Knee Medial Compartment Contact Pressure Increases with Release of the Type I Anterior Intermeniscal Ligament
Knee Medial Compartment Contact Pressure Increases with Release of the Type I Anterior Intermeniscal Ligament
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DOI：
10.1177/0363546509331418
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发表时间：
2009-03
期刊：
影响因子：
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通讯作者：
James M. Paci;M. Scuderi;F. Werner;Levi G. Sutton;P. Rosenbaum;John P Cannizzaro
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文献类型：
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作者：
James M. Paci;M. Scuderi;F. Werner;Levi G. Sutton;P. Rosenbaum;John P Cannizzaro
背景：膝关节前半月板间韧带在膝关节镜检查、前交叉韧带重建和胫骨钉插入时存在危险。假设对于I型韧带的膝关节，前半月板间韧带的释放会导致内侧隔室接触压力的改变。研究设计对照实验室研究。方法选择5个新鲜冷冻的I型前半月板间韧带完整的人尸体膝关节，在0°~ 60°屈曲的改良MTS机器上，在2种情况下进行测试：(1)完整和(2)前半月板间韧带锋利切片。使用覆盖内侧隔室的耻骨下接触压力传感器进行测量。在屈曲0°至60°之间以10°增量进行研究后分析，观察峰值接触压力和接触面积的大小。结果前半月板间韧带切开后，膝关节屈曲20°、30°、40°和50°处的峰值压力均有统计学意义上的升高。最大的变化发生在膝关节屈曲40°时，峰值压力增加27.5% （3.68 MPa至4.69 MPa）。接触面积减少，尽管这种差异在统计学上不显著。结论前半月板间韧带松解导致膝关节内侧腔室接触压力峰值升高。临床意义手术中应注意避免损伤该韧带。
Background The anterior intermeniscal ligament of the knee is at risk during knee arthroscopy, anterior cruciate ligament reconstruction, and tibial nail insertion. Hypothesis Release of the anterior intermeniscal ligament, in knees with type I ligaments, will result in altered contact pressures in the medial compartment. Study Design Controlled laboratory study. Methods Five fresh-frozen human cadaveric knees with intact type I anterior intermeniscal ligaments were chosen for testing in a modified MTS machine from 0° to 60° of flexion under 2 conditions: (1) intact and (2) after sharp sectioning of the anterior intermeniscal ligament. Measurements were made using inframeniscal contact pressure sensors covering the medial compartment. Poststudy analysis was done in 10° increments between 0° and 60° of flexion, looking at peak contact pressure and the amount of contact area seeing pressure. Results Sectioning of the anterior intermeniscal ligament caused a statistically significant increase in the peak pressure at 20°, 30°, 40°, and 50° of knee flexion. The largest change occurred at 40° of knee flexion, when the peak pressure increased by 27.5% (3.68 MPa to 4.69 MPa). Contact area decreased, although this difference was not statistically significant. Conclusion Release of the anterior intermeniscal ligament results in increased peak contact pressures in the medial compartment of the knee. Clinical Relevance Care should be taken to avoid sacrifice of this ligament during surgery.