THE LUBRICATION OF ANIMAL JOINTS IN RELATION TO SURGICAL RECONSTRUCTION BY ARTHROPLASTY
THE LUBRICATION OF ANIMAL JOINTS IN RELATION TO SURGICAL RECONSTRUCTION BY ARTHROPLASTY
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DOI：
10.1136/ard.19.1.10
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发表时间：
1960-01-01
影响因子：
27.4
通讯作者：
CHARNLEY, J
中科院分区：
文献类型：
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作者：
CHARNLEY, J
将水动力理论应用于动物关节的主要论点是解剖学上的事实，即在关节中，关节表面的曲率在其整个运动弧线中并不完全一致。Walmsley（1917, 1928）观察到，只有在完全伸展的位置，即静止直立的位置，膝关节和髋关节的表面才完全一致，而在用于行走或跑步的弧线中，凸面的半径略小于凹面。这使麦康纳想到了楔形空间的存在，这些空间被滑液的楔形薄膜所占据；流体动力学理论的本质是，由于表面的运动，在楔形润滑剂中产生流体压力，并且这种压力支持负载并使滑动表面在润滑剂垫上分离（图1）。甚至在动物关节实验研究这个问题之前，就有一些理论上的批评，使水动力理论不太可能。首先是关节软骨，它是一层。在关节的滑动表面上很厚，很有弹性，很容易被拇指指甲的压力压痕。成年男性的踝关节的投影表面积小于2平方。在。因此，一个体重12磅的人背着1磅重的重物。肩膀上的负荷会使他的踝关节承受大约每平方150磅的压力。在。毫无疑问，这些弹性表面在整个区域内紧密地相互作用，特别是在承载载荷时。
The principal argument in applying the hydro-dynamic theory to animal joints was the anatomical fact that in joints the curvatures of articulating surfaces are not completely congruous throughout their whole arc of movement. It was observed by Walmsley (1917, 1928) that the surfaces of the knee and hip are exactly congruous only in the position of full extension, which is the position of the motionless erect stance, but that in the arc employed for walking or running the convex surface has a slightly smaller radius than the concave surface. This presented to MacConaill's mind the existence of wedge-shaped spaces, occupied by wedge-shaped films of synovial fluid; it is the essence of the hydrodynamic theory that fluid pressure isgenerated in a wedge of lubricant as a result of the motion of the surfaces and that this pressure supports the load and keeps the sliding surfaces separated on a cushion of lubricant (Fig. 1).Even before examining the problem experimentally in animal joints, there are theoretical criticisms which make the hydrodynamic theory unlikely. Firstly, the articular cartilage, which is present as layer about I in. thick over the sliding surfaces of the joint, is very resilient, being easily indented by pressure of the thumb-nail. An ankle-joint of an adult male has a projected surface area of less than 2 sq. in., so that a man weighing 12 st. carrying a l-cwt. load on his shoulders will expose an ankle-joint to pressuresof about 150 lb. per sq. in. There can be little doubt that these resilient surfaces are intimately applied to each other over the whole area especially when carrying loads.