Effects of the Ankle Flexion Angle During Anterior Talofibular Ligament Reconstruction on Ankle Kinematics, Laxity, and In Situ Forces of the Reconstructed Graft
Effects of the Ankle Flexion Angle During Anterior Talofibular Ligament Reconstruction on Ankle Kinematics, Laxity, and In Situ Forces of the Reconstructed Graft
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DOI：
10.1177/10711007211069327
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发表时间：
2022-01-13
影响因子：
2.7
通讯作者：
Yamashita, Toshihiko
中科院分区：
文献类型：
--
作者：
Sakakibara, Yuzuru;Teramoto, Atsushi;Yamashita, Toshihiko
背景资料：本研究旨在评价前距腓韧带（ATFL）重建过程中踝关节屈曲角度对踝关节运动学、松弛度和移植物原位力的影响。研究方法：使用6自由度机器人系统对12个尸体踝关节进行评价，以施加被动跖屈和背屈运动以及多方向载荷。设计了一个重复测量实验，使用完整的ATFL，横断ATFL，重建ATFL。在ATFL重建（ATFLR）期间，移植物固定在中立位（ATFLR 0度）、15度跖屈（ATFLR PF 15度）和30度跖屈（ATFLR PF 30度），初始张力恒定为10 N。同时记录三维路径和重建的移植物张力，并利用叠加原理计算ATFL和重建移植物的原位力。结果如下：在ATFLR 0 °和ATFLR PF 15 °时，重建移植物的原位力显著高于完整踝关节。ATFLR PF 30 °产生的踝关节运动学和松弛度与完整踝关节无显著差异。在跖屈30 °时，ATFL上的原位力为19.0 N。在ATFLR 0 °、15 °和30 °跖屈30 °时观察到的原位力分别为41.0、33.7和21.9 N。结论：在跖屈30 °时，用腓骨长肌（PL）肌腱进行ATFL重建，结果踝关节运动学、松弛度和原位力与完整踝关节相似。在跖屈0度和15度固定移植物进行ATFL重建，导致重建移植物上的原位力更高。
Background: This study aimed to evaluate the effects of the ankle flexion angle during anterior talofibular ligament (ATFL) reconstruction on ankle kinematics, laxity, and in situ force of a graft. Methods: Twelve cadaveric ankles were evaluated using a 6-degrees of freedom robotic system to apply passive plantar flexion and dorsiflexion motions and multidirectional loads. A repeated measures experiment was designed using the intact ATFL, transected ATFL, and reconstructed ATFL. During ATFL reconstruction (ATFLR), the graft was fixed at a neutral position (ATFLR 0 degrees), 15 degrees of plantar flexion (ATFLR PF15 degrees), and 30 degrees of plantar flexion (ATFLR PF30 degrees) with a constant initial tension of 10 N. The 3-dimensional path and reconstructed graft tension were simultaneously recorded, and the in situ force of the ATFL and reconstructed grafts were calculated using the principle of superposition. Results: The in situ forces of the reconstructed grafts in ATFLR 0 degrees and ATFLR PF 15 degrees were significantly higher than those of intact ankles. The ankle kinematics and laxity produced by ATFLR PF 30 degrees were not significantly different from those of intact ankles. The in situ force on the ATFL was 19.0 N at 30 degrees of plantar flexion. In situ forces of 41.0, 33.7, and 21.9 N were observed at 30 degrees of plantar flexion in ATFLR 0, 15, and 30 degrees, respectively. Conclusion: ATFL reconstruction with the peroneus longus (PL) tendon was performed with the graft at 30 degrees of plantar flexion resulted in ankle kinematics, laxity, and in situ forces similar to those of intact ankles. ATFL reconstructions performed with the graft fixed at 0 and 15 degrees of the plantar flexion resulted in higher in situ forces on the reconstructed graft.