Butler Adam M, Walsh William R
Orthopaedic and Surgical Research Laboratories, Division of Surgery, University of New South Wales, Prince of Wales Hospital, Randwick, NSW, Australia.
Foot Ankle Int. 2004 Jan;25(1):8-12. doi: 10.1177/107110070402500103.
The aim of this study was to examine the mechanical behavior of human ankle ligaments at low forces. Predominantly, ankle ligaments have been studied under the auspices of ligament injury. While the mechanical properties of a ligament when tested to failure provide a basis for comparisons, the loads and displacement do not reflect normal physiologic loading.
Eight fresh-frozen ankles (mean age 65) were dissected to expose the ligaments surrounding the talocrural joint. Eight ankle ligaments were studied and included: medially-anterior tibiotalar (ATTL), posterior tibiotalar (PTTL), tibiocalcaneal (TCL); laterally-anterior tibiofibular (ATiFL), posterior tibiofibular (PTiFL), anterior talofibular (ATFL), posterior talofibular (PTFL), and calcaneofibular (CFL). Stress relaxation tests were carried out at 30% and 10% strain. The peak load and area under the curve were assessed for all experiments.
Significant differences were found for the average peak loads of the elastic response between 30% and 10% strain for each ligament (p < .05). At 10% strain the relationship between the ligaments on the medial and lateral side revealed a Pearson R value of .991 (p = .087). No significant difference was found between the strain energies of the various ligaments (p > .05). The anterior talofibular ligament was found to possess similar relaxation results to the medial ligaments. The calcaneofibular ligament relaxed up to 10% more compared to the anterior talofibular for the same relaxation period. The mechanical testing was performed in uniaxial tension and did not consider off-axis loading that may occur in vivo during ankle motion.
The stress relaxation experiments revealed all ligaments to relax even when loaded to less than 5 N, reflecting the viscoelastic nature of ligaments. The stress relaxation results show that the anterior talofibular ligament does not relax to the same extent as the other lateral ligaments. Examining the properties of human ankle ligaments at low loads has revealed some new findings.
This study highlights the need to understand the synergistic effects of the ligaments. This is important for reconstruction and arthroplasty procedures.
本研究的目的是检测人体踝关节韧带在低负荷下的力学行为。目前，踝关节韧带的研究主要集中在韧带损伤方面。虽然韧带直至断裂的力学性能为比较提供了依据，但负荷和位移并不能反映正常的生理负荷情况。
解剖8个新鲜冷冻的踝关节（平均年龄65岁），以暴露距小腿关节周围的韧带。研究了8条踝关节韧带，包括：胫距前内侧韧带（ATTL）、胫距后韧带（PTTL）、胫跟韧带（TCL）；胫腓前外侧韧带（ATiFL）、胫腓后韧带（PTiFL）、距腓前韧带（ATFL）、距腓后韧带（PTFL）和跟腓韧带（CFL）。在30%和10%应变下进行应力松弛试验。评估所有实验的峰值负荷和曲线下面积。
各韧带在30%和10%应变下弹性反应的平均峰值负荷存在显著差异（p < 0.05）。在10%应变时，内侧和外侧韧带之间的关系显示皮尔逊相关系数R值为0.991（p = 0.087）。各韧带的应变能之间无显著差异（p > 0.05）。发现距腓前韧带与内侧韧带具有相似的松弛结果。在相同的松弛期内，跟腓韧带的松弛程度比距腓前韧带多10%。力学测试是在单轴拉伸下进行的，未考虑踝关节运动时体内可能出现的非轴向负荷。
应力松弛实验表明，即使负荷小于5 N，所有韧带都会松弛，这反映了韧带的粘弹性本质。应力松弛结果表明，距腓前韧带的松弛程度与其他外侧韧带不同。在低负荷下检测人体踝关节韧带的特性揭示了一些新发现。
本研究强调了理解韧带协同作用的必要性。这对重建和关节置换手术很重要。
