Kinematic and Kinetic Interactions During Normal and ACL-Deficient Gait: A Longitudinal In Vivo Study
Kinematic and Kinetic Interactions During Normal and ACL-Deficient Gait: A Longitudinal In Vivo Study
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DOI：
10.1007/s10439-013-0914-3
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发表时间：
2014-03-01
影响因子：
3.8
通讯作者：
Shrive, Nigel G.
中科院分区：
文献类型：
--
作者：
Atarod, Mohammad;Frank, Cyril B.;Shrive, Nigel G.
研究了正常步态下膝关节内不同组织之间的相互作用以及不同运动自由度与关节屈曲之间的相互作用。这些相互作用在ACL横断后发生变化，短期（4周）和长期（20周）。选取10只骨骼成熟的绵羊作为对照组（N = 5）和试验组（N = 5）。首先在正常步态下测量六自由度膝关节运动。然后对对照组实施安乐死，并将其安装在一个独特的机器人测试平台上进行动力学测量。实验组行ACL横断手术，术后4周和20周重复运动学测量。然后对实验组实施安乐死，并使用机器人系统进行动力学评估。结果表明关节屈曲与外展、胫骨内旋以及胫骨内侧、前侧和上侧平移在正常和acl缺失步态中具有显著的耦合关系。膝关节内不同组织之间也观察到明显的动力学相互作用。正常步态时，ACL与LM/MM、PCL与MCL负荷之间存在直接关系；ACL与PCL、PCL与LM/MM负荷呈负相关。前交叉韧带损伤显著改变了这些动力学相互作用模式。在步态期间，还观察到关节运动学和组织负荷模式的显着主体间变异性。这项研究进一步了解了膝关节内不同组织的体内功能，以及它们在正常步态和前交叉韧带横断后随时间推移与关节运动学的耦合。
The interactions between different tissues within the knee joint and between different kinematic DOF and joint flexion during normal gait were investigated. These interactions change following ACL transection, in both short (4 weeks) and long (20 weeks) term. Ten skeletally mature sheep were used in control (N = 5) and experimental (N = 5) groups. The 6-DOF stifle joint motion was first measured during normal gait. The control group were then euthanized and mounted on a unique robotic testing platform for kinetic measurements. The experimental group underwent ACL transection surgery, and kinematics measurements were repeated 4 and 20 weeks post-operatively. The experimental group were then euthanized and underwent kinetic assessment using the robotic system. Results indicated significant couplings between joint flexion vs. abduction and internal tibial rotation, as well as medial, anterior, and superior tibial translations during both normal and ACL-deficient gait. Distinct kinetic interactions were also observed between different tissues within the knee joint. Direct relationships were found between ACL vs. LM/MM, and PCL vs. MCL loads during normal gait; inverse relationships were detected between ACL vs. PCL and PCL vs. LM/MM loads. These kinetic interaction patterns were considerably altered by ACL injury. Significant inter-subject variability in joint kinematics and tissue loading patterns during gait was also observed. This study provides further understanding of the in vivo function of different tissues within the knee joint and their couplings with joint kinematics during normal gait and over time following ACL transection.