Liu W, Maitland M E
Department of Physical Therapy Education University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, USA.
J Biomech. 2000 Jul;33(7):871-9. doi: 10.1016/s0021-9290(00)00047-6.
The hamstring muscles have been recognized as an important element in compensating for the loss of stability in the ACL-deficient knee, but it is still not clear whether the hamstring muscle force can completely compensate for the loss of ACL, and the consequences of increased hamstring muscle force. A two-dimensional anatomical knee model in the sagittal plane was developed to examine the effect of various levels of hamstring muscle activation on restraining anterior tibial translation in the ACL-deficient knee during level walking. The model included the tibiofemoral and patellofemoral joints, four major ligaments, the medial capsule, and five muscle units surrounding the knee. Simulations were conducted to determine anterior tibial translation and internal joint loading at a single selected position when the knee was under a peak external flexion moment during early stance phase of gait. Incremental hamstring muscle forces were applied to the modeled normal and the ACL-deficient knees. Results of simulations showed that the ACL injury increased the anterior tibial translation by 11.8mm, while 56% of the maximal hamstring muscle force could reduce the anterior translation of the tibia to a normal level during the stance phase of gait. The consequences of increased hamstring muscle force included increased quadriceps muscle force and joint contact force.
腘绳肌被认为是补偿前交叉韧带（ACL）损伤膝关节稳定性丧失的重要因素，但目前尚不清楚腘绳肌力量是否能完全弥补ACL的损失，以及腘绳肌力量增加的后果。建立了矢状面二维膝关节解剖模型，以研究不同程度的腘绳肌激活对ACL损伤膝关节在平步行走时限制胫骨前移的影响。该模型包括胫股关节和髌股关节、四条主要韧带、内侧关节囊以及膝关节周围的五个肌肉单元。通过模拟确定在步态早期支撑阶段膝关节处于最大外部屈曲力矩时，单个选定位置的胫骨前移和关节内部负荷。对模拟的正常膝关节和ACL损伤膝关节施加递增的腘绳肌力量。模拟结果表明，ACL损伤使胫骨前移增加了11.8mm，而在步态支撑阶段，56%的最大腘绳肌力量可将胫骨前移恢复到正常水平。腘绳肌力量增加的后果包括股四头肌力量和关节接触力增加。
