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卸载式膝关节支具对内侧半月板应变的影响。

The effect of unloader knee braces on medial meniscal strain.

作者信息

Kalra Mayank, Bakker Ryan, Tomescu Sebastian S, Polak Anna M, Nicholls Micah, Chandrashekar Naveen

机构信息

1 University of Waterloo, Waterloo, ON, Canada.

2 University of Toronto Scarborough, Toronto, ON, Canada.

出版信息

Prosthet Orthot Int. 2019 Apr;43(2):132-139. doi: 10.1177/0309364618798173. Epub 2018 Sep 10.

DOI:10.1177/0309364618798173
PMID:30200814
Abstract

BACKGROUND

: A medial meniscal tear is a common knee injury, especially following an anterior cruciate ligament injury. Decreasing the compressive force on the medial meniscus during dynamic activities using an unloader knee brace could reduce meniscal strain, effectively reducing injury risk and/or severity.

OBJECTIVES

: To investigate the efficacy of two unloader knee braces on medial meniscus strain during dynamic activities in intact & deficient anterior cruciate ligament states.

STUDY DESIGN

: Combined in vivo/in vitro study.

METHODS

: In vivo knee kinematics and muscle force profiles from a healthy individual performing single/doubleleg squats and walking motions were simulated on 10 cadaveric specimens using a dynamic knee simulator system. Simulations were performed on knees in unbraced and braced scenarios, with and without the anterior cruciate ligament. Anterior and posterior medial meniscal strains were measured.

RESULTS

: Two different braces each showed a significant reduction in the posteromedial meniscal strain ( p ⩽ 0.01) in an intact anterior cruciate ligament state. Neither brace mirrored this result for the anteromedial strain ( p > 0.05). In the deficient anterior cruciate ligament state, the braces had no significant effect on strain ( p > 0.05).

CONCLUSION

: Two unloader knee braces effectively reduced strain in the medial meniscus with an intact anterior cruciate ligament during dynamic activities. Neither brace made a significant reduction in strain for anterior cruciate ligament-deficient knees.

CLINICAL RELEVANCE

Unloader knee braces could be used to reduce the medial meniscus strain following meniscal surgery and during rehabilitation in patients with an isolated medial meniscus injury. However, these braces cannot be recommended for this purpose in patients with an anterior cruciate ligament deficiency.

摘要

背景

内侧半月板撕裂是一种常见的膝关节损伤,尤其是在前交叉韧带损伤之后。使用卸载式膝关节支具在动态活动期间减少内侧半月板上的压力,可以降低半月板应变,有效降低受伤风险和/或严重程度。

目的

研究两种卸载式膝关节支具在完整和前交叉韧带损伤状态下的动态活动中对内侧半月板应变的疗效。

研究设计

体内/体外联合研究。

方法

使用动态膝关节模拟器系统在10个尸体标本上模拟一名健康个体进行单腿/双腿深蹲和行走动作时的体内膝关节运动学和肌肉力分布。在有无前交叉韧带的情况下,对未佩戴支具和佩戴支具的膝关节进行模拟。测量前后内侧半月板应变。

结果

在完整的前交叉韧带状态下,两种不同的支具均显示后内侧半月板应变显著降低(p⩽0.01)。两种支具均未使前内侧应变出现类似结果(p>0.05)。在前交叉韧带损伤状态下,支具对应变无显著影响(p>0.05)。

结论

两种卸载式膝关节支具在动态活动期间能有效降低前交叉韧带完整时内侧半月板的应变。对于前交叉韧带损伤的膝关节,两种支具均未使应变显著降低。

临床意义

卸载式膝关节支具可用于减少半月板手术后及孤立性内侧半月板损伤患者康复期间的内侧半月板应变。然而,对于前交叉韧带损伤的患者,不建议为此目的使用这些支具。

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