Effects of increasing tibial slope on the biomechanics of the knee
Effects of increasing tibial slope on the biomechanics of the knee
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DOI：
10.1177/0363546503258880
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发表时间：
2004-03-01
影响因子：
4.8
通讯作者：
Harner, CD
中科院分区：
文献类型：
--
作者：
Giffin, JR;Vogrin, TM;Harner, CD
目的：为了确定增加前后（A-P）胫骨斜率对膝关节运动学和交叉韧带原位力的影响，使用机器人测试系统研究了10个尸体膝关节，使用三种载荷条件：（1）200 N轴向压缩;（2）134 N A-P胫骨载荷;（3）200 N轴向和134 N A-P载荷相结合。在5 mm前开口楔形截骨术前后测定膝关节运动学结果。确定每个交叉韧带的原位力。结果：胫骨倾斜度从8.8+/-1.8度增加到13.2 +/-2.1度，导致胫骨相对于股骨的静止位置前移3.6 +/- 1.4 mm。在轴向压缩下，截骨术导致胫骨向前平移达1.9 ± 2.5 mm（90 °）。在A-P和组合载荷下，没有发现A-P平移或交叉韧带原位力（完整与截骨）的差异：结果表明，胫骨斜率的小幅增加不影响A-P平移或交叉韧带原位力。然而，增加斜率会导致胫骨静止位置前移，在轴向载荷下会加重。这表明，增加胫骨倾斜度可能有利于减少PCL缺陷膝关节的胫骨下垂，而降低倾斜度可能对ACL缺陷膝关节具有保护作用。
Purpose: To determine the effects of increasing anterior-posterior (A-P) tibial slope on knee kinematics and in situ forces in the cruciate ligaments.Methods: Ten cadaveric knees were studied using a robotic testing system using three loading conditions: (1) 200 N axial compression; (2) 134 N A-P tibial load; and (3) combined 200 N axial and 134 N A-P loads. Resulting knee kinematics were determined before and after a 5-mm anterior opening wedge osteotomy. Resulting in situ forces in each cruciate ligament were determined.Results: Tibial slope was increased from 8.8+/- 1.8degrees to 13.2 +/- 2.1degrees, causing an anterior shift in the resting position of the tibia relative to the femur up to 3.6 +/- 1.4 mm. Under axial compression, the osteotomy caused a significant anterior tibial translation up to 1.9 +/- 2.5 mm (90degrees). Under A-P and combined loads, no differences were detected in A-P translation or in situ forces in the cruciates (intact versus osteotomy).Conclusions: Results suggest that small increases in tibial slope do not affect A-P translations or in situ forces in the cruciate ligaments. However, increasing slope causes an anterior shift in tibial resting position that is accentuated under axial loads. This suggests that increasing tibial slope may be beneficial in reducing tibial sag in a PCL-deficient knee, whereas decreasing slope may be protective in an ACL-deficient knee.