Hsieh Y F, Draganich L F
University of Chicago, Department of Surgery, IL 60637, USA.
J Biomech Eng. 1998 Dec;120(6):750-6. doi: 10.1115/1.2834889.
The relationships between the lengths of the ligaments and kinematics of the knee and quadriceps load, for low to physiologic levels of quadriceps loads, have not previously been studied. We investigated the effects of increasing levels of quadriceps force, necessary to balance increasing levels of externally applied flexion moments, on the kinematics of the tibiofemoral joint and on the separation distances between insertions of selected fibers of the major ligaments of the knee in twelve cadavera. Static measurements were made using a six-degree-of-freedom digitizer for flexion angles ranging from 0 to 120 deg in 15 deg increments. Quadriceps generated extension of the knee was performed by applying loads to the quadriceps tendon to equilibrate each of four magnitudes of external flexion moments equivalent to 8.33, 16.67, 25.00, and 33.33 percent of values previously reported for maximum isometric extension moments. The magnitude of quadriceps force increased linearly (p < 0.0001) as external flexion moment increased throughout the entire range of flexion. Anterior translation, internal rotation, and abduction of the tibia increased linearly (p < 0.0001, p < 0.001, p < 0.001) as external flexion moment and, hence, quadriceps load increased. For the fibers studied, the anterior cruciate ligament (p < 0.0076), posterior cruciate ligament (p < 0.0001), and medial collateral ligament (p < 0.0383) lengthened linearly while the lateral collateral ligament (p < 0.0124) shortened linearly as quadriceps load increased. Based on these results for low to physiologic levels of quadriceps loads, it is reasonable to assume that the ligament lengths or knee kinematics expected with higher quadriceps loads can be extrapolated.
对于低至生理水平的股四头肌负荷，韧带长度与膝关节运动学及股四头肌负荷之间的关系此前尚未得到研究。我们在12具尸体上研究了为平衡逐渐增加的外部施加的屈曲力矩而增加的股四头肌力量水平，对胫股关节运动学以及膝关节主要韧带选定纤维插入点之间的分离距离的影响。使用六自由度数字化仪在0至120度的屈曲角度范围内以15度增量进行静态测量。通过向股四头肌腱施加负荷来产生膝关节伸展，以平衡相当于先前报道的最大等长伸展力矩值的8.33%、16.67%、25.00%和33.33%的四个外部屈曲力矩大小。在整个屈曲范围内，随着外部屈曲力矩增加，股四头肌力量大小呈线性增加（p < 0.0001）。随着外部屈曲力矩以及股四头肌负荷增加，胫骨的前向平移、内旋和外展呈线性增加（p < 0.0001、p < 0.001、p < 0.001）。对于所研究的纤维，随着股四头肌负荷增加，前交叉韧带（p < 0.0076）、后交叉韧带（p < 0.0001）和内侧副韧带（p < 0.0383）呈线性延长，而外侧副韧带（p < 0.0124）呈线性缩短。基于这些低至生理水平的股四头肌负荷的结果，可以合理假设，更高股四头肌负荷下预期的韧带长度或膝关节运动学情况可以外推得出。
