Lilly Susan, Seeber Gesine H, Smith Michael P, McGaugh Janna M, James C Roger, Brismxsée Jean-Michel, Sizer Phillip S
MD Anderson Cancer Center, Houston, TX, USA.
Department of Biology, The Sages College, Troy, NY, USA.
Int J Sports Phys Ther. 2019 Feb;14(1):32-45.
Anterior knee pain during knee extension may be related to a meniscal movement restriction and increased meniscal load during function. One method of treatment involves the use of manual posterior mobilization of the tibia to specifically target the meniscotibial interface of the knee joint.
The purpose of this study was to measure motion at a cadaveric medial meniscus anterior horn during a posterior tibial mobilization.
Prospective, multifactorial, repeated-measures laboratory study.
Eight unembalmed cadaveric knee specimens were mounted in a custom apparatus and markers were placed in the medial meniscus, tibia and femur. The tibia was posteriorly mobilized in two randomized knee positions (0 degrees and 25 degrees) using three randomly assigned loads (44.48N, 88.96N, and 177.93N). Markers were photographed and digitally measured and analyzed.
All load x position conditions produced anterior displacement of the meniscus on the tibia, where the displacement was significant [ (7) = -3.299; = 0.013] at 0 degrees loaded with 177.93N (mean 0.41 ± 0.35 mm). The results of 2(position) x 3(load) repeated measures ANOVA for meniscotibial displacement produced no significant main effects for load [F (2,14) = 2.542; p = 0.114) or position [F (1,7) = 0.324, p = 0.587]. All load x position conditions produced significant posterior tibial and meniscal displacement on the femur. The 2(position) x 3(load) repeated measures ANOVA revealed a significant main effect for load for both femoral marker displacement relative to the tibial axis [F (2,14) = 77.994; p < 0.001] and meniscal marker displacement relative to the femoral marker [F (2,14) = 83.620; p < 0.001].
Use of a mobilization technique to target the meniscotibial interface appears to move the meniscus anteriorly on the tibia. It appears that this technique may be most effective at the end range position.
2 (laboratory study).
膝关节伸展时的前膝疼痛可能与半月板运动受限以及功能期间半月板负荷增加有关。一种治疗方法是使用胫骨手动后向松动术，专门针对膝关节的半月板胫骨界面。
本研究的目的是测量胫骨后向松动术期间尸体内侧半月板前角的运动。
前瞻性、多因素、重复测量实验室研究。
将8个未防腐处理的尸体膝关节标本安装在定制装置中，并在半月板、胫骨和股骨上放置标记物。在两个随机的膝关节位置（0度和25度）使用三种随机分配的负荷（44.48N、88.96N和177.93N）对胫骨进行后向松动。对标记物进行拍照并进行数字测量和分析。
所有负荷×位置条件均使半月板在胫骨上向前移位，其中在0度加载177.93N时移位显著[（7）=-3.299；P=0.013]（平均0.41±0.35mm）。对半月板胫骨移位进行的2（位置）×3（负荷）重复测量方差分析结果显示，负荷[F（2,14）=2.542；P=0.114]或位置[F（1,7）=0.324，P=0.587]均无显著主效应。所有负荷×位置条件均使胫骨和半月板在股骨上产生显著的后向移位。2（位置）×（3负荷）重复测量方差分析显示，相对于胫骨轴的股骨标记物移位[F（2,14）=77.994；P<0.001]和相对于股骨标记物的半月板标记物移位[F（2,14）=83.620；P<0.001]的负荷均有显著主效应。
使用针对半月板胫骨界面的松动技术似乎会使半月板在胫骨上向前移动。看来该技术在终末范围位置可能最有效。
2（实验室研究）。
