Li Guoan, DeFrate Louis E, Park Sang Eun, Gill Thomas J, Rubash Harry E
Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts 02114, USA.
Am J Sports Med. 2005 Jan;33(1):102-7. doi: 10.1177/0363546504265577.
Quantifying the in vivo cartilage contact mechanics of the knee may improve our understanding of the mechanisms of joint degeneration and may therefore improve the surgical repair of the joint after injury.
To measure tibiofemoral articular cartilage contact kinematics during in vivo knee flexion.
Descriptive laboratory study.
Orthogonal fluoroscopic images and magnetic resonance image-based computer models were used to measure the motion of the cartilage contact points during a quasi-static lunge in 5 human subjects.
On the tibial plateau, the contact point moved in both the anteroposterior and the mediolateral directions during knee flexion. On the medial tibial plateau, flexion angle did not have a statistically significant effect on the location of the contact points. The total translation of the contact point from full extension to 90 degrees of flexion was less than 1.5 mm in the anteroposterior direction, whereas the translation in the mediolateral direction was more than 5.0 mm. In the anteroposterior direction, the contact points were centered on the medial tibial plateau. On the lateral tibial plateau, there was a statistically significant difference between the location of the contact point at full extension and the locations of the contact points at other flexion angles in the anteroposterior direction. No significant difference was detected between the location of the contact points at other flexion angles. The overall range of contact point motion was about 9.0 mm in the anteroposterior direction and about 4.0 mm in the mediolateral direction. The contact points were primarily on the inner half of the medial and lateral tibial plateaus (the half closest to the tibial spine). The contact points on both femoral condyles were also on the inner half of the condyles (near the condylar notch).
The tibiofemoral contact points move in 3 dimensions during weightbearing knee flexion. The medial tibiofemoral contact points remained within the central portion of the tibial plateau in the anteroposterior direction. Both the medial and lateral tibiofemoral contact points were located on the inner portions of the tibial plateau and femoral condyles (close to the tibial spine), indicating that the tibial spine may play an important role in knee stability.
The results of this study may provide important insight as to the mechanisms contributing to the development of osteoarthritis after ligament injuries.
量化膝关节的体内软骨接触力学，可能会增进我们对关节退变机制的理解，进而改善损伤后关节的手术修复效果。
测量活体膝关节屈曲过程中胫股关节软骨的接触运动学。
描述性实验室研究。
利用正交荧光透视图像和基于磁共振成像的计算机模型，测量5名受试者在准静态弓步动作中软骨接触点的运动。
在胫骨平台上，膝关节屈曲时接触点在前后方向和内外侧方向均发生移动。在内侧胫骨平台，屈曲角度对接触点位置无统计学显著影响。接触点从完全伸展到屈曲90度在前后方向的总移动距离小于1.5毫米，而在内外侧方向的移动距离超过5.0毫米。在前后方向，接触点集中在内侧胫骨平台。在外侧胫骨平台，完全伸展时接触点位置与其他屈曲角度时接触点位置在前后方向存在统计学显著差异。其他屈曲角度的接触点位置之间未检测到显著差异。接触点运动的总体范围在前后方向约为9.0毫米，在内外侧方向约为4.0毫米。接触点主要位于内侧和外侧胫骨平台的内半部分（最靠近胫骨棘的一半）。两个股骨髁上的接触点也位于髁的内半部分（靠近髁间切迹）。
负重膝关节屈曲时，胫股接触点在三维空间内移动。内侧胫股接触点在前后方向上仍位于胫骨平台的中央部分。内侧和外侧胫股接触点均位于胫骨平台和股骨髁的内侧部分（靠近胫骨棘），表明胫骨棘可能在膝关节稳定性中起重要作用。
本研究结果可能为韧带损伤后骨关节炎发展机制提供重要见解。
