Texas Tech University, Mechanical Engineering, Lubbock, Texas 79409-1021, USA.
Alumni Association/LEQSF Professor and Department Head, University of Louisiana at Lafayette, Department of Mechanical Engineering, Lafayette, LA 70503, USA.
J Healthc Eng. 2018 Dec 10;2018:8698167. doi: 10.1155/2018/8698167. eCollection 2018.
Research has indicated that a smaller intercondylar notch could cause contact between the anterior cruciate ligament and the femoral notch, which may predispose individuals to an increased rate of anterior cruciate ligament injury.
Contact between the lateral notch wall and the anterior cruciate ligament does increase the strain past the structural integrity of the ligament.
A descriptive laboratory study.
A biomechanical study using robotic manipulators was conducted to investigate the occurrence of impingement in human cadaver specimens. Six cadaveric knees from six donors (three male and three female) were instrumented with a thin force sensor, placed on the lateral wall of the femoral condyle, and a differential variable reluctance transducer (DVRT) was attached to the middle section of the anterior medial bundle of the ACL. The knees were then moved through a series of flexion (5° to 90°), valgus (0 to 7.5°), and external rotation (0 to 7.5°) movements using two interacting robots.
The results revealed that impingement occurred in both male and female specimens with a maximum impingement force of 28 N. Impingement occurred more prominently in female knees and in the combination loading of valgus and external rotation for both genders. The corresponding strain due to impingement was small or compressive, with the male knee maximum strain less than 1.28% and the female knee strain less than 7.1% in the worse case conditions.
The lack of increased force or strain when impingement occurred indicates that impingement may not affect the healthy function of the knee with a nonstenotic notch. Additionally, the analysis shows that impingement may not be a major contributing factor to anterior cruciate ligament injury, but rather a common occurrence in healthy knees.
Impingement within the femoral notch does not appear to be a major contributory factor to ACL injury. Other more severe injuries to the knee would occur before ACL impingement with the femoral notch becoming a contributing factor to ACL injury. The small sample size limits the conclusivity of the results presented in this research; thus, additional large sample size studies are warranted.
研究表明，较小的髁间切迹可能导致前交叉韧带与股骨切迹之间发生接触，从而使个体更容易发生前交叉韧带损伤。
外侧切迹壁与前交叉韧带之间的接触确实会增加韧带结构完整性以外的应变。
描述性实验室研究。
使用机器人操纵器进行生物力学研究，以调查在人体尸体标本中发生撞击的情况。六个供体（三个男性和三个女性）的六个尸体膝关节被植入一个薄力传感器，放置在股骨髁的外侧壁上，一个差动可变磁阻传感器（DVRT）被附在 ACL 的前内侧束的中间部分。然后，使用两个相互作用的机器人使膝关节通过一系列的弯曲（5°至 90°）、外翻（0 至 7.5°）和外旋（0 至 7.5°）运动。
结果显示，在男性和女性标本中均发生了撞击，最大撞击力为 28N。女性膝关节和两性的外翻和外旋联合加载时撞击更为明显。由于撞击而产生的应变较小或为压缩应变，男性膝关节在最坏情况下的最大应变小于 1.28%，女性膝关节的应变小于 7.1%。
发生撞击时没有增加力或应变表明，在非狭窄切迹的情况下，撞击可能不会影响膝关节的健康功能。此外，分析表明，撞击可能不是前交叉韧带损伤的主要因素，而是健康膝关节的常见现象。
股骨切迹内的撞击似乎不是 ACL 损伤的主要因素。膝关节会发生更严重的损伤，然后才会发生 ACL 撞击，并且股骨切迹成为 ACL 损伤的一个因素。小样本量限制了本研究结果的结论性；因此，需要进行更大样本量的研究。
