Sobczak S, Dugailly P-M, Feipel V, Baillon B, Rooze M, Salvia P, Van Sint Jan S
Laboratory of Anatomy, Biomechanics and Organogenesis, Faculté de Médicine, Université Libre de Bruxelles, Bruxelles, Belgium.
Clin Biomech (Bristol). 2013 Feb;28(2):187-92. doi: 10.1016/j.clinbiomech.2012.12.008. Epub 2013 Jan 18.
Lower limb torsion disorders have been considered as a factor inducing gonarthrosis and the three-dimensional effect of the surgical correction is not well reported yet. This paper reports an in vitro study aiming at quantifying the relationships between experimental femoral torsion disorders and moment arms of thigh muscles.
Five unembalmed lower limbs were used and fixed on an experimental jig. Muscles were loaded and 6 Linear Variable Differential Transformers were used to measure tendon excursions. Experimental osteotomies were performed to simulate torsions by steps of 6° up to 18°. Moment arms of the main thigh muscles were estimated by the tendon excursion method during knee flexion.
Moment arms of the tensor of fascia latae, the gracilis and the semitendinosus were significantly influenced by experimental conditions while the rectus femoris, the biceps femoris and the semimembranosus did not show modifications. Medial femoral torsion decreased the moment arm of both the gracilis and the semimembranosus. Opposite changes were observed during lateral femoral torsion. The moment arm of the tensor of fascia latae decreased significantly after 30° of knee flexion for 18° of medial femoral torsion.
Our results showed that medial and lateral femoral torsion disorders induced alterations of the moment arms of the muscles located medially to the knee joint when applied in aligned lower limbs. These results highlight a potential clinical relevance of the effect of femoral torsion alterations on moment arms of muscles of the thigh which may be related, with knee kinematics modifications, to the development of long-term knee disease.
下肢扭转紊乱被认为是诱发膝关节病的一个因素，而手术矫正的三维效果尚未得到充分报道。本文报告一项体外研究，旨在量化实验性股骨扭转紊乱与大腿肌肉力臂之间的关系。
使用5条未防腐处理的下肢并固定在实验夹具上。对肌肉施加负荷，并使用6个线性可变差动变压器测量肌腱偏移。进行实验性截骨术以模拟扭转，每次扭转6°，直至18°。在膝关节屈曲过程中，采用肌腱偏移法估算大腿主要肌肉的力臂。
阔筋膜张肌、股薄肌和半腱肌的力臂受实验条件的显著影响，而股直肌、股二头肌和半膜肌未显示出变化。股骨内旋降低了股薄肌和半膜肌的力臂。股骨外旋时观察到相反的变化。对于18°的股骨内旋，膝关节屈曲30°后，阔筋膜张肌的力臂显著降低。
我们的结果表明，在下肢对齐的情况下，股骨内旋和外旋紊乱会导致膝关节内侧肌肉力臂的改变。这些结果突出了股骨扭转改变对大腿肌肉力臂影响的潜在临床相关性，这可能与膝关节运动学改变有关，进而与长期膝关节疾病的发生发展相关。
