Tapper Janet E, Fukushima Shige, Azuma Hiro, Sutherland Craig, Marchuk Linda, Thornton Gail M, Ronsky Janet L, Zernicke Ron, Shrive Nigel G, Frank Cyril B
Department of Mechanical and Manufacturing Engineering, University of Calgary, c/o Joint Injury and Arthritis Research Group, 3330 Hospital Drive, Calgary, Alberta, Canada.
J Orthop Res. 2008 May;26(5):660-72. doi: 10.1002/jor.20557.
The objective of this study was to use an ovine stifle joint model to assess the impact of combined transection of the anterior cruciate and medial collateral ligaments on three-dimensional (3D) joint motion serially over 20 weeks after transection. In vivo 3D kinematics were measured in the right hind limb of eight sheep while walking on a treadmill (accuracy, 0.4 mm +/- 0.4 mm, 0.4 degrees +/- 0.4 degrees ). Five sheep received surgical ligament transection and three sheep received sham surgery without transection. At 2 weeks after transection, average joint flexion at hoof strike was significantly increased (8.9 degrees +/- 3.0 degrees ), and the tibial position was significantly shifted in the anterior direction relative to the femur during midstance (4.9 mm +/- 0.9 mm). By 20 weeks after transection, joint flexion had normalized, but the tibial position was significantly adducted (0.5 degrees +/- 0.7 degrees ) and shifted in the medial (2.5 mm +/- 1.2 mm), anterior (5.8 mm +/- 1.9 mm), and superior directions (1.6 mm +/- 0.4 mm). At 2 and 20 weeks after surgical intervention, the maximal anterior tibial position was significantly increased during mid-stance in the transected group (4.9 mm +/- 0. 9 mm and 5.8 mm +/- 1.9 mm) compared to the sham operated group (0.2 mm +/- 0.2 mm and -0.1 +/- 0.1 mm). Although the anterior tibial shift was observed in all transected sheep, a high degree of variability existed between sheep, in the initial joint position, the magnitude of the early change, the change over time, and the change at 20 weeks. In this situation statistics must be interpreted carefully, and in future studies, individual changes should be assessed in the context of individual pathological changes in order to investigate potential clinical significance.
本研究的目的是使用绵羊膝关节模型，评估在前交叉韧带和内侧副韧带联合横断后20周内，横断对三维（3D）关节运动的影响。在八只绵羊的右后肢在跑步机上行走时测量其体内3D运动学（精度为0.4毫米±0.4毫米，0.4度±0.4度）。五只绵羊接受手术韧带横断，三只绵羊接受假手术（未横断）。横断后2周，蹄触地时的平均关节屈曲显著增加（8.9度±3.0度），并且在站立中期胫骨位置相对于股骨向前显著移位（4.9毫米±0.9毫米）。到横断后20周，关节屈曲已恢复正常，但胫骨位置显著内收（0.5度±0.7度），并在内侧（2.5毫米±1.2毫米）、前方（5.8毫米±1.9毫米）和上方方向移位（1.6毫米±0.4毫米）。在手术干预后2周和20周，与假手术组（0.2毫米±0.2毫米和-0.1±0.1毫米）相比，横断组在站立中期的最大胫骨前位显著增加（4.9毫米±0.9毫米和5.8毫米±1.9毫米）。尽管在所有横断的绵羊中均观察到胫骨前移，但绵羊之间在初始关节位置、早期变化幅度、随时间的变化以及20周时的变化方面存在高度变异性。在这种情况下，对统计数据的解释必须谨慎，并且在未来的研究中，应结合个体病理变化评估个体变化，以研究潜在的临床意义。
