Ahmed A M, Burke D L, Duncan N A, Chan K H
Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada.
J Orthop Res. 1992 Nov;10(6):854-67. doi: 10.1002/jor.1100100615.
Twenty-two fresh-frozen specimens were used to measure tensions generated in selected bands of the major ligaments of the flexed knee (40-90 degrees) when an axially prerotated tibia is subjected to passive anterior shear and when an anteriorly pretranslated tibia is subjected to passive axial torque. The tensions were measured using the buckle transducer attached to the anteromedial band of the anterior cruciate ligament [ACL (am)], the posterior fibers of the posterior cruciate ligament [PCL (pf)], the long fibers of the medial collateral ligament [MCL (lf)], and in the total lateral collateral ligament [LCL]. The knee specimens were subjected to the combined motions in a 6-df passive loading apparatus. The results indicated that the joint resistance to anterior translation increased markedly with internal prerotation and only marginally with external prerotation. This increase in joint resistance, however, was associated with a decrease in ACL function. It has been inferred that the posterior structures, capsular and meniscal, contribute significantly to joint resistance when the tibia is prerotated in either sense. For internal prerotation, the interference between the medial femoral condyle and the central tibial eminence was found to be an additional mechanism of resistance to anterior translation. Also, it has been found that although the ACL (am) tension increased with internal rotation in the normal case, it decreased with internal rotation in the presence of an anterior pretranslation. It is concluded that ACL response to combined joint motion cannot be ascertained by a simple summation of its responses to individual motions.
使用22个新鲜冷冻标本，测量屈膝（40 - 90度）时，在轴向预旋转的胫骨受到被动前向剪切力以及前向预平移的胫骨受到被动轴向扭矩时，主要韧带选定束带所产生的张力。使用附着在前交叉韧带前内侧束[ACL(am)]、后交叉韧带后纤维[PCL(pf)]、内侧副韧带长纤维[MCL(lf)]以及外侧副韧带全束[LCL]上的带扣式传感器测量张力。在一个六自由度被动加载装置中对膝关节标本施加联合运动。结果表明，关节对前向平移的阻力随着内旋显著增加，而随着外旋仅略有增加。然而，这种关节阻力的增加与前交叉韧带功能的降低有关。据推断，当胫骨向任何一个方向预旋转时，后部结构，即关节囊和半月板，对关节阻力有显著贡献。对于内旋，发现股骨内侧髁与胫骨中央隆起之间的干涉是抵抗前向平移的另一种机制。此外，还发现虽然在正常情况下前交叉韧带(am)张力随着内旋增加，但在存在前向预平移的情况下，它随着内旋而降低。结论是，前交叉韧带对联合关节运动的反应不能通过简单地将其对单个运动的反应相加来确定。
