Hintermann B, Nigg B M, Sommer C, Cole G K
Human Performance Laboratory, The University of Calgary, Canada.
Clin Biomech (Bristol). 1994 Nov;9(6):349-55. doi: 10.1016/0268-0033(94)90064-7.
Excessive foot eversion and/or abnormal tibial rotation have been associated with knee injuries. The mechanical coupling of leg and foot, which may be related to the aetiology of knee injuries, is still not well understood. The goal of this study was to determine in vitro, as a function of loading and flexion position of the foot, the movement transfer from calcaneal eversion-inversion to tibial rotation and vice versa occurring in the ankle-joint complex. A lower leg holding and loading device with 6 degrees of freedom was used in the investigation. Fourteen fresh-frozen, foot-leg specimens were tested. The movement transfer from calcaneus to tibia and vice versa differed significantly between the specimens. The transferred movement was not the same for all input modes. Specifically, calcaneal eversion resulted in significant internal tibial rotation; however, internal tibial rotation did not induce any calcaneal eversion. Vertical loading of the tibia and foot flexion position had a major influence on this movement transfer. The amount of calcaneal eversion transferred to internal tibial rotation depends on the individual mechanical coupling at the ankle-joint complex. Therefore excessive pronation, in running for instance, is only critical for high knee loading when coupled with a high movement transfer in the ankle-joint complex. The interindividual differences may also signal difficulties for prosthesis design in total ankle-joint replacement and for the design of shoe orthotics.
足部过度外翻和/或胫骨异常旋转与膝关节损伤有关。腿部和足部的机械耦合可能与膝关节损伤的病因有关，但目前仍未得到充分理解。本研究的目的是在体外确定踝关节复合体中，从跟骨外翻-内翻到胫骨旋转以及反之的运动传递，作为足部加载和屈曲位置的函数。在研究中使用了具有6个自由度的小腿固定和加载装置。测试了14个新鲜冷冻的足-腿标本。标本之间从跟骨到胫骨以及反之的运动传递存在显著差异。对于所有输入模式，传递的运动并不相同。具体而言，跟骨外翻导致胫骨显著内旋；然而，胫骨内旋并未引起任何跟骨外翻。胫骨的垂直加载和足部屈曲位置对这种运动传递有重大影响。传递到胫骨内旋的跟骨外翻量取决于踝关节复合体处的个体机械耦合。因此，例如在跑步时，过度旋前仅在与踝关节复合体中高运动传递相结合时，对于高膝关节负荷才是关键的。个体差异也可能预示着全踝关节置换中的假体设计以及鞋类矫形器设计存在困难。
