷对后外侧束的原位力大小有显着影响。与前十字韧带中看到的非常相似。相反，前内侧束中原位力的大小保持相对恒定，不随屈曲角度变化。仅在屈曲角度为 0 度和 60 度且仅在施加大于 66 N 的前胫骨载荷时，发现前内侧束和后外侧束之间的原位力方向存在显着差异。我们已经证明了前十字韧带在不受约束的前胫骨载荷下的不均匀性。我们的数据进一步表明，为了使前交叉韧带置换移植物重现正常前交叉韧带的原位力，重建技术除了前内侧束外还应考虑后外侧束的作用。
The anterior cruciate ligament has a complex fiber anatomy and is not considered to be a uniform structure. Current anterior cruciate ligament reconstructions succeed in stabilizing the knee, but they neither fully restore normal knee kinematics nor reproduce normal ligament function. To improve the outcome of the reconstruction, it may be necessary to reproduce the complex function of the intact anterior cruciate ligament in the replacement graft. We examined the in situ forces in nine human anterior cruciate ligaments as well as the force distribution between the anteromedial and posterolateral bundles of the ligament in response to applied anterior tibial loads ranging from 22 to 110 N at knee flexion angles of 0-90 degrees. The analysis was performed using a robotic manipulator in conjunction with a universal force-moment sensor. The in situ forces were determined with no device attached to the ligament, while the knee was permitted to move freely in response to the applied loads. We found that the in situ forces in the anterior cruciate ligament ranged from 12.8 +/- 7.3 N under 22 N of anterior tibial load applied at 90 degrees of knee flexion to 110.6 +/- 14.8 N under 110 N of applied load at 15 degrees of flexion. The magnitude of the in sial force in the posterolateral bundle was larger than that in the anteromedial bundle at knee flexion angles between 0 and 45 degrees, reaching a maximum of 75.2 +/- 18.3 N at 15 degrees of knee flexion under an anterior tibial load of 110 N. The magnitude of the in situ force in the posterolateral bundle was significantly affected by knee flexion angle and anterior tibial load in a fashion remarkably similar to that seen in the anterior cruciate ligament. The magnitude of the in situ force in the anteromedial bundle, in contrast, remained relatively constant, not changing with flexion angle. Significant differences in the direction of the in situ force between the anteromedial bundle and the posterolateral bundle were found only at flexion angles of 0 and 60 degrees and only under applied anterior tibial loads greater than 66 N. We have demonstrated the nonuniformity of the anterior cruciate ligament under unconstrained anterior tibial loads. Our data further suggest that in order for the anterior cruciate ligament replacement graft to reproduce the in situ forces of the normal anterior cruciate ligament, reconstruction techniques should take into account the role of the posterolateral bundle in addition to that of the anteromedial bundle.