Changes in dynamic medial tibiofemoral contact mechanics and kinematics after injury of the anterior cruciate ligament: a cadaveric model.
Changes in dynamic medial tibiofemoral contact mechanics and kinematics after injury of the anterior cruciate ligament: a cadaveric model.
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DOI：
10.1177/0954411913490387
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Maher SA
中科院分区：
文献类型：
--
作者：
Bedi A;Chen T;Santner TJ;El-Amin S;Kelly NH;Warren RF;Maher SA
在动态日常活动（例如步态）中，前十字韧带撕裂对膝关节运动学和接触力学的影响仍不清楚。本研究的目的是表征模拟步态期间前十字韧带缺陷的膝关节接触力学和运动学。九个人类尸体膝盖上分别安装了一个传感器，能够测量胫骨平台上的动态法向接触应力，安装在负载控制模拟器上，并承受生理、多向、动态负载以模拟步态。使用具有随机膝关节标识符的混合模型，在步态周期中轴向力达到峰值的两个点（步态周期的 14% 和 45%）处构建了前十字韧带横断前后接触应力的置信区间。前交叉韧带横断后运动学和接触力学的变化在膝盖上变化很大。尽管如此，在步态周期的 45% 处，内侧胫骨平台后中央部分的接触应力在统计学上显着增加，其位置对应于慢性前交叉韧带损伤患者中常见的退行性变化的位置。步态周期 45% 的内侧平台其他区域的接触应力的变化部分是由所测试的 9 个膝关节的骨几何形状的变化来解释的。在 14% 步态时，前交叉韧带横断后四个象限中的任何一个的峰值接触应力均无显着变化，并且所有可能的解释变量均未显示出统计显着性。基于骨解剖结构的几何差异，了解前交叉韧带损伤对接触力学的可变影响具有至关重要的临床意义，对于选择最佳重建技术和建议患者了解随后软骨退变的个体风险可能具有无价的价值。
The effects of tears of the anterior cruciate ligament on knee kinematics and contact mechanics during dynamic everyday activities, such as gait, remains unclear. The objective of this study was to characterize anterior cruciate ligament–deficient knee contact mechanics and kinematics during simulated gait. Nine human cadaveric knees were each augmented with a sensor capable of measuring dynamic normal contact stresses on the tibial plateau, mounted on a load-controlled simulator, and subjected to physiological, multidirectional, dynamic loads to mimic gait. Using a mixed model with random knee identifiers, confidence intervals were constructed for contact stress before and after anterior cruciate ligament transection at two points in the gait cycle at which axial force peaked (14% and 45% of the gait cycle). Kinematic and contact mechanics changes after anterior cruciate ligament transection were highly variable across knees. Nonetheless, a statistically significant increase in contact stress in the posterior–central aspect of the medial tibial plateau at 45% of the gait cycle was identified, the location of which corresponds to the location of degenerative changes that are frequently found in patients with chronic anterior cruciate ligament injury. The variability in the contact stress in other regions of the medial plateau at 45% of the gait cycle was partly explained by the variations in osseous geometry across the nine knees tested. At 14% of gait, there was no significant change in peak contact stress after anterior cruciate ligament transection in any of the four quadrants, and none of the possible explanatory variables showed statistical significance. Understanding the variable effect of anterior cruciate ligament injury on contact mechanics based on geometric differences in osseous anatomy is of paramount clinical importance and may be invaluable to select the best reconstruction techniques and counsel patients on their individual risk of subsequent chondral degeneration.
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DOI：
10.1016/0020-1383(90)90130-m
发表时间：
1990-11-01
影响因子：
2.5
作者：
FAIRCLOUGH, JA;GRAHAM, GP;DENT, CM
通讯作者：
DENT, CM
DOI：
10.1097/01.blo.0000197079.26600.09
发表时间：
2006-01-01
影响因子：
4.2
作者：
Andriacchi, Thomas P.;Briant, Paul L.;Koo, Seungbum
通讯作者：
Koo, Seungbum
影响因子：
2.4
作者：
Andriacchi, TP;Dyrby, CO
通讯作者：
Dyrby, CO
影响因子：
--
作者：
Hernandez-Molina, Gabriela;Guermazi, Ali;Felson, David T.
通讯作者：
Felson, David T.
影响因子：
1.8
作者：
Kozanek, Michal;Hosseini, Ali;Li, Guoan
通讯作者：
Li, Guoan