DuMontier T A, Metcalf M H, Simonian P T, Larson R V
Department of Orthopedic Surgery, University of Washington, Seattle, USA.
Am J Knee Surg. 2001 Winter;14(1):9-15.
Tensile failure of a patella after anterior cruciate ligament (ACL) reconstruction with autogenous patellar tendon graft is an uncommon but serious complication. One factor that may affect post-harvest patella strength is the shape of the bony defect. The effect of patella defect shape on ultimate tensile strength and mode of failure of the extensor mechanism has not been studied using physiologic moments. Twelve matched pair knee specimens were randomly distributed within three groups comparing rectangular versus triangular, rectangular versus circular, and circular versus triangular shaped patella defects. Specimens were loaded in tension to failure using physiologic moments. Patella fracture occurred in 21 of 24 specimens. Mean ultimate strength for all patellae with a circular defect was 2540 N (+/-651), rectangular defect was 3267 N (+/-920), and triangular defect was 3009 N (+/-1057). There was no significant difference in mean ultimate tensile strength between defect shapes or between matched pairs within the groups. Mode of failure also was similar in all three groups. No defect shape was found to be superior in this investigation comparing ultimate tensile strength or mode of failure between different shaped patella defects.
采用自体髌腱移植进行前交叉韧带（ACL）重建术后髌骨出现拉伸性断裂是一种罕见但严重的并发症。一个可能影响取腱后髌骨强度的因素是骨缺损的形状。尚未使用生理力矩研究髌骨缺损形状对伸膝装置极限拉伸强度和失效模式的影响。将12对匹配的膝关节标本随机分为三组，比较矩形与三角形、矩形与圆形以及圆形与三角形形状的髌骨缺损。使用生理力矩对标本进行拉伸加载直至失效。24个标本中有21个发生了髌骨骨折。所有圆形缺损髌骨的平均极限强度为2540 N（±651），矩形缺损髌骨为3267 N（±920），三角形缺损髌骨为3009 N（±1057）。缺损形状之间或组内匹配对之间的平均极限拉伸强度没有显著差异。所有三组的失效模式也相似。在这项比较不同形状髌骨缺损的极限拉伸强度或失效模式的研究中，未发现哪种缺损形状更具优势。
