Quantifying the Motion of Kager's Fat Pad
Quantifying the Motion of Kager's Fat Pad
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DOI：
10.1002/jor.20900
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发表时间：
2009-11-01
影响因子：
2.8
通讯作者：
Nokes, Len
中科院分区：
文献类型：
--
作者：
Ghazzawi, Ahmad;Theobald, Peter;Nokes, Len
卡格脂肪垫位于跟腱、跟骨上皮层以及拇长屈肌 (FHL) 肌肉和肌腱之间的卡格三角区。其生物力学功能尚未确定，但最近的研究表明它发挥着重要的生物力学作用，因为它内衬有滑膜，并且在踝关节跖屈期间可以观察到其跟骨后突出的楔形物移动到法氏囊空间中。这些特征促使人们提出这样的假设：突出的楔形物有助于润滑跟腱腱下区域，分散跟腱附着处的应力，并清除跟骨后囊内的碎片。本研究利用动态超声成像和表面肌电图检查了 FHL 活动和跟腱负荷对突出楔块滑动距离的影响。志愿者间的结果显示滑动距离与 FHL 活动无关。这项研究表明，在比较加载与未加载的跟腱时，突出的楔形物平均会进一步滑入跟骨后囊 60%，始终到达远端肢体。滑动距离取决于跟腱插入角度的变化。我们的结果支持了突出楔形物的许多假设的生物力学功能，包括： 腱下区域的润滑；减少跟腱附着器官内的压力变化；并清除跟骨后囊内的碎片。 (C) 2009 年骨科研究学会。由 Wiley periodicals, Inc. 出版。J Orthop Res 27:1457-1460, 2009
Kager's fat pad is located in Kager's triangle between the Achilles tendon, the superior cortex of the calcaneus, and flexor hallucis longus (FHL) muscle and tendon. Its biomechanical functions are not yet established, but recent studies suggest it performs important biomechanical roles as it is lined by a synovial membrane and its retrocalcaneal protruding wedge can be observed moving into the bursal space during ankle plantarflexion. Such features have prompted hypotheses that the protruding wedge assists in the lubrication of the Achilles tendon subtendinous area, distributes stress at the Achilles enthesis, and removes debris from within the retrocalcaneal bursa. This study examined the influence of FHL activity and Achilles tendon load on the protruding wedge sliding distance, using both dynamic ultrasound imaging and surface electromyogram. Intervolunteer results showed sliding distance was independent of FHL activity. This study has shown the protruding wedge to slide on average 60% further into the retrocalcaneal bursa when comparing the Achilles tendon loaded versus unloaded, consistently reaching the distal extremity. Sliding distance was dependant on a change in the Achilles tendon insertion angle. Our results support a number of hypothesized biomechanical functions of the protruding wedge including: lubrication of the subtendinous region; reduction of pressure change within the Achilles tendon enthesis organ; and removal of debris from within the retrocalcaneal bursa. (C) 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:1457-1460, 2009