von Eisenhart-Rothe R, Witte H, Steinlechner M, Müller-Gerbl M, Putz R, Eckstein F
Ludwig-Maximilians-Universität München.
Unfallchirurg. 1999 Aug;102(8):625-31. doi: 10.1007/s001130050458.
The objective of this investigation was the experimental determination of the contact pressures in the hip joint for characteristic phases of the gait cycle. The joint forces determined in vivo with telemetric endoprosthesis by Bergmann et al. (1993) were converted into a pelvic reference system, based on kinematic gait analysis. In eight cadaveric hip joints (age 18-75 yrs.) the reaction forces were applied corresponding to four phases of the gait cycle (heel strike, mid-stance, heel off, toe off) and the pressure distribution determined with FUJI pressure sensitive film. We found maxima of 10 MPa during mid stance. The areas of highest pressure were located in the ventro-superior aspect of the acetabulum (anterior part of the acetabular roof) and in the dorso-inferior aspect of the lunate surface. The pressure distribution was relatively constant during the four phases and the maxima did not vary proportional to the applied load. The normal pressure distribution in the hip appears to be determined by the physiological incongruity of the articular surfaces and the inhomogeneous bony support of the acetabulum. During operative interventions this normal load transfer should be restored as accurately as possible.
本研究的目的是通过实验测定步态周期特征阶段髋关节的接触压力。基于运动步态分析，将Bergmann等人（1993年）使用遥测假体在体内测定的关节力转换为骨盆参考系。在八个尸体髋关节（年龄18 - 75岁）中，对应步态周期的四个阶段（足跟触地、站立中期、足跟离地、足趾离地）施加反作用力，并使用富士压力敏感膜测定压力分布。我们发现在站立中期压力最大值为10兆帕。压力最高的区域位于髋臼的腹侧上缘（髋臼顶的前部）和半月面的背侧下缘。在这四个阶段中压力分布相对恒定，且最大值与所施加的载荷不成比例变化。髋关节的正常压力分布似乎由关节面的生理不一致性和髋臼不均匀的骨质支撑所决定。在手术干预期间，应尽可能准确地恢复这种正常的载荷传递。
