Biomechanical consequences of PCL deficiency in the knee under simulated muscle loads - an in vitro experimental study
Biomechanical consequences of PCL deficiency in the knee under simulated muscle loads - an in vitro experimental study
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DOI：
10.1016/s0736-0266(01)00184-x
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发表时间：
2002-07-01
影响因子：
2.8
通讯作者：
Zarins, B
中科院分区：
文献类型：
--
作者：
Li, G;Gill, TJ;Zarins, B
后交叉韧带（PCL）损伤后膝关节慢性退行性变的机制尚不清楚。虽然已经进行了大量的生物力学研究来研究PCL在膝关节前后稳定性方面的功能，但很少有关于其对膝关节旋转稳定性的影响的报道。在这项研究中，8个人体尸体膝关节标本在机器人测试系统中进行了从完全伸展到120度屈曲的测试，并切除了PCL。当膝关节受到各种模拟肌肉负荷时，在股四头肌负荷（400 N）和股四头肌/腘绳肌联合负荷（400 N）下，测量胫骨前后平移和胫骨内外旋转。400/200 N)，胫骨以低屈曲角度（低于60度）向前移动。胫骨前移位后PCL切除无显著性差异。高弯曲角度（超过60度）。在肌肉负荷下，胫骨向后移动并向外旋转。PCL缺乏显著增加胫骨后平移和胫骨外旋转。本研究结果表明，PCL缺失不仅改变了胫骨的平移。因此，仅评价胫骨在前后方向的平移可能不能完全描述PCL缺乏对膝关节功能的影响。此外。进一步假设胫骨外旋转增加导致髌骨-股骨关节接触压力升高。这些数据可能有助于解释PCL损伤后引起膝关节长期退行性改变的生物力学因素。通过充分了解这些变化的病因。有可能开发出一种针对PCL损伤的最佳手术治疗方法，旨在最大限度地减少膝关节的长期关节炎变化。(C) 2002骨科研究学会，Elsevier Science Ltd.出版版权所有。
The mechanism of chronic degeneration of the knee after posterior cruciate ligament (PCL) injury is still not clearly understood. While numerous biomechanical studies have been conducted to investigate the function of the PCL with regard to antero-posterior stability of the knee, little has been reported oil its effect oil the rotational stability of the knee. In this study, eight cadaveric human knee specimens were tested oil a robotic testing system from full extension to 120degrees of flexion with the PCL intact and with the PCL resected. The antero-posterior tibial translation and the internal-external tibial rotation were measured when the knee was subjected to various simulated muscle loads, Under a quadriceps load (400 N) and a combined quadriceps/hamstring load (.400/200 N), the tibia moved anteriorly at low flexion angles (below 60degrees). Resection of the PCL did not significantly after anterior tibial translation. At high flexion angles (beyond 60degrees). the tibia moved posteriorly and rotated externally under the muscle loads. PCL deficiency significantly increased the posterior tibial translation and external tibial rotation. The results Of this Study indicate that PCL deficiency not only changed tibial translation. but also tibial rotation, Therefore, only evaluating the tibial translation in the anteroposterior direction may not completely describe the effect of PCL deficiency on knee joint function. Furthermore. the increased external tibial rotations Were further hypothesized to cause elevated patello-femoral joint contact pressures. These data may help explain the biomechanical factors causing long-term degenerative changes of the knee after PCL injury. By fully understanding the etiology of these changes. it may be possible to develop an optimal Surgical treatment for PCL injury that is aimed Lit minimizing the long-term arthritic changes in the knee joint. (C) 2002 Orthopaedic Research Society, Published by Elsevier Science Ltd. All rights reserved.