BIOMECHANICAL ANALYSIS OF HUMAN LIGAMENT GRAFTS USED IN KNEE-LIGAMENT REPAIRS AND RECONSTRUCTIONS
BIOMECHANICAL ANALYSIS OF HUMAN LIGAMENT GRAFTS USED IN KNEE-LIGAMENT REPAIRS AND RECONSTRUCTIONS
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DOI：
10.2106/00004623-198466030-00005
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发表时间：
1984-01-01
影响因子：
5.3
通讯作者：
HEFZY, MS
中科院分区：
文献类型：
--
作者：
NOYES, FR;BUTLER, DL;HEFZY, MS
几乎所有类型的胶原组织都被转移到膝关节内和周围，用于关节内和关节外韧带重建。在排除年龄和dissuse相关影响的情况下，未在年轻成人供体的组织中确定此类移植物的机械性能（特别是强度）。为了提供这一信息，韧带移植组织进行高应变率失效测试，以确定其强度和伸长率性能。将结果与来自类似的成年人供体群体的前交叉韧带的力学性能进行比较。韧带重建中使用的一些移植组织明显较弱，因此在低力下有伸长和失效的风险。利用髌韧带支持带组织的移植物（如某些前交叉韧带重建）和其他利用宽度稍窄的阔筋膜或远端髂胫束的移植物均包括在该风险组中。从髂胫束或阔筋膜移植更宽的骨片当然会成比例地增加极限强度。半腱肌腱和股薄肌腱更强，分别为前交叉韧带初始强度的70%和49%。骨-髌腱-骨移植物（14-15 mm宽，内侧或中央部分）最强，平均强度为前交叉韧带的159-168%。髌骨肌腱-骨单位，基于抓握到抓握运动，被发现比类似抓握的前交叉韧带的刚度大3-4倍，而股薄肌和半腱肌腱准备的值与前交叉韧带的值几乎相同。阔筋膜和髌骨支持带移植组织的刚度远低于前交叉韧带。
Virtually all types of collagenous tissues were transferred in and around the knee joint for intra-articular and extra-articular ligament reconstructions. The mechanical properties (in particular, strength) of such grafts were not determined in tissues from young adult donors, where age and dissuse-related effects were excluded. To provide this information, ligament graft tissues were subjected to high-strain-rate failure tests to determine their strength and elongation properties. The results were compared with the mechanical properties of anterior cruciate ligaments from a similar young-adult donor population. Some graft tissues used in ligament reconstructions are markedly weak and therefore are at risk for elongation and failure at low forces. Grafts utilizing prepatellar retinacular tissues (as in certain anterior-cruciate reconstructions) and others in which a somewhat narrow width of fascia lata or distal iliotibial tract is utilized are included in this at-risk-group. Wider grafts from the iliotibial tract or fascia lata would of course proportionally increase ultimate strength. The semitendinosus and gracilis tendons are stronger, having 70 and 49%, respectively, of the initial strength of anterior cruciate ligaments. The bone-patellar tendon-bone graft (14-15 mm wide, medial or central portion) was the strongest, with a mean strength of 159-168% of that of anterior cruciate ligaments. Patellar tendon-bone units, based on grip-to-grip motions, were found to be 3-4 times stiffer than similarly gripped anterior cruciate ligaments, while gracilis and semitendinosus tendon preparations had values that were nearly identical to those of anterior cruciate ligaments. Fascia lata and patellar retinacular graft tissues showed much lower stiffnesses than did the anterior cruciate ligaments.