固有圆韧带的结构特性。
Structural Properties of the Native Ligamentum Teres.
机构信息
Steadman Philippon Research Institute, Vail, Colorado, USA. ; The Steadman Clinic, Vail, Colorado, USA.
Steadman Philippon Research Institute, Vail, Colorado, USA.
出版信息
Orthop J Sports Med. 2014 Dec 12;2(12):2325967114561962. doi: 10.1177/2325967114561962. eCollection 2014 Dec.
BACKGROUND
A majority of studies investigating the role of the ligamentum teres (LT) have focused primarily on anatomical and histological descriptions. To date, however, the structural properties of the LT have yet to be fully elucidated.
PURPOSE
To investigate the structural properties of the native LT in a human cadaveric model.
STUDY DESIGN
Descriptive laboratory study.
METHODS
A total of 12 human cadaveric hemipelvises (mean age, 53.6 years; range, 34-63 years) were dissected free of all extra-articular soft tissues to isolate the LT and its acetabular and femoral attachments. A dynamic tensile testing machine distracted each femur in line with the fibers of the LT at a displacement-controlled rate of 0.5 mm/s. The anatomic dimensions, structural properties, and modes of failure were recorded.
RESULTS
The LT achieved a mean yield load of 75 N and ultimate failure load of 204 N. The LT had mean lengths of 38.0 and 53.0 mm at its yield and failure points, respectively. The most common (75% of specimens) mechanism of failure was tearing at the fovea capitis. On average, the LT had a linear stiffness of 16 N/mm and elastic modulus of 9.24 MPa. The mean initial length and cross-sectional area were 32 mm and 59 mm(2), respectively.
CONCLUSION
The human LT had a mean ultimate failure load of 204 N. Therefore, the results of this investigation, combined with recent biomechanical and outcomes studies, suggest that special consideration should be given to preserving the structural and corresponding biomechanical integrity of the LT during surgical intervention.
CLINICAL RELEVANCE
The LT may be more important as a static stabilizer of the hip joint than previously recognized. Further studies are recommended to investigate the appropriate indications to perform surgical repair or reconstruction of the LT for preservation of hip stability and function.
背景
大多数研究韧带（LT）的作用主要集中在解剖学和组织学描述上。然而，到目前为止，LT 的结构特性尚未完全阐明。
目的
在人体尸体模型中研究 LT 的结构特性。
研究设计
描述性实验室研究。
方法
共解剖了 12 个人体半骨盆（平均年龄 53.6 岁；范围 34-63 岁），以将 LT 及其髋臼和股骨附着处与所有关节外软组织分离。使用动态拉伸试验机以 0.5mm/s 的位移控制速度沿 LT 纤维对线分离每个股骨。记录解剖尺寸、结构特性和失效模式。
结果
LT 达到了 75N 的屈服载荷和 204N 的极限失效载荷。LT 在屈服点和失效点的平均长度分别为 38.0 和 53.0mm。最常见（75%的标本）的失效机制是在头窝撕裂。LT 的平均线性刚度为 16N/mm，弹性模量为 9.24MPa。平均初始长度和横截面积分别为 32mm 和 59mm(2)。
结论
人类 LT 的极限失效载荷平均为 204N。因此，这项研究的结果，结合最近的生物力学和结果研究，表明在手术干预过程中，应特别注意保留 LT 的结构和相应的生物力学完整性。
临床相关性
LT 作为髋关节的静态稳定器可能比以前认为的更为重要。建议进一步研究，以确定进行 LT 手术修复或重建的适当指征，以保持髋关节的稳定性和功能。
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