Höher J, Vogrin T M, Woo S L, Carlin G J, Arøen A, Harner C D
Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania 15213, USA.
J Orthop Res. 1999 Sep;17(5):763-8. doi: 10.1002/jor.1100170522.
The objectives of this study were to determine the effects of hamstrings and quadriceps muscle loads on knee kinematics and in situ forces in the posterior cruciate ligament of the knee and to evaluate how the effects of these muscle loads change with knee flexion. Nine human cadaveric knees were studied with a robotic manipulator/universal force-moment sensor testing system. The knees were subjected to an isolated hamstrings load (40 N to both the biceps and the semimembranosus), a combined hamstrings and quadriceps load (the hamstrings load and a 200-N quadriceps load), and an isolated quadriceps load of 200 N. Each load was applied with the knee at full extension and at 30, 60, 90, and 120 degrees of flexion. Without muscle loads, in situ forces in the posterior cruciate ligament were small, ranging from 6+/-5 N at 30 degrees of flexion to 15+/-3 N at 90 degrees. Under an isolated hamstrings load, the in situ force in the posterior cruciate ligament increased significantly throughout all angles of knee flexion, from 13+/-6 N at full extension to 86+/-19 N at 90 degrees. A posterior tibial translation ranging from 1.3+/-0.6 to 2.5+/-0.5 mm was also observed from full extension to 30 degrees of flexion under the hamstrings load. With a combined hamstrings and quadriceps load, tibial translation was 2.2+/-0.7 mm posteriorly at 120 degrees of flexion ut was as high as 4.6+/-1.7 mm anteriorly at 30 degrees. The in situ force in the posterior cruciate ligament decreased significantly under this loading condition compared with under an isolated hamstrings load, ranging from 6+/-7 to 58+/-13 N from 30 to 120 degrees of flexion. With an isolated quadriceps load of 200 N, the in situ forces in the posterior cruciate ligament ranged from 4+/-3 N at 60 degrees of flexion to 34+/-12 N at 120 degrees. Our findings support the notion that, compared with an isolated hamstrings load, combined hamstrings and quadriceps loads significantly reduce the in situ force in the posterior cruciate ligament. These data are in direct contrast to those for the anterior cruciate ligament. Furthermore, we have demonstrated that the effects of muscle loads depend significantly on the angle of knee flexion.
本研究的目的是确定腘绳肌和股四头肌负荷对膝关节运动学以及膝关节后交叉韧带原位力的影响，并评估这些肌肉负荷的影响如何随膝关节屈曲而变化。使用机器人操纵器/通用力-力矩传感器测试系统对九个新鲜人体膝关节进行了研究。对膝关节施加单独的腘绳肌负荷（对股二头肌和半膜肌均施加40 N负荷）、腘绳肌和股四头肌联合负荷（腘绳肌负荷和200 N股四头肌负荷）以及200 N的单独股四头肌负荷。每种负荷均在膝关节完全伸展以及屈曲30°、60°、90°和120°时施加。在无肌肉负荷情况下，后交叉韧带的原位力较小，在屈曲30°时为6±5 N，在屈曲90°时为15±3 N。在单独的腘绳肌负荷下，后交叉韧带的原位力在膝关节所有屈曲角度下均显著增加，从完全伸展时的13±6 N增加到屈曲90°时的86±19 N。在腘绳肌负荷下，从完全伸展到屈曲30°还观察到胫骨后移范围为1.3±0.6至2.5±0.5 mm。在腘绳肌和股四头肌联合负荷下，在屈曲120°时胫骨后移为2.2±0.7 mm，而在屈曲30°时向前高达4.6±1.7 mm。与单独的腘绳肌负荷相比，在此负荷条件下后交叉韧带的原位力显著降低，在屈曲30°至120°范围内为6±7至58±13 N。在200 N的单独股四头肌负荷下，后交叉韧带的原位力在屈曲60°时为4±3 N，在屈曲120°时为34±12 N。我们的研究结果支持以下观点，即与单独的腘绳肌负荷相比，腘绳肌和股四头肌联合负荷可显著降低后交叉韧带的原位力。这些数据与前交叉韧带的数据形成直接对比。此外，我们已经证明肌肉负荷的影响显著取决于膝关节屈曲角度。
