Lujan Trevor J, Dalton Michelle S, Thompson Brent M, Ellis Benjamin J, Weiss Jeffrey A
Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA.
J Biomech Eng. 2007 Jun;129(3):386-92. doi: 10.1115/1.2720915.
The knee joint is partially stabilized by the interaction of multiple ligament structures. This study tested the interdependent functions of the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) by evaluating the effects of ACL deficiency on local MCL strain while simultaneously measuring joint kinematics under specific loading scenarios. A structural testing machine applied anterior translation and valgus rotation (limits 100 N and 10 N m, respectively) to the tibia of ten human cadaveric knees with the ACL intact or severed. A three-dimensional motion analysis system measured joint kinematics and MCL tissue strain in 18 regions of the superficial MCL. ACL deficiency significantly increased MCL strains by 1.8% (p<0.05) during anterior translation, bringing ligament fibers to strain levels characteristic of microtrauma. In contrast, ACL transection had no effect on MCL strains during valgus rotation (increase of only 0.1%). Therefore, isolated valgus rotation in the ACL-deficient knee was nondetrimental to the MCL. The ACL was also found to promote internal tibial rotation during anterior translation, which in turn decreased strains near the femoral insertion of the MCL. These data advance the basic structure-function understanding of the MCL, and may benefit the treatment of ACL injuries by improving the knowledge of ACL function and clarifying motions that are potentially harmful to secondary stabilizers.
膝关节通过多种韧带结构的相互作用而部分稳定。本研究通过评估前交叉韧带（ACL）缺失对内侧副韧带（MCL）局部应变的影响，同时测量特定加载情况下的关节运动学，测试了ACL和MCL的相互依存功能。一台结构试验机对10具ACL完整或切断的人体尸体膝关节的胫骨施加前向平移和外翻旋转（分别限制在100 N和10 N·m）。一个三维运动分析系统测量了浅部MCL的18个区域的关节运动学和MCL组织应变。ACL缺失在前向平移过程中使MCL应变显著增加1.8%（p<0.05），使韧带纤维达到微创伤特征性的应变水平。相比之下，ACL横断在外翻旋转过程中对MCL应变没有影响（仅增加0.1%）。因此，ACL缺失的膝关节单独外翻旋转对MCL无害。还发现ACL在前向平移过程中促进胫骨内旋，这反过来又降低了MCL股骨附着处附近的应变。这些数据推进了对MCL基本结构-功能的理解，并可能通过提高对ACL功能的认识和明确对二级稳定器有潜在危害的运动，对ACL损伤的治疗有益。
