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[髌腱中三分之一取材对膝关节动力学及髌后压力的影响]

[Effects of harvesting the central third of the patella tendon on the kinetics of the knee joint and the retropatellar pressure].

作者信息

Wilharm A, Dermitas T, Hurschler C, Ostermeier S, Wirth C J, Bohnsack M

机构信息

Klinik für Unfall, Hand- und Wiederherstellungschirurgie, Universitätsklinikum der Friedrich-Schiller Universität Jena.

出版信息

Z Orthop Ihre Grenzgeb. 2006 Jan-Feb;144(1):102-7. doi: 10.1055/s-2006-921416.

Abstract

AIM

This biomechanical study was performed to evaluate the consequences of removing the central part of the patellar tendon on the kinematics and kinetics of the femoro-patellar joint. The tendonectomy was performed in the same manner as is frequently done during anterior cruciate ligament reconstructions. Of particular interest in this study was to identify potential factors of the patellar tendon resection which could result in anterior knee pain.

METHOD

A simulated isokinetic knee extension from 120 degrees of flexion to full extension was performed on nine human knee cadaver specimens. Joint kinematics was evaluated with ultrasound sensors, and retropatellar contact pressure was measured using a thin-film resistive ink pressure measuring system. Data were taken before and after resection of the central third of the patellar tendon.

RESULTS

Harvesting of the central third of the patellar tendon resulted in an elongation of the remaining patellar tendon by less then 0.5 mm. Furthermore, increases in patellar flexion lower than 1 degree were observed. Small changes in retropatellar pressure were also observed.

CONCLUSION

The shortening of the patellar tendon due to tendon removal, as already suggested in several previous studies, is not attributed to the removal of the central portion of the tendon itself, but more likely due to secondary scarring contraction of the tissue. The changes of the patellarkinematics and the retropatellar pressure observed in this study are probably not of any clinical significance.

摘要

目的

本生物力学研究旨在评估切除髌腱中央部分对髌股关节运动学和动力学的影响。腱切除术的操作方式与前交叉韧带重建术中常用的方式相同。本研究特别关注的是确定髌腱切除可能导致前膝痛的潜在因素。

方法

对九个尸体膝关节标本进行了从120度屈曲到完全伸直的模拟等速膝关节伸展。用超声传感器评估关节运动学,并用薄膜电阻油墨压力测量系统测量髌后接触压力。在切除髌腱中央三分之一前后采集数据。

结果

切除髌腱中央三分之一导致剩余髌腱伸长不到0.5毫米。此外,观察到髌骨屈曲增加不到1度。髌后压力也有微小变化。

结论

如先前多项研究中所指出的,由于腱切除导致的髌腱缩短并非归因于腱本身中央部分的切除,而更可能是由于组织的继发性瘢痕收缩。本研究中观察到的髌骨运动学和髌后压力变化可能没有任何临床意义。

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