Ishida Tomoya, Yamanaka Masanori, Takeda Naoki, Aoki Yoshimitsu
Graduate School of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan; Dept. of Rehabilitation, Hokushin Orthopedic Hospital, Sapporo, Hokkaido, Japan.
Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
Knee. 2014 Mar;21(2):563-6. doi: 10.1016/j.knee.2012.12.002. Epub 2013 Jan 3.
Dynamic knee valgus contributes to injuries of the anterior cruciate ligament (ACL). However, it is unclear how the knee rotates during dynamic knee valgus. Knee rotation significantly affects ACL strain. To understand knee rotation during dynamic knee valgus should help the clinician evaluate dynamic alignment. The purpose of this study was to determine how the knee rotates during dynamic knee valgus and whether the knee rotation is affected by toe direction (foot rotation).
Sixteen females performed dynamic knee valgus in three toe directions (neutral, toe-out, and toe-in) while maintaining the knee flexion angle at 30°. The knee rotation angle was evaluated using a 7-camera motion analysis system. Knee rotation was compared between the start position and the dynamic knee valgus position, as well as among the three toe directions, using repeated measures ANOVA models.
The knee significantly rotated externally in the dynamic knee valgus position compared with the start position in two toe directions (neutral and toe-out). A similar tendency was observed with the toe-in condition. Toe direction significantly affected the knee rotation angle. For toe-out and toe-in conditions, external and internal shifts of knee rotation compared with neutral were observed.
The knee rotates externally during dynamic knee valgus, and the knee rotation is affected by toe direction.
Because of knee abduction and external rotation, the ACL may impinge on the femoral condyle in the case of dynamic valgus, especially in the toe-out position.
动态膝外翻会导致前交叉韧带（ACL）损伤。然而，目前尚不清楚在动态膝外翻过程中膝关节是如何旋转的。膝关节旋转会显著影响ACL的应变。了解动态膝外翻过程中的膝关节旋转情况有助于临床医生评估动态对线。本研究的目的是确定在动态膝外翻过程中膝关节是如何旋转的，以及膝关节旋转是否受足趾方向（足部旋转）的影响。
16名女性在保持膝关节屈曲角度为30°的情况下，在三个足趾方向（中立、足趾外展和足趾内收）进行动态膝外翻动作。使用7台摄像机的运动分析系统评估膝关节旋转角度。使用重复测量方差分析模型比较起始位置与动态膝外翻位置之间以及三个足趾方向之间的膝关节旋转情况。
与起始位置相比，在两个足趾方向（中立和足趾外展）的动态膝外翻位置，膝关节显著向外旋转。在足趾内收情况下也观察到类似趋势。足趾方向显著影响膝关节旋转角度。与中立位相比，在足趾外展和足趾内收情况下，观察到膝关节旋转的向外和向内偏移。
在动态膝外翻过程中膝关节向外旋转，且膝关节旋转受足趾方向影响。
由于膝关节外展和外旋，在动态外翻情况下，尤其是在足趾外展位置，ACL可能会撞击股骨髁。
