Cyr Adam J, Shalhoub Sami S, Fitzwater Fallon G, Ferris Lauren A, Maletsky Lorin P
J Biomech Eng. 2015 Jun;137(6):061006. doi: 10.1115/1.4029980. Epub 2015 Mar 25.
Understanding the contribution of the soft-tissues to total joint constraint (TJC) is important for predicting joint kinematics, developing surgical procedures, and increasing accuracy of computational models. Previous studies on the collateral ligaments have focused on quantifying strain and tension properties under discrete loads or kinematic paths; however, there has been little work to quantify collateral ligament contribution over a broad range of applied loads and range of motion (ROM) in passive constraint. To accomplish this, passive envelopes were collected from nine cadaveric knees instrumented with implantable pressure transducers (IPT) in the collateral ligaments. The contributions from medial and lateral collateral ligaments (LCL) were quantified by the relative contribution of each structure at various flexion angles (0-120 deg) and compound external loads (±10 N m valgus, ±8 N m external, and ±40 N anterior). Average medial collateral ligament (MCL) contributions were highest under external and valgus torques from 60 deg to 120 deg flexion. The MCL showed significant contributions to TJC under external torques throughout the flexion range. Average LCL contributions were highest from 0 deg to 60 deg flexion under external and varus torques, as well as internal torques from 60 deg to 110 deg flexion. Similarly, these regions were found to have statistically significant LCL contributions. Anterior and posterior loads generally reduced collateral contribution to TJC; however, posterior loads further reduced MCL contribution, while anterior loads further reduced LCL contribution. These results provide insight to the functional role of the collaterals over a broad range of passive constraint. Developing a map of collateral ligament contribution to TJC may be used to identify the effects of injury or surgical intervention on soft-tissue, and how collateral ligament contributions to constraint correlate with activities of daily living.
了解软组织对全关节约束（TJC）的贡献对于预测关节运动学、制定外科手术以及提高计算模型的准确性至关重要。先前关于侧副韧带的研究主要集中在量化离散载荷或运动路径下的应变和张力特性；然而，在被动约束中，很少有工作去量化侧副韧带在广泛的施加载荷和运动范围（ROM）内的贡献。为了实现这一点，从九个尸体膝关节收集了被动包络，这些膝关节在侧副韧带中植入了可植入压力传感器（IPT）。通过每个结构在不同屈曲角度（0 - 120°）和复合外部载荷（±10 N m外翻、±8 N m外部和±40 N前部）下的相对贡献来量化内侧和外侧副韧带（LCL）的贡献。在60°至120°屈曲的外部和外翻扭矩下，内侧副韧带（MCL）的平均贡献最高。在整个屈曲范围内，MCL在外部扭矩下对TJC有显著贡献。在外部和内翻扭矩下，以及在60°至110°屈曲的内部扭矩下，LCL的平均贡献在0°至60°屈曲时最高。同样，这些区域被发现有统计学上显著的LCL贡献。前后载荷通常会降低侧副韧带对TJC的贡献；然而，后向载荷进一步降低了MCL的贡献，而前向载荷进一步降低了LCL的贡献。这些结果为侧副韧带在广泛的被动约束中的功能作用提供了见解。绘制侧副韧带对TJC的贡献图可用于识别损伤或手术干预对软组织的影响，以及侧副韧带对约束的贡献与日常生活活动之间的相关性。
