Markolf Keith L, O'Neill Geoffery, Jackson Steven R, McAllister David R
Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, CHS, Box 956902, Los Angeles, CA 90095-6902.
Am J Sports Med. 2004 Jul-Aug;32(5):1144-9. doi: 10.1177/0363546503262198. Epub 2004 May 18.
Muscle contraction can subject healing knee ligament grafts to high loads.
To directly measure the effects of quadriceps and hamstrings muscle loads on forces in the anterior cruciate ligaments and posterior cruciate ligaments.
Controlled laboratory study.
Thirteen cadaveric knee specimens had load cells installed to record resultant forces in both anterior and posterior cruciate ligaments under 5 loading conditions. Cruciate force measurements were repeated with a 100-N load applied to the quadriceps tendon and again with a combined 50-N biceps load and 50-N semimembranosus-semitendinosus load.
Applied quadriceps loads resulted in mean changes in anterior cruciate ligament and posterior cruciate ligament forces that were less than 20 N for all loading conditions. Hamstrings load significantly increased mean posterior cruciate ligament force between 30 degrees and 105 degrees of flexion with 100 N of applied posterior tibial force.
At the muscle force levels used in this study, the hamstrings were more effective than the quadriceps in altering cruciate force levels, especially near 90 degrees of flexion, where they have an excellent mechanical advantage for controlling anterior-posterior tibial translation.
Isolated hamstrings activity generally had little or no effect on anterior cruciate ligament forces but significantly increased forces in the posterior cruciate ligament beyond approximately 30 degrees of flexion.
肌肉收缩会使正在愈合的膝关节韧带移植物承受高负荷。
直接测量股四头肌和腘绳肌负荷对前交叉韧带和后交叉韧带中力的影响。
对照实验室研究。
对13个尸体膝关节标本安装测力传感器,以记录在5种负荷条件下前交叉韧带和后交叉韧带中的合力。在股四头肌肌腱上施加100 N负荷时重复测量交叉韧带力,然后再在股二头肌施加50 N负荷和半膜肌 - 半腱肌施加50 N负荷的组合情况下重复测量。
在所有负荷条件下,施加的股四头肌负荷导致前交叉韧带和后交叉韧带力的平均变化小于20 N。在施加100 N胫骨后向力时,腘绳肌负荷在30度至105度屈曲之间显著增加了后交叉韧带的平均力。
在本研究使用的肌肉力水平下,腘绳肌在改变交叉韧带力水平方面比股四头肌更有效,尤其是在接近90度屈曲时,此时它们在控制胫骨前后平移方面具有出色的机械优势。
单独的腘绳肌活动通常对前交叉韧带力影响很小或没有影响,但在超过约30度屈曲时会显著增加后交叉韧带中的力。