In vivo kinematics of the knee during weight bearing high flexion
In vivo kinematics of the knee during weight bearing high flexion
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DOI：
10.1016/j.jbiomech.2013.03.014
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发表时间：
2013-05-31
影响因子：
2.4
通讯作者：
Li, Guoan
中科院分区：
文献类型：
--
作者：
Qi, Wei;Hosseini, Ali;Li, Guoan
实现高屈曲是当代全膝关节置换术的目标，然而，关于负重条件下高屈曲时膝关节生物力学的研究甚少。本研究对膝关节负重屈曲从最大屈曲到最大屈曲的六自由度运动学和胫股软骨接触生物力学进行了研究。共招募了7名健康受试者的8个膝关节，这些受试者没有受伤或慢性疼痛的病史。对膝盖进行核磁共振扫描，以创建胫骨和股骨的3D模型，包括它们的关节软骨表面。然后，受试者在进行从完全伸展到最大屈曲的负重准静态单腿弓步时，使用双透视成像系统进行成像。测量膝关节屈曲路径上的6自由度运动学参数和关节软骨接触位置。结果表明，胫骨内旋角度在低屈角(完全伸展至30°)时急剧增加，在中等屈曲范围内(30~120°)维持较小的变化，然后在高屈角(120°至最大屈角)时又急剧增加。在屈曲120°前，接触点在内侧和外侧椎间的移动相似，但在高屈曲角度时，内侧椎间的接触点移动较小。结果表明，在整个屈曲范围内，膝关节的运动不能用一个特征来描述，尤其是在高屈曲时。膝关节在整个屈曲范围内的运动学数据可用于设计新的膝关节假体，以实现物理上的高屈曲，并改进膝关节损伤后的康复方案。(C)2013爱思唯尔有限公司。保留所有权利。
Achieving high flexion is an objective of contemporary total knee arthoplasty; however little is known on the knee biomechanics at high flexion under weight-bearing conditions. This study investigates the 6DOF kinematics and tibiofemoral cartilage contact biomechanics of the knee during weight-bearing flexion from full extension to maximal flexion. Eight knees from seven healthy subjects with no history of injuries or chronic pain were recruited. The knees were MRI scanned to create 3D models of the tibia and femur, including their articular cartilage surfaces. The subjects were then imaged using a dual fluoroscopic image system while performing a weight-bearing quasi-static single-legged lunge from full extension to maximal flexion. The 6DOF kinematics and the articular cartilage contact locations were measured along the flexion path of the knee. The result indicated that the internal tibial rotation increased sharply at low flexion angles (full extension to 30 degrees), maintained a small variation in the middle range of flexion (30-120 degrees, and then sharply increased again at high flexion angles (120 degrees to maximal flexion). The contact point moved similarly in the medial and lateral compartments before 120 degrees of flexion, but less on the medial compartment at high flexion angles. The results indicated that the knee motion could not be described using one character in the entire range of flexion, especially in high flexion. The knee kinematic data in the entire range of flexion of the knee could be instrumental for designing new knee prostheses to achieve physical high flexion and improving rehabilitation protocols after knee injuries. (C) 2013 Elsevier Ltd. All rights reserved.