Sato Koji, Maeda Akira, Takano Yoshio, Matsuse Hiroo, Ida Hirofumi, Shiba Naoto
Kurume University Graduate School of Medicine.
Kurume Med J. 2013;60(1):1-6. doi: 10.2739/kurumemedj.ms62002. Epub 2013 Aug 7.
The anterior cruciate ligament (ACL) plays an important role in controlling knee joint stability, not only by limiting tibial anterior translation but also by controlling knee axial rotation. The aim of ACL reconstruction is to reduce excessive anterior joint laxity, hoping to restore normal tibiofemoral kinematics including knee axial rotation. The purpose of this study was to investigate the relationship between static anterior instability and tibial rotation during several activities in an anterior cruciate ligament reconstructed knee. Seven patients with unilateral ACL injury performed plain walking, running, landing and side step cutting tasks after ACL reconstruction with a mean follow-up of 14 months. The kinematic data for the 4 motions was measured using a motion analysis system and the point cluster technique. The evaluation period was defined to be from the first contact to removal of the tested leg from the ground. Maximum tibial internal rotation during tasks was calculated using the point cluster technique (PCT). Passive anterior tibial translation was measured using a KT-1000 arthrometer. Regression analysis was used to determine the correlation of the maximum internal rotation with the side-to-side difference of static anterior tibial translation measured using a KT-1000 arthrometer. During side step cutting maneuvers, maximum tibial internal rotation significantly showed negative correlation with static anterior tibial translation (p<0.05, r=0.83). The anterior laxity contributed to the normal knee rotation kinematics. The normal anterior tibial translation obtained by ACL reconstruction is thought to be the key factor in successful restoration of normal knee kinematics.
前交叉韧带(ACL)在控制膝关节稳定性方面起着重要作用,不仅通过限制胫骨向前平移,还通过控制膝关节的轴向旋转。ACL重建的目的是减少关节过度的前向松弛,希望恢复包括膝关节轴向旋转在内的正常胫股运动学。本研究的目的是调查ACL重建膝关节在几种活动中静态前向不稳定与胫骨旋转之间的关系。7名单侧ACL损伤患者在ACL重建后进行了平地行走、跑步、落地和侧步切入任务,平均随访14个月。使用运动分析系统和点簇技术测量这4种运动的运动学数据。评估期定义为从首次接触到测试腿离开地面。使用点簇技术(PCT)计算任务期间胫骨最大内旋。使用KT-1000关节测量仪测量胫骨被动前向平移。采用回归分析确定最大内旋与使用KT-1000关节测量仪测量的静态胫骨前向平移的左右差异之间的相关性。在侧步切入动作中,胫骨最大内旋与静态胫骨前向平移显著呈负相关(p<0.05,r=0.83)。前向松弛有助于正常的膝关节旋转运动学。ACL重建获得的正常胫骨前向平移被认为是成功恢复正常膝关节运动学的关键因素。