Interactions between kinematics and loading during walking for the normal and ACL deficient knee
Interactions between kinematics and loading during walking for the normal and ACL deficient knee
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DOI：
10.1016/j.jbiomech.2004.02.010
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发表时间：
2005-02-01
影响因子：
2.4
通讯作者：
Dyrby, CO
中科院分区：
文献类型：
--
作者：
Andriacchi, TP;Dyrby, CO
研究了作用于膝关节的外力与膝关节运动学之间的关系，目的是识别导致前交叉韧带(ACL)缺陷膝关节运动学异常的步行周期的特定阶段。在步行周期的四个选定阶段(脚跟着地、承重、末端伸展和摆动)，将在膝关节产生前后平移(AP)、内外旋转(IE)和屈伸(FE)方向的节间力和力矩分别与胫骨相对于股骨的平移和旋转进行比较。与前交叉韧带丧失相关的运动学改变主要发生在步行周期的摆动阶段的末期，对于前交叉韧带缺乏的膝关节，由于膝关节在脚跟着地之前伸展，胫骨的外旋和前移减少。摆动阶段的运动学变化与胫骨向内旋转的平均位置相对于对侧膝关节的旋转偏移量有关。偏移量在整个步态周期中保持不变。旋转位置的异常偏移量与体重接受过程中屈曲力矩的大小(由股四头肌净力矩平衡)相关。这些结果表明，对行走过程中肌肉放电模式的适应可以补偿与前交叉韧带丧失相关的运动学变化。旋转位置的改变会导致行走过程中胫股接触的变化，这可能会导致报道的半月板和关节软骨在前交叉韧带损伤后的退行性变化。(C)2004爱思唯尔有限公司。保留所有权利。
The relationships between extrinsic forces acting at the knee and knee kinematics were examined with the purpose of identifying specific phases of the walking cycle that could cause abnormal kinematics in the anterior cruciate ligament (ACL) deficient knee. Intersegmental forces and moments in directions that would produce anterior-posterior (AP) translation, internal-external (IE) rotation and flexion-extension (FE) at the knee were compared with the respective translation and rotations of the tibia relative to the femur during four selected phases (heel strike, weight acceptance, terminal extension and swing) of the walking cycle. The kinematic changes associated with loss of the ACL occurred primarily during the terminal portion of swing phase of the walking cycle where, for the ACL deficient knee, the tibia had reduced external rotation and anterior translation as the knee extended prior to heel strike. The kinematic changes during swing phase were associated with a rotational offset relative to the contralateral knee in the average position of the tibia towards internal rotation. The offset was maintained through the entire gait cycle. The abnormal offsets in the rotational position were correlated with the magnitude of the flexion moment (balanced by a net quadriceps moment) during weight acceptance. These results suggest that adaptations to the patterns of muscle firing during walking can compensate for kinematic changes associated with the loss of the ACL. The altered rotational position would cause changes in tibiofemoral contact during walking that could cause the type of degenerative changes reported in the meniscus and the articular cartilage following ACL injury. (C) 2004 Elsevier Ltd. All rights reserved.