The effect of tibial tuberosity realignment procedures on the patellofemoral pressure distribution.
The effect of tibial tuberosity realignment procedures on the patellofemoral pressure distribution.
复制标题
胫骨结节重新对准手术对髌股压力分布的影响。
DOI：
10.1007/s00167-011-1802-8
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Elias,JohnJ
中科院分区：
文献类型：
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作者：
Saranathan,Archana;Kirkpatrick,MarcusS;Mani,Saandeep;Smith,LauraG;Cosgarea,AndrewJ;Tan,JuaySeng;Elias,JohnJ
PurposeThe study was performed to characterize the impact of tibial tuberosity realizing on the pressure applied to the cartilage on the patella in the intact condition and with lesions on the lateral and medial facets.MethodsTen knees was loaded in vitro through the quadriceps（586 N）and hamstrings（200 N）at 40°，60°，and 80° of flexion while measuring patellofemoral contact pressures with a pressure sensor.胫骨结节位于正常位置外侧5 mm处代表外侧对线不良，位于正常位置内侧5 mm处代表结节内侧化，位于内侧位置前方10 mm处代表结节前内侧化。对软骨完整的膝关节进行测试，在外侧髌骨软骨内创建直径为12 mm的损伤，并用硅胶修复外侧损伤并合并内侧损伤。A重复测量方差分析和事后检验被用来确定显着（P< 0.05）的差异，在最大的外侧和内侧压力之间的结节positions.ResultsObjectiveMedialization和anteromedialization显着降低约15%，在60°和80°的完整的软骨和软骨与外侧病变的最大外侧压力。膝关节内侧化显着增加了最大内侧压力为完整的软骨在80°，但最大内侧压力并没有超过最大外侧压力为任何testingcondition.ConclusionsThe结果表明，内侧胫骨结节10 mm减少了压力施加到外侧髌骨软骨为完整的软骨和软骨与外侧病变，但不超载内侧软骨。
PurposeThe study was performed to characterize the influence of tibial tuberosity realignment on the pressure applied to cartilage on the patella in the intact condition and with lesions on the lateral and medial facets.MethodsTen knees were loaded in vitro through the quadriceps (586 N) and hamstrings (200 N) at 40°, 60°, and 80° of flexion while measuring patellofemoral contact pressures with a pressure sensor. The tibial tuberosity was positioned 5 mm lateral of the normal position to represent lateral malalignment, 5 mm medial of the normal position to represent tuberosity medialization, and 10 mm anterior of the medial position to represent tuberosity anteromedialization. The knees were tested with intact cartilage, with a 12-mm-diameter lesion created within the lateral patellar cartilage, and with the lateral lesion repaired with silicone combined with a medial lesion. A repeated measures ANOVA and post hoc tests were used to identify significant (P< 0.05) differences in the maximum lateral and medial pressure between the tuberosity positions.ResultsTuberosity medialization and anteromedialization significantly decreased the maximum lateral pressure by approximately 15% at 60° and 80° for intact cartilage and cartilage with a lateral lesion. Tuberosity medialization significantly increased the maximum medial pressure for intact cartilage at 80°, but the maximum medial pressure did not exceed the maximum lateral pressure for any testing condition.ConclusionsThe results indicate that medializing the tibial tuberosity by 10 mm reduces the pressure applied to lateral patellar cartilage for intact cartilage and cartilage with lateral lesions, but does not overload medial cartilage.