The effects of medialization and anteromedialization of the tibial tubercle on patellofemoral mechanics and kinematics
The effects of medialization and anteromedialization of the tibial tubercle on patellofemoral mechanics and kinematics
复制标题
DOI：
10.1177/0363546505283460
复制
发表时间：
2006-05-01
影响因子：
4.8
通讯作者：
Gill, TJ
中科院分区：
文献类型：
--
作者：
Ramappa, AJ;Apreleva, M;Gill, TJ
背景：胫骨结节内侧化和前内侧化用于矫正成人髌骨半脱位。目的：比较两种截骨术对髌股关节接触压力和运动学的影响。研究设计：对照实验室研究。方法：对 10 具尸体膝盖进行胫骨结节截骨术。在0度和90度屈曲之间测试膝盖，同时获得动态髌股关节接触压力和运动学数据。测试了四种条件：正常的膝关节排列、模拟增加的 Q 角、胫骨结节的后内侧化和结节的后内侧化。结果：增加的 Q 角横向平移髌骨，将力转移到外侧小关节，并增加髌骨接触压力。内侧化和前内侧化都部分纠正了异常的接触压力。内侧化部分纠正了因 Q 角增加而引起的力向外侧关节面的转移，而前内侧化则不能。内侧化和前内侧化均纠正了髌骨运动轨迹不良。结论：内侧化和前内侧化在纠正异常髌骨力学和运动学方面的能力相当。
Background: Medialization and anteromedialization of the tibial tubercle are used to correct patellar subluxation in adults.Purpose: To compare the effects of the 2 osteotomies on patellofemoral joint contact pressures and kinematics.Study Design: Controlled laboratory study.Methods: Tibial tubercle osteotomies were performed on 10 cadaveric human knees. The knees were tested between 0 degrees and 90 degrees of flexion while dynamic patellofemoral joint contact pressure and kinematic data were simultaneously obtained. Four conditions were tested: normal knee alignment, simulated increased Q angle, postmedialization of the tibial tubercle, and postanteromedialization of the tubercle.Results: An increased Q angle laterally translated the patella, shifted force to the lateral facet, and increased patella contact pressures. Both medialization and anteromedialization partially corrected the abnormal contact pressures. Medialization partially corrected the shift of force to the lateral facet induced by an increased Q angle, whereas the anteromedialization could not. Both medialization and anteromedialization corrected the patella maltracking.Conclusion: Medialization and anteromedialization are equivalent in their ability to correct abnormal patellar mechanics and kinematics.