Hosseini Ali, Qi Wei, Tsai Tsung-Yuan, Liu Yujie, Rubash Harry, Li Guoan
Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA, 02114, USA.
Department of Orthopaedic Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Knee Surg Sports Traumatol Arthrosc. 2015 Oct;23(10):3055-61. doi: 10.1007/s00167-014-3306-9. Epub 2014 Sep 20.
The knowledge of the function of the collateral ligaments-i.e., superficial medial collateral ligament (sMCL), deep medial collateral ligament (dMCL) and lateral collateral ligament (LCL)-in the entire range of knee flexion is important for soft tissue balance during total knee arthroplasty (TKA). The objective of this study was to investigate the length changes of different portions (anterior, middle and posterior) of the sMCL, dMCL and LCL during in vivo weightbearing flexion from full extension to maximal knee flexion.
Using a dual fluoroscopic imaging system, eight healthy knees were imaged while performing a lunge from full extension to maximal flexion. The length changes of each portion of the collateral ligaments were measured along the flexion path of the knee.
All anterior portions of the collateral ligaments were shown to have increasing length with flexion except that of the sMCL, which showed a reduction in length at high flexion. The middle portions showed minimal change in lengths except that of the sMCL, which showed a consistent reduction in length with flexion. All posterior portions showed reduction in lengths with flexion.
These data indicated that every portion of the ligaments may play important roles in knee stability at different knee flexion range. The soft tissue releasing during TKA may need to consider the function of the ligament portions along the entire flexion path including maximum flexion.
III.
了解在膝关节全范围屈曲过程中，侧副韧带——即浅层内侧副韧带（sMCL）、深层内侧副韧带（dMCL）和外侧副韧带（LCL）——的功能，对于全膝关节置换术（TKA）中的软组织平衡至关重要。本研究的目的是调查在体内负重情况下，从完全伸展到最大膝关节屈曲过程中，sMCL、dMCL和LCL不同部分（前部、中部和后部）的长度变化。
使用双荧光透视成像系统，对8个健康膝关节在从完全伸展到最大屈曲的弓步动作过程中进行成像。沿着膝关节的屈曲路径测量侧副韧带各部分的长度变化。
除sMCL外，所有侧副韧带的前部长度均随屈曲增加，而sMCL在高屈曲时长度减小。中部长度变化最小，除sMCL外，其长度随屈曲持续减小。所有后部长度均随屈曲减小。
这些数据表明，韧带的每个部分在不同膝关节屈曲范围内对膝关节稳定性可能都起着重要作用。TKA期间的软组织松解可能需要考虑包括最大屈曲在内的整个屈曲路径上韧带各部分的功能。
III级。
