Kanamori Akihiro, Lee J Mi, Haemmerle Marcus J, Vogrin Tracy M, Harner Christopher D
Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Knee Surg Sports Traumatol Arthrosc. 2003 Sep;11(5):312-7. doi: 10.1007/s00167-003-0379-2. Epub 2003 Aug 21.
The objective of this study was to evaluate the effects of the biceps femoris tenodesis and popliteofibular ligament reconstruction on knee biomechanics. Ten human cadaveric knees were tested in the intact, posterolateral corner (PLC)-deficient, and PLC-reconstructed conditions using a robotic/universal force moment sensor testing system. The knees were subjected to: (1) a 134 N posterior tibial load, and (2) a 10 Nm external tibial torque applied to the tibia at full extension, 30 degrees and 90 degrees of flexion. External tibial rotation of the intact knee ranged from 18.3+/-4.6 degrees at full extension to 27.9+/-4.6 degrees at 30 degrees under the 10 Nm external tibial torque. These values increased after sectioning the PLC by 2.8 degrees -7.5 degrees at 30 degrees and 90 degrees respectively. After the popliteofibular ligament reconstruction, external tibial rotation values were not significantly different from those for the intact knee at any angle tested, while values following the biceps tenodesis were as much as 5.7 degrees greater than the intact knee. Under the 134 N posterior tibial load, there were minimal decreases in posterior tibial translation of up to 0.9 mm with the biceps tenodesis and up to 1.6 mm with the popliteofibular ligament reconstruction compared to the intact knee. The in situ forces in the biceps tenodesis were not significantly different than the intact PLC at full extension or 30 degrees, while the in situ forces in the popliteofibular graft were not significantly different at any flexion angle. Our data suggests that by restoring external tibial rotation the popliteofibular ligament reconstruction more closely reproduces the primary function of the PLC as compared to the biceps tenodesis.
本研究的目的是评估股二头肌肌腱固定术和腘腓韧带重建对膝关节生物力学的影响。使用机器人/通用力力矩传感器测试系统，对10个尸体人膝关节在完整、后外侧角（PLC）缺损和PLC重建状态下进行测试。膝关节承受：（1）134 N的胫骨后向负荷，以及（2）在完全伸展、30度和90度屈曲时施加于胫骨的10 N·m的外部胫骨扭矩。在10 N·m的外部胫骨扭矩下，完整膝关节的胫骨外旋角度范围从完全伸展时的18.3±4.6度到30度时的27.9±4.6度。切断PLC后，这些值在30度和90度时分别增加了2.8度至7.5度。腘腓韧带重建后，在任何测试角度下，胫骨外旋值与完整膝关节相比均无显著差异，而股二头肌肌腱固定术后的值比完整膝关节大5.7度。在134 N的胫骨后向负荷下，与完整膝关节相比，股二头肌肌腱固定术导致胫骨后移最大减少0.9 mm，腘腓韧带重建导致胫骨后移最大减少1.6 mm。在完全伸展或30度时，股二头肌肌腱固定术的原位力与完整PLC无显著差异，而在任何屈曲角度下，腘腓韧带移植物的原位力均无显著差异。我们的数据表明，与股二头肌肌腱固定术相比，通过恢复胫骨外旋，腘腓韧带重建更能紧密再现PLC的主要功能。
