Smeets Kristof, Slane Joshua, Scheys Lennart, Claes Steven, Bellemans Johan
Doctoral School for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Orthopedic Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
Institute for Orthopaedic Research and Training, Division of Orthopaedics, University Hospitals Leuven/Department of Development and Regenartion, Faculty of Medicine, KULeuven, Leuven, Belgium.
Knee. 2017 Oct;24(5):949-956. doi: 10.1016/j.knee.2017.07.013. Epub 2017 Aug 5.
The aim of this study was to provide a characterization of the tensile properties of the medial collateral ligament (MCL), lateral collateral ligament (LCL), anterolateral ligament (ALL) and medial patellofemoral ligament (MPFL). Our hypothesis was that extra-articular knee ligaments are heterogeneous in nature and possess distinct material properties.
MCL (n=12), LCL (n=11), MPFL (n=12) and ALL (n=19) samples from fresh frozen human cadaveric knees were subjected to uniaxial tensile testing to failure and analyzed for their material properties. The elastic modulus (slope of the linear portion of the stress/strain curve), ultimate stress (stress at failure), ultimate strain (strain at failure) and strain energy density (area under the stress/strain curve) were calculated.
The MCL had the highest elastic modulus (441.8±117.2MPa) and was significantly greater than the MPFL (294.6±190.4MPa) and LCL (289.0±159.7MPa) (P<0.05) as well as the ALL (173.7±91.8MPa) (P<0.001). The ultimate stress was significantly higher (P<0.05) for the LCL (83.6±38.1MPa) and MCL (72.4±20.7MPa), relative to the MPFL (49.1±31.0MPa) and ALL (46.4±20.1MPa). The ultimate strain of the LCL (41.0±9.9%) and ALL (37.8±7.9%) were significantly higher (P<0.05) compared to the MCL (22.9±2.5%) and MPFL (22.2±5.6%). The strain energy density of the LCL (15.2±6.4MPa) was significantly greater (P<0.05) than all other ligaments (ALL 7.8±3.1MPa, MCL 7.5±2.9MPa and MPFL 5.0±2.9MPa).
Extra-articular knee ligaments are a heterogeneous group with respect to material characteristics. Each ligament has tensile properties that are significantly different from others and treatment strategies should take these findings into account.
本研究的目的是对内侧副韧带（MCL）、外侧副韧带（LCL）、前外侧韧带（ALL）和内侧髌股韧带（MPFL）的拉伸特性进行表征。我们的假设是，膝关节的关节外韧带本质上是异质的，具有不同的材料特性。
对来自新鲜冷冻人体尸体膝关节的MCL（n = 12）、LCL（n = 11）、MPFL（n = 12）和ALL（n = 19）样本进行单轴拉伸试验直至失效，并分析其材料特性。计算弹性模量（应力/应变曲线线性部分的斜率）、极限应力（失效时的应力）、极限应变（失效时的应变）和应变能密度（应力/应变曲线下的面积）。
MCL具有最高的弹性模量（441.8±117.2MPa），显著大于MPFL（294.6±190.4MPa）、LCL（289.0±159.7MPa）（P<0.05）以及ALL（173.7±91.8MPa）（P<0.001）。LCL（83.6±38.1MPa）和MCL（72.4±20.7MPa）的极限应力相对于MPFL（49.1±31.0MPa）和ALL（46.4±20.1MPa）显著更高（P<0.05）。LCL（41.0±9.9%）和ALL（37.8±7.9%）的极限应变与MCL（22.9±2.5%）和MPFL（22.2±5.6%）相比显著更高（P<0.05）。LCL的应变能密度（15.2±6.4MPa）显著大于所有其他韧带（ALL 7.8±3.1MPa、MCL 7.5±2.9MPa和MPFL 5.0±2.9MPa）（P<0.05）。
膝关节的关节外韧带在材料特性方面是一个异质群体。每条韧带都有与其他韧带显著不同的拉伸特性，治疗策略应考虑这些发现。
