Method for setting total graft force and load sharing in augmented ACL grafts.
Method for setting total graft force and load sharing in augmented ACL grafts.
复制标题
设置增强 ACL 移植物中总移植物力和负载分配的方法。
DOI：
10.1002/jor.1100080512
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Kowalczyk,C
中科院分区：
文献类型：
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作者：
Lew,WD;Engebretsen,L;Lewis,JL;Hunter,RE;Kowalczyk,C
本研究的目的是开发一种方法，用于在膝关节前交叉韧带（ACL）重建术中获得可控和可重现的术后即刻力学状态。该方法被称为力设定技术，使用由髌腱中间三分之一与骨块（PT）和韧带增强装置（LAD）组成的复合移植物进行了证明。将总移植物力设置为与膝关节在相同标准化外部载荷下30°屈曲时完整ACL中的力相匹配，同时控制生物和增强组件之间的载荷分配。将总移植物力设置为与每个膝关节的ACL力匹配三次，载荷分配比率设置为以下水平：50% PT-50% LAD、25% PT-75% LAD和75% PT-25% LAD。使用带扣传感器测量ACL、PT、LAD和侧支力量，并使用内固定空间连接测量三维膝关节运动，在0°、30°、60°和90°屈曲时，将90 N前向胫骨载荷施加到8个样本上，其中ACL完整、ACL切除和三种载荷共享重建状态。在30°屈曲时，总移植物力可始终设置在完整ACL力的平均2%范围内，在30°屈曲时，移植物节段之间的载荷分配可设置在所需比值的平均5.1%范围内。当PT承受25%和50%的总移植物力时，除90°外，在其他屈曲角度保持载荷分配，当PT承受75%的移植物力时，保持伸展。当对所有样本和屈曲角度取平均值时，总移植物力比ACL中的力大15%，这在统计学上不显著。
The objective of this study was to develop a method for obtaining a controllable and reproducible immediate postoperative mechanical state in a knee with an anterior cruciate ligament (ACL) reconstruction. This method, called the force‐setting technique, was demonstrated using a composite graft consisting of the middle third of the patellar tendon with bone blocks (PT) and the ligament augmentation device (LAD). The total graft force was set to match the force in the intact ACL at 30° flexion with the knee under the same standardized external load, while at the same time the load sharing between the biologic and augmentation components was controlled. The total graft force was set to match the ACL force three separate times in each knee, with ratios of load sharing set at the following levels: 50% PT‐50% LAD, 25% PT‐75% LAD, and 75% PT‐25% LAD. ACL, PT, LAD, and collateral forces were measured using buckle transducers, and three‐dimensional knee motion was measured using an instrumented spatial linkage as 90 N anteriorly directed tibial loads were applied to eigth specimens at 0°, 30°, 60°, and 90° flexion with an intact ACL, an excised ACL, and the three load‐sharing reconstruction states. The total graft force could be consistently set to within an average of 2% of the intact ACL force at 30° flexion, and load sharing between the graft segments could be set to within an average of 5.1% of the desired ratio at 30°. The load sharing was maintained at the other flexion angles except 90° when the PT was to have carried 25 and 50% of the total graft force, and extension when the PT was to have carried 75% of the graft force. When averaged over all specimens and flexion angles, the total graft force was 15% greater than the force in the ACL, and this was not statistically significant.