Nelitz Manfred, Seitz Andreas M, Bauer Jasmin, Reichel Heiko, Ignatius Anita, Dürselen Lutz
Department of Orthopaedic Surgery, Centre of Musculoskeletal Research, University of Ulm, Germany.
Clin Biomech (Bristol). 2013 Mar;28(3):285-90. doi: 10.1016/j.clinbiomech.2013.01.011. Epub 2013 Mar 13.
It was investigated whether the strain of the anterior cruciate ligament and tibial kinematics are affected by increasing posterior tibial slope.
9 human cadaveric knee joints were passively moved between full extension and 120° flexion in a motion and loading simulator under various loading conditions and at 0°, 5°, 10° and 15° posterior tibial slope angles. The anterior cruciate ligament strain and the tibial rotation angle were registered. To assess the influence of posterior tibial slope on the anterior cruciate ligament strain at a fixed flexion angle the anterior cruciate ligament strain was recorded at three different flexion angles of 0°, 30° and 90° while continuously increasing the osteotomy angle from 5° to 15°.
The anterior cruciate ligament strain was either not affected by the posterior tibial slope angle or, in some load cases, was decreased for increasing posterior tibial slope (P<0.05). There was a significant decrease of tibial rotation when the posterior tibial slope was increased to 15° for many of the load cases tested (P<0.05). The mean maximum decrease was from 17.4° (SD 5.7°) to 11.2° (SD 4.7°) observed for flexion-extension motion under 30N axial load in combination with an internal rotation moment.
The hypothesis that increasing posterior tibial slope results in higher anterior cruciate ligament strain was not confirmed. However, knee kinematics were affected in terms of a reduced tibial rotation. From a biomechanical point of view the data do not support the efficacy of sagittal osteotomies as performed to stabilize anterior cruciate ligament deficient knees.
研究了后胫骨坡度增加是否会影响前交叉韧带的应变和胫骨运动学。
在运动和加载模拟器中，在各种加载条件下，以及在0°、5°、10°和15°的后胫骨坡度角下，对9个尸体膝关节在完全伸展和120°屈曲之间进行被动移动。记录前交叉韧带应变和胫骨旋转角度。为了评估在固定屈曲角度下后胫骨坡度对前交叉韧带应变的影响，在0°、30°和90°三个不同的屈曲角度下记录前交叉韧带应变，同时将截骨角度从5°连续增加到15°。
后胫骨坡度角对前交叉韧带应变要么没有影响，要么在某些加载情况下，后胫骨坡度增加时前交叉韧带应变降低（P<0.05）。在许多测试的加载情况下，当后胫骨坡度增加到15°时，胫骨旋转显著降低（P<0.05）。在30N轴向载荷与内旋力矩相结合的屈伸运动中，平均最大降幅从17.4°（标准差5.7°）降至11.2°（标准差4.7°）。
后胫骨坡度增加会导致更高的前交叉韧带应变这一假设未得到证实。然而，膝关节运动学在胫骨旋转减少方面受到了影响。从生物力学角度来看，这些数据不支持为稳定前交叉韧带损伤膝关节而进行的矢状面截骨术的有效性。
