Internal tibial rotation during in vivo, dynamic activity induces greater sliding of tibio-femoral joint contact on the medial compartment
Internal tibial rotation during in vivo, dynamic activity induces greater sliding of tibio-femoral joint contact on the medial compartment
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DOI：
10.1007/s00167-011-1731-6
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发表时间：
2012-07-01
影响因子：
3.8
通讯作者：
Tashman, Scott
中科院分区：
文献类型：
--
作者：
Hoshino, Yuichi;Tashman, Scott
尽管已经对旋转运动学进行了广泛的研究，但是胫股关节的内/外旋转对于保护关节健康的重要性可能不如其对关节接触力学的影响。本研究旨在评估功能活动（跑步）时胫股关节的接触路径，并探讨这些关节运动学指标与传统运动学之间的关系（内旋/外旋）。评估对侧的胫股运动29例ACL重建患者在下坡跑过程中的（未受伤）膝关节，使用动态立体X射线结合三维CT骨骼模型来产生膝关节运动学和动态关节接触路径。通过比较股骨和胫骨接触路径估计关节接触滑动长度。内侧滑动长度（10.2 ± A 3.8 mm）明显大于外侧（2.3 ± A 4.0 mm）。关节间室滑动长度的差异（平均7.8 ± A3.0 mm）与胫骨内旋显著相关（P < 0.01，R（2）= 0.74），膝关节旋转运动学与关节接触路径之间的关系被明确揭示为胫骨内旋越大，内侧间室滑动运动幅度越大。这可能表明跑步时发生了外侧枢轴运动。旋转运动学异常应进行治疗，以恢复内外侧间室之间关节滑动的正常平衡，并预防未来的骨关节炎。预后研究，II级。
Although extensive research has been conducted on rotational kinematics, the internal/external rotation of the tibio-femoral joint is perhaps less important for protecting joint health than its effect on joint contact mechanics. The purpose of this study was to evaluate tibio-femoral joint contact paths during a functional activity (running) and investigate the relationship between these arthrokinematic measures and traditional kinematics (internal/external rotation).Tibio-femoral motion was assessed for the contralateral (uninjured) knees of 29 ACL-reconstructed individuals during downhill running, using dynamic stereo X-ray combined with three-dimensional CT bone models to produce knee kinematics and dynamic joint contact paths. The joint contact sliding length was estimated by comparing femoral and tibial contact paths. The difference in sliding length between compartments was compared to knee rotation.Sliding length was significantly larger on the medial side (10.2 +/- A 3.8 mm) than the lateral side (2.3 +/- A 4.0 mm). The difference in sliding length between compartments (mean 7.8 +/- A 3.0 mm) was significantly correlated with internal tibial rotation (P < 0.01, R (2) = 0.74).The relationship between rotational knee kinematics and joint contact paths was specifically revealed as greater tibial internal rotation was associated with larger magnitude of sliding motion in the medial compartment. This could suggest that lateral pivot movement occurs during running.Rotational kinematics abnormality should be treated for restoring normal balance of joint sliding between medial and lateral compartments and preventing future osteoarthritis.Prognostic studies, Level II.