STATIC AND DYNAMIC LOADING PATTERNS IN KNEE JOINTS WITH DEFORMITIES
STATIC AND DYNAMIC LOADING PATTERNS IN KNEE JOINTS WITH DEFORMITIES
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DOI：
10.2106/00004623-198365020-00016
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发表时间：
1983-01-01
影响因子：
5.3
通讯作者：
HARRINGTON, IJ
中科院分区：
文献类型：
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作者：
HARRINGTON, IJ
通过动态（正常行走）和静态（单腿站立）分析确定关节成角畸形受试者的膝关节负荷。使用测力平台电影摄影技术检查了16名表现出膝关节内翻、外翻或屈曲畸形的受试者。并与3名正常人进行比较。正常人的特征负荷峰有3个，分别对应于腘绳肌、股四头肌和腓肠肌的收缩。膝关节畸形受试者的载荷曲线未显示这些峰值;一般而言，畸形受试者的关节力大小小于正常受试者。不支持膝关节内成角、载荷大小和载荷位置（压力中心）之间存在直接关系的概念。尽管观察到总载荷的增加幅度与所有平面中关节成角的增加有一般趋势，但这种关系无法明确预测。压力的中心被发现在整个步态周期的立场阶段变化，并没有直接关系到关节的角度的大小。例如，对于一些外翻成角的受试者，压力中心位于膝关节内侧。个人显然可以通过采用导致膝关节卸载的补偿机制来修改力传递。关节疼痛、步行速度和畸形等因素被认为有助于关节的卸载。与内翻畸形相比，外翻畸形更容易补偿，因为内翻畸形膝关节的载荷模式（压力中心位置）比外翻畸形膝关节更可预测。
Joint loading at the knee for subjects with angular deformity of the joint was determined by dynamic (normal-walking) and static (1-legged-stance) analysis. Sixteen subjects who exhibited varus, valgus or flexion deformity of the knee were examined using a force-platform cinephotographic technique. Comparisons were made with 3 normal subjects. Normal individuals showed 3 characteristic load-peaks corresponding to hamstrings, quadriceps and gastrocnemius muscle contraction. Loading profiles for subjects with knee deformity did not show these peaks; in general, the magnitude of joint force was less in subjects with deformity than in normal subjects. The concept that there is a direct relationship between angulation, magnitude of load and the location of load within the knee (center of pressure) is not supported. Although a general tendency for increased magnitude of total load was observed with increased angulation of the joint in all planes, the relationship was not clearly predictable. The center of pressure was found to vary throughout the stance phase of the gait cycle and was not directly related to the magnitude of angulation of the joint. For example, the center of pressure was located in the medial part of the knee for some subjects with valgus angulation. Individuals apparently can modify force transmission by adopting compensatory mechanisms that result in unloading of the knee. Factors such as pain in the joint, walking speed and deformity are believed to contribute to unloading of the joint. It is easier to compensate for a valgus than for a varus deformity, since knees with varus deformity showed a more predictable loading pattern (location of the center of pressure) than did knees with valgus deformity.