Smeets Kristof, Slane Josh, Scheys Lennart, Forsyth Ramses, Claes Steven, Bellemans Johan
Doctoral School for Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Orthopedic Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
Institute for Orthopaedic Research and Training, University Hospitals Leuven, Campus Pellenberg, Pellenberg, Belgium.
Arthroscopy. 2017 May;33(5):1028-1035.e1. doi: 10.1016/j.arthro.2017.01.038. Epub 2017 Mar 27.
To characterize the tensile and histologic properties of the anterolateral ligament (ALL), inferior glenohumeral ligament (IGHL), and knee capsule.
Standardized samples of the ALL (n = 19), anterolateral knee capsule (n = 15), and IGHL (n = 13) were isolated from fresh-frozen human cadavers for uniaxial tensile testing to failure. An additional 6 samples of the ALL, capsule, and IGHL were procured for histologic analysis and determination of elastin content.
All investigated mechanical properties were significantly greater for both the ALL and IGHL when compared with capsular tissue. In contrast, no significant differences between the ALL and IGHL were found for any property. The elastic modulus of ALL and IGHL samples was 174 ± 92 MPa and 139 ± 60 MPa, respectively, compared with 62 ± 30 MPa for the capsule (P = .001). Ultimate stress was significantly lower (P < .001) for the capsule, at 13.4 ± 7.7 MPa, relative to the ALL and IGHL, at 46.4 ± 20.1 MPa and 38.7 ± 16.3 MPa, respectively. The ultimate strain at failure was 37.8% ± 7.9% for the ALL and 39.5% ± 9.4% for the IGHL; this was significantly greater (P = .041 and P = .02, respectively) for both relative to the capsule, at 32.6% ± 8.4%. The strain energy density was 7.8 ± 3.1 MPa for the ALL, 2.1 ± 1.3 MPa for the capsule, and 7.1 ± 3.1 MPa for the IGHL (P < .001). The ALL and IGHL consisted of collagen bundles aligned in a parallel manner, containing elastin bundles, which was in contrast to the random collagen architecture noted in capsule samples.
The ALL has similar tensile and histologic properties to the IGHL. The tensile properties of the ALL are significantly greater than those observed in the knee capsule. CLINICAL RELEVANCE: The ALL is not just a thickening of capsular tissue and should be considered a distinct ligamentous structure comparable to the IGHL in the shoulder. The tensile behavior of the ALL is similar to the IGHL, and treatment strategies should take this into account.
描述外侧韧带（ALL）、下盂肱韧带（IGHL）和膝关节囊的拉伸及组织学特性。
从新鲜冷冻的人体尸体中分离出标准化的ALL样本（n = 19）、膝关节外侧囊样本（n = 15）和IGHL样本（n = 13），进行单轴拉伸直至破坏测试。另外获取6个ALL、关节囊和IGHL样本用于组织学分析及弹性蛋白含量测定。
与关节囊组织相比，ALL和IGHL的所有研究力学性能均显著更高。相比之下，ALL和IGHL在任何性能方面均未发现显著差异。ALL和IGHL样本的弹性模量分别为174±92MPa和139±60MPa，而关节囊的弹性模量为62±30MPa（P = .001）。关节囊的极限应力显著更低（P < .001），为13.4±7.7MPa，而ALL和IGHL的极限应力分别为46.4±20.1MPa和38.7±16.3MPa。ALL的破坏时极限应变和IGHL的破坏时极限应变分别为37.8%±7.9%和39.5%±9.4%；相对于关节囊的32.6%±8.4%，这两者均显著更高（分别为P = .041和P = .02）。ALL的应变能密度为7.8±3.1MPa，关节囊的应变能密度为2.1±1.3MPa，IGHL的应变能密度为7.1±3.1MPa（P < .001）。ALL和IGHL由平行排列的胶原束组成，包含弹性蛋白束，这与关节囊样本中随机的胶原结构形成对比。
ALL与IGHL具有相似的拉伸和组织学特性。ALL的拉伸性能显著高于膝关节囊。临床意义：ALL不仅仅是关节囊组织的增厚，应被视为与肩部IGHL相当的独特韧带结构。ALL的拉伸行为与IGHL相似，治疗策略应考虑到这一点。
