Zavatsky A B, Wright H J
Department of Engineering Science, University of Oxford, Oxford Orthopaedic Engineering Centre, Nuffield Orthopaedic Centre NHS Trust, Windmill Road, Oxford OX3 7LD, UK.
Clin Biomech (Bristol). 2001 Jan;16(1):47-53. doi: 10.1016/s0268-0033(00)00066-8.
To develop a theoretical model to identify mechanisms by which total and partial tears of the anterior cruciate ligament could occur.
A sagittal-plane knee model was used to investigate anterior cruciate ligament injury due to excessive anterior tibial translation. The ligament was modelled as an ordered array of fibres linking femur and tibia.
Despite years of research, the detailed biomechanics of anterior cruciate ligament injury is not well understood.
A "critical strain criterion" was used to identify the onset and progression of model ligament fibre disruption. The associated forces were also calculated.
At low flexion angles (<20 degrees ), the posterior fibre of the model ligament failed first, and the tear progressed anteriorly through the ligament. At higher flexion angles, the anterior fibre failed first, and the tear progressed posteriorly. Near the flexion angle at which the progression of injury changed direction, all fibres failed at approximately the same anterior tibial translation. At all but very high flexion angles, the force supported by the injured ligament was maximum when initial fibre failure occurred; the force then decreased with increasing anterior tibial translation.
Near (20 degrees ) flexion, all model anterior cruciate ligament fibres fail at approximately the same anterior tibial translation, implying that a partial ligament tear may be impossible in this flexion region. Relevance. This study provides insight into possible mechanisms of initiation and progression of anterior cruciate ligament injury. It suggests that a partial tear of the posterior half of the ligament may be difficult to detect clinically.
建立一个理论模型，以确定前交叉韧带完全和部分撕裂可能发生的机制。
采用矢状面膝关节模型来研究由于胫骨过度向前平移导致的前交叉韧带损伤。韧带被模拟为连接股骨和胫骨的有序纤维阵列。
尽管经过多年研究，前交叉韧带损伤的详细生物力学仍未得到充分理解。
使用“临界应变标准”来确定模型韧带纤维破坏的起始和进展情况。还计算了相关的力。
在低屈曲角度（<20度）时，模型韧带的后纤维首先失效，撕裂从前向后穿过韧带。在较高屈曲角度时，前纤维首先失效，撕裂从后向前进展。在损伤进展方向改变的屈曲角度附近，所有纤维在大约相同的胫骨向前平移时失效。除了非常高的屈曲角度外，在初始纤维失效时，受损韧带所承受的力最大；然后随着胫骨向前平移的增加，力减小。
在接近（20度）屈曲时，所有模型前交叉韧带纤维在大约相同的胫骨向前平移时失效，这意味着在这个屈曲区域可能不可能发生部分韧带撕裂。相关性。本研究深入探讨了前交叉韧带损伤起始和进展的可能机制。它表明韧带后半部分的部分撕裂在临床上可能难以检测到。
