Capsular ligaments provide a passive stabilizing force to protect the hip against edge loading.
Capsular ligaments provide a passive stabilizing force to protect the hip against edge loading.
复制标题
关节囊韧带提供被动稳定力，保护髋关节免受边缘负荷。
DOI：
10.1302/2046-3758.109.bjr-2020-0536.r1
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发表时间：
2021-09
影响因子：
4.6
通讯作者：
Jeffers JRT
中科院分区：
文献类型：
--
作者：
Karunaseelan KJ;Dandridge O;Muirhead-Allwood SK;van Arkel RJ;Jeffers JRT
在天然髋关节中，髋关节囊韧带在髋关节活动范围的极限处收紧，并且可以提供被动稳定力以保护髋关节免受边缘载荷。在这项研究中，我们量化了关节囊韧带在极端活动度（ROM）下产生的稳定力矢量，并检查了它们防止边缘负荷的能力。从9个尸体髋关节获得扭矩-旋转曲线，以确定36个位置的关节囊韧带的旋转约束作用。开发韧带模型以确定所有位置中内侧/外侧髂股、坐骨股和耻骨股韧带的作用线和有效力臂。在5 Nm旋转约束条件下测定功能韧带力和刚度。在每个位置，接合的关节囊韧带对关节反作用力的贡献用于评估关节囊产生的净力矢量。髂股韧带的内侧和外侧臂在伸展和内收结合的位置产生最高的向内力矢量，提供前部稳定性。坐骨股韧带在屈曲内收和内旋时产生最大的向内力，降低了后脱位的风险。在该位置，髋关节反作用力每Nm向内移动0.8°，防止边缘载荷。关节囊韧带有助于保持关节力矢量从髋臼边缘向内，在极端ROM。保存和适当的拉伸这些结构后，任何类型的髋关节手术可能是至关重要的，以尽量减少与关节不稳定的并发症。引用这篇文章：骨关节研究2021;10（9）：594-601。
In the native hip, the hip capsular ligaments tighten at the limits of range of hip motion and may provide a passive stabilizing force to protect the hip against edge loading. In this study we quantified the stabilizing force vectors generated by capsular ligaments at extreme range of motion (ROM), and examined their ability to prevent edge loading. Torque-rotation curves were obtained from nine cadaveric hips to define the rotational restraint contributions of the capsular ligaments in 36 positions. A ligament model was developed to determine the line-of-action and effective moment arms of the medial/lateral iliofemoral, ischiofemoral, and pubofemoral ligaments in all positions. The functioning ligament forces and stiffness were determined at 5 Nm rotational restraint. In each position, the contribution of engaged capsular ligaments to the joint reaction force was used to evaluate the net force vector generated by the capsule. The medial and lateral arms of the iliofemoral ligament generated the highest inbound force vector in positions combining extension and adduction providing anterior stability. The ischiofemoral ligament generated the highest inbound force in flexion with adduction and internal rotation (FADIR), reducing the risk of posterior dislocation. In this position the hip joint reaction force moved 0.8° inbound per Nm of internal capsular restraint, preventing edge loading. The capsular ligaments contribute to keep the joint force vector inbound from the edge of the acetabulum at extreme ROM. Preservation and appropriate tensioning of these structures following any type of hip surgery may be crucial to minimizing complications related to joint instability. Cite this article: Bone Joint Res 2021;10(9):594–601.