Engebretsen L, Lew W D, Lewis J L, Hunter R E, Benum P
Department of Orthopedics, Trondheim University Hospital, Norway.
Acta Orthop Scand. 1990 Jun;61(3):225-30. doi: 10.3109/17453679008993505.
A cadaver knee-testing system was used to analyze the effect of an extraarticular reconstruction for anterolateral rotatory instability in which the lateral one third of the patellar tendon with a patellar bone block was transposed to the lateral femoral condyle. Ligament and reconstruction tendon forces were measured using buckle transducers, and joint motion was measured using an instrumented spatial linkage as 90 N anteriorly directed tibial loads were applied to seven knee specimens at 0 degree, 30 degrees, 60 degrees, and 90 degrees of flexion by a pneumatic load apparatus. This was done for each knee with first an intact, then an excised anterior cruciate ligament, and finally the extraarticular reconstruction. Forces in the transposed graft exhibited an isotonic pattern over the flexion range, unlike the intact anterior cruciate ligament, which was more highly loaded in extension than in flexion. The transposition of the patellar tendon led to external rotation of the tibia in both unloaded and anterior load conditions throughout flexion. Collateral ligament forces increased with anterior cruciate ligament excision, with the force in the medial ligament remaining higher than normal with the reconstruction, while the lateral forces became lower than normal.
使用一具尸体膝关节测试系统来分析关节外重建对前外侧旋转不稳定的影响，其中带有髌骨骨块的髌腱外侧三分之一被转移至股骨外侧髁。使用扣式传感器测量韧带和重建肌腱的力，并使用仪器化空间连杆测量关节运动，通过气动加载装置对七个膝关节标本在0度、30度、60度和90度屈曲时施加90 N向前的胫骨负荷。对每个膝关节先在完整状态下进行，然后切除前交叉韧带，最后进行关节外重建。与完整的前交叉韧带不同，转位移植物中的力在屈曲范围内呈现等张模式，完整的前交叉韧带在伸展时比在屈曲时承受更高的负荷。在整个屈曲过程中，髌腱的转位在无负荷和前负荷条件下均导致胫骨外旋。随着前交叉韧带的切除，侧副韧带的力增加，重建时内侧韧带的力仍高于正常，而外侧韧带的力则低于正常。
