Ferrari Dudley A, Wilson David R, Hayes Wilson C
Department of Orthopedics, Umass Memorial Healthcare, 55 Lake Avenue North, Worcester, MA 01655, USA.
Clin Orthop Relat Res. 2003 Jul(412):225-33. doi: 10.1097/01.blo.0000071752.41516.6e.
The current study was done to determine whether an isolated, partial, or complete injury to the popliteus at the femur increases rotational knee laxity. The other aim was to determine how quadriceps loading affects internal and external rotation. Ten cadaver knee specimens with an intact posterolateral complex were held in a biomechanical testing rig at 0 degrees, 30 degrees, 60 degrees, and 90 degrees flexion. Movement of the tibia relative to the femur was measured while internal and external moments of 3 N-m were applied about the long axis of the tibia. Laxity was assessed for an intact specimen, and with partial and complete detachment of the popliteus femoral insertion. In five of the 10 specimens laxity additionally was assessed with sufficient quadriceps loading to resist 100 N vertical force at the hip. The results showed that partial and total release of the popliteus increased external laxity of the knee by as much as 6.6 degrees (90 degrees flexion) and by as much as 3.5 degrees (90 degrees flexion). Quadriceps loading reduced internal and external knee laxity significantly. Injury of the popliteus at the femoral insertion may be associated with increased rotational laxity of the knee. An increase in quadriceps force may be necessary to control increased external rotation of the tibia.
本研究旨在确定腘肌在股骨处发生孤立性、部分性或完全性损伤是否会增加膝关节的旋转松弛度。另一目的是确定股四头肌负荷如何影响内旋和外旋。将10个后外侧复合体完整的尸体膝关节标本固定在生物力学测试装置中,分别处于0度、30度、60度和90度屈曲位。在绕胫骨长轴施加3 N·m的内力矩和外力矩时,测量胫骨相对于股骨的运动。评估完整标本以及腘肌股骨附着点部分和完全分离时的松弛度。在10个标本中的5个中,还在股四头肌施加足够负荷以抵抗髋部100 N垂直力的情况下评估松弛度。结果表明,腘肌部分和完全松解分别使膝关节外旋松弛度增加多达6.6度(90度屈曲时)和3.5度(90度屈曲时)。股四头肌负荷显著降低了膝关节的内旋和外旋松弛度。腘肌在股骨附着点处损伤可能与膝关节旋转松弛度增加有关。可能需要增加股四头肌力量来控制胫骨外旋增加。