Three-dimensional joint kinematics of ACL-deficient and ACL-reconstructed knees during stair ascent and descent
Three-dimensional joint kinematics of ACL-deficient and ACL-reconstructed knees during stair ascent and descent
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DOI：
10.1016/j.humov.2011.04.009
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发表时间：
2012-02-01
影响因子：
2.1
通讯作者：
Zheng, Naiquan (Nigel)
中科院分区：
文献类型：
--
作者：
Gao, Bo;Cordova, Mitchell L.;Zheng, Naiquan (Nigel)
前交叉韧带（ACL）损伤后，在日常生活活动中，在周期性负荷下，关节运动学的改变会引起膝关节的机械环境变化。这被认为是ACL损伤后甚至重建手术后进行性软骨退化和骨关节炎早期发作的风险因素。本研究的目的是检查ACL缺陷和ACL重建的膝关节在上楼梯和下楼梯时的三维关节运动学。3D光学视频运动捕捉系统用于记录对象上下定制楼梯时位于对象上的反射标记的坐标数据。计算时空步态和膝关节运动学变量并进一步分析。与ACL完整对照组相比，ACL缺陷膝关节表现出显著的伸展缺陷。在上楼梯和下楼梯过程中，ACL缺陷膝关节也发现了更多的内翻和内旋胫骨位置。ACL重建的膝关节在时空步态参数和关节运动学方面表现出较少的异常，但这些变量并没有完全恢复到正常水平。与ACL完好膝关节相比，ACL重建膝关节的运动学特征与ACL缺陷膝关节的运动学特征更相似。这表明ACL重建的膝关节在重建手术过程中是“矫正不足”而不是“过度矫正”。本研究的结果可能为改善ACL重建手术技术提供更多见解，这可能有助于ACL重建膝关节中软骨退变的早期进展。(C)2011 Elsevier B.V.保留所有权利。
Mechanical environmental changes in the knee are induced by altered joint kinematics under cyclic loading during activities of daily living after anterior cruciate ligament (ACL) injury. This is considered a risk factor in progressive cartilage degeneration and the early onset of osteoarthritis following ACL injury and even after reconstructive surgery. The purpose of this study was to examine 3D joint kinematics of ACL-deficient and ACL-reconstructed knees to health controls during stair ascent and descent. A 3D optical video motion capture system was used to record coordinate data from reflective markers positioned on subjects as they ascended and descended a custom-built staircase. Spatiotemporal gait and knee joint kinematic variables were calculated and further analyzed. The ACL-deficient knees exhibited a significant extension deficit compared to the ACL-intact controls. A more varus and internally rotated tibial position was also identified in the ACL-deficient knees during both stair ascent and descent. The ACL-reconstructed knees exhibited less abnormality in both spatiotemporal gait parameters and joint kinematics, but these variables were not fully restored to a normal level. The kinematic profiles of the ACL-reconstructed knees were more similar to those of the ACL-deficient knees when compared to the ACL-intact knees. This suggests that the ACL-reconstructed knees had been "under-corrected" rather than "over-corrected" by the reconstructive surgery procedure. Findings from this study may provide more insight with respect to improving ACL reconstruction surgical techniques, which may aid the early progression of cartilage degeneration in ACL-reconstructed knees. (C) 2011 Elsevier B.V. All rights reserved.