Sherbondy Paul S, Queale William S, McFarland Edward G, Mizuno Yasuyuki, Cosgarea Andrew J
Department of Orthopedics and Rehabilitation, The Milton S. Hershey Medical Center, Hershey, Pa, USA.
J Knee Surg. 2003 Jul;16(3):152-8.
This study evaluated the effect of the gastrocnemius and soleus muscles on dynamic knee stability by studying the effect of passive calf muscle loading on anterior tibial translation in normal and anterior cruciate ligament (ACL) deficient knees. Anterior tibial translation was measured bilaterally in 12 anesthetized patients with unilateral ACL-deficient knees using a KT-1000 arthrometer. An ankle-foot orthosis was used to passively dorsiflex the ankle and generate tension in the calf muscles. As the ankle flexion angle was progressively changed from 30 degrees plantar flexion to 10 degrees dorsiflexion, anterior tibial translation decreased 43% and 37% with manual maximum force in normal and ACL-deficient knees, respectively (P < .0001). These findings suggest that the calf muscles may function as dynamic knee stabilizers. Anterior tibial translation also was measured in four cadaver knees. Significant decreases were seen in anterior tibial translation with progressive ankle dorsiflexion in ACL-intact specimens and after the ACL had been cut (P < .05). This effect persisted when the gastrocnemius muscle was cut, but was lost when the soleus muscle was released. The data suggest that the soleus muscle may play a role in dynamically stabilizing the knee.
本研究通过研究正常膝关节和前交叉韧带(ACL)损伤膝关节中被动小腿肌肉负荷对胫骨前移的影响,评估腓肠肌和比目鱼肌对膝关节动态稳定性的作用。使用KT-1000关节测量仪对12例单侧ACL损伤的麻醉患者双侧测量胫骨前移。使用踝足矫形器被动背屈踝关节并在小腿肌肉中产生张力。当踝关节屈曲角度从跖屈30度逐渐变为背屈10度时,正常膝关节和ACL损伤膝关节在手动最大力作用下胫骨前移分别减少43%和37%(P < .0001)。这些发现表明小腿肌肉可能起到膝关节动态稳定器的作用。还对四个尸体膝关节测量了胫骨前移。在ACL完整的标本以及切断ACL后,随着踝关节逐渐背屈,胫骨前移显著减少(P < .05)。当腓肠肌切断时这种效应仍然存在,但当比目鱼肌松解时这种效应消失。数据表明比目鱼肌可能在膝关节动态稳定中发挥作用。