Yamaguchi Satoshi, Gamada Kazuyoshi, Sasho Takahisa, Kato Hideyuki, Sonoda Masaki, Banks Scott A
Department of Mechanical and Aerospace Engineering, University of Florida, 330 MAE-A P.O. Box 116250, Gainesville, FL 32611-6250, USA.
Clin Biomech (Bristol). 2009 Jan;24(1):71-6. doi: 10.1016/j.clinbiomech.2008.08.007. Epub 2008 Nov 5.
Knee kinematics during pivoting activities are not well studied, but might provide insight critical to understanding the pathology of the anterior cruciate ligament deficient knee. The purpose of this study was to compare in vivo kinematics during weight bearing pivot and squat activities in patients with unilateral anterior cruciate ligament deficient knees, and to contrast those kinematics with the uninjured contralateral knees.
Eight unilateral anterior cruciate ligament deficient patients with a mean age of 41 (SD 7) years were enrolled. Anterior cruciate injury was confirmed by positive Lachman test and MRI. Lateral fluoroscopic images of pivot and squat activities were recorded for both anterior cruciate ligament deficient and contralateral knees. Three-dimensional tibiofemoral kinematics and centers of rotation for each knee were determined using 3D-2D model registration techniques.
During pivoting, the tibia of the anterior cruciate ligament deficient knee was significantly more anterior than the contralateral knee during tibial neutral to internal rotation. The pivot activity showed lateral centers of rotation in both anterior cruciate ligament deficient and contralateral knees while squatting showed medial centers of rotation.
This dynamic method might be useful to objectively characterize restoration of dynamic function in knees with various types of anterior cruciate ligament reconstructions. These results also indicate kinematics during squatting type activities cannot be extrapolated to predict knee kinematics during pivoting types of activities.
旋转活动期间的膝关节运动学尚未得到充分研究，但可能为理解前交叉韧带损伤膝关节的病理学提供关键见解。本研究的目的是比较单侧前交叉韧带损伤膝关节患者在负重旋转和下蹲活动期间的体内运动学，并将这些运动学与未受伤的对侧膝关节进行对比。
纳入8名单侧前交叉韧带损伤患者，平均年龄41（标准差7）岁。通过阳性拉赫曼试验和磁共振成像确认前交叉韧带损伤。记录前交叉韧带损伤膝关节和对侧膝关节旋转和下蹲活动的侧位透视图像。使用三维-二维模型配准技术确定每个膝关节的三维胫股运动学和旋转中心。
在旋转过程中，前交叉韧带损伤膝关节的胫骨在胫骨中立位至内旋时明显比对侧膝关节更靠前。旋转活动时，前交叉韧带损伤膝关节和对侧膝关节均显示外侧旋转中心，而下蹲时显示内侧旋转中心。
这种动态方法可能有助于客观地描述各种类型前交叉韧带重建膝关节动态功能的恢复情况。这些结果还表明，下蹲类型活动期间的运动学不能外推以预测旋转类型活动期间的膝关节运动学。
