In vivo function of the posterior cruciate ligament during weightbearing knee flexion
In vivo function of the posterior cruciate ligament during weightbearing knee flexion
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DOI：
10.1177/0363546504264896
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发表时间：
2004-12-01
影响因子：
4.8
通讯作者：
Li, G
中科院分区：
文献类型：
--
作者：
DeFrate, LE;Gill, TJ;Li, G
背景：目前对后交叉韧带功能的认识主要基于体外尸体研究。关于后交叉韧带在体内功能的研究很少。本研究的目的是量化后交叉韧带的多维变形。假设：在体内负重屈曲过程中，后交叉韧带经历复杂的三维变形，包括伸长、扭曲和方向变化。研究设计：体内生物力学研究。方法：使用5个人类膝关节的磁共振图像来创建每个受试者膝关节的三维计算机模型，包括后交叉韧带的插入区域。在准静态弓步时采集每个受试者膝关节的正交透视图像。图像和计算机模型用于再现膝关节的体内运动。股骨和胫骨插入的相对运动被描述在伸长，扭曲，海拔（胫骨平台和后交叉韧带之间的角度，在矢状面测量），和偏差（内外方向，在胫骨平台平面测量）。当膝关节从0度屈曲到90度时，它几乎扭转了801。仰角保持相对恒定，为50度。结论：后交叉韧带在屈曲状态下发生复杂的扭转运动，在后交叉韧带重建过程中，隧道和移植物的放置可能需要再现完整后交叉韧带的多维变形。
Background: Current knowledge of posterior cruciate ligament function is mainly based on in vitro cadaveric studies. There are few studies on the in vivo function of the posterior cruciate ligament. The objective of the study was to quantify the multidimensional deformation of the posterior cruciate ligament.Hypothesis: During in vivo weightbearing flexion, the posterior cruciate ligament undergoes complex 3-dimensional deformations, including elongation, twist, and changes in orientation.Study Design: In vivo biomechanical study.Methods: Magnetic resonance images of 5 human knees were used to create 3-dimensional computer models of each subject's knee, including the insertion areas of the posterior cruciate ligament. Orthogonal fluoroscopic images of each subject's knee were acquired as a quasi-static lunge was performed. The images and computer models were used to reproduce the in vivo motion of the knee. The relative motion of the femoral and tibial insertions was described in terms of elongation, twist, elevation (the angle between the tibial plateau and posterior cruciate ligament, measured in the sagittal plane), and deviation (mediolateral orientation, measured in plane of tibial plateau).Results: The length of the posterior cruciate ligament increased significantly with increasing flexion. It twisted almost 801 as the knee flexed from 0degrees to 90degrees. The elevation angle remained relatively constant at 50degrees. The deviation angle was medially oriented by 20degrees at full extension, then decreased to approximately 10degrees at 30degrees through 90degrees of flexion.Conclusion: The posterior cruciate ligament undergoes a complex twisting motion as it elongates with flexion.Clinical Relevance: During reconstruction, the tunnels and graft may need to be placed such that the multidimensional deformation of the intact posterior cruciate ligament is reproduced.