Shoifi Abubakar Muhammad, Nakamura Shinichiro, Kuriyama Shinichi, Ito Hiromu, Ishikawa Masahiro, Furu Moritoshi, Tanaka Yoshihisa, Matsuda Shuichi
Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.
J Knee Surg. 2016 Nov;29(8):684-689. doi: 10.1055/s-0036-1571803. Epub 2016 Feb 23.
The posterior cruciate ligament (PCL) has an important role in cruciate-retaining total knee arthroplasty to achieve good clinical results. The purpose of the study was to examine the influence of PCL tension on knee kinematics and kinetics and to propose an indicator for proper PCL tension during surgery. A squatting activity was simulated in a weight-bearing deep knee bend using a musculoskeletal computer simulation knee model. The length of the PCL was changed to represent different PCL tension models. The amount of PCL tension significantly influenced knee kinematics and kinetics. In the normal PCL model, the facet center positions at 90 degrees of knee flexion were positioned at almost the same position as in full extension. A loose PCL-induced paradoxical anterior movement and greater patellofemoral forces, whereas a tight PCL was related to excessive rollback and increased tibiofemoral forces. This study suggested ideal knee kinematics with proper PCL tension, in which the medial contact position at full flexion was almost similar to the position at 90 degrees of knee flexion.
后交叉韧带（PCL）在保留交叉韧带的全膝关节置换术中对于取得良好临床效果起着重要作用。本研究的目的是研究PCL张力对膝关节运动学和动力学的影响，并提出手术中合适PCL张力的指标。使用肌肉骨骼计算机模拟膝关节模型在负重深屈膝中模拟蹲坐活动。改变PCL的长度以代表不同的PCL张力模型。PCL张力的大小显著影响膝关节运动学和动力学。在正常PCL模型中，膝关节屈曲90度时小关节中心位置与完全伸展时几乎处于同一位置。PCL松弛会导致矛盾的向前运动和更大的髌股关节力，而PCL紧张则与过度后移和胫股关节力增加有关。本研究提出了具有合适PCL张力的理想膝关节运动学，其中完全屈曲时的内侧接触位置与膝关节屈曲90度时的位置几乎相似。
