Huberti H H, Hayes W C
Department of Orthopaedic Surgery, Charles A. Dana Research Institute, Boston, Massachusetts.
J Orthop Res. 1988;6(4):499-508. doi: 10.1002/jor.1100060405.
We measured patellofemoral contact areas and pressures using pressure sensitive film in ten human cadaver knees exhibiting degenerative lesions of patellar cartilage. We studied a flexion range from 20 degrees to 90 degrees and compared contact pressures before and after capsular reconstructive procedures. With an intact, normal capsule, localized lesions of grade I-II exhibited a 50% reduction in pressure (from 3.4 +/- 0.7 MPa to 1.6 +/- 0.9 MPa) directly over the lesion. Grade III-IV lesions exhibited a loss of contact pressure greater than 90%. This reduction in pressure appears to result from a loss of stiffness in the low-grade cartilage lesions and from a loss of cartilage thickness in higher grade lesions. Highly localized peak pressures were also observed on the normal cartilage bordering the lesions. Capsular reconstructive procedures (medial plication, lateral plication, lateral release, and bilateral release) did not result in consistent pressure reductions or in the creation of more uniform pressure distributions. In particular, lateral capsular release, a popular surgical procedure, resulted in no change in three knees and four different pressure patterns in the other seven knees.
我们使用压敏胶片测量了10个患有髌软骨退行性病变的人类尸体膝关节的髌股关节接触面积和压力。我们研究了20度至90度的屈曲范围，并比较了关节囊重建手术前后的接触压力。在完整、正常的关节囊情况下，I-II级局部病变在病变正上方的压力降低了50%（从3.4±0.7兆帕降至1.6±0.9兆帕）。III-IV级病变的接触压力损失超过90%。这种压力降低似乎是由于低级别软骨病变的硬度丧失以及高级别病变中软骨厚度的丧失所致。在病变周围的正常软骨上也观察到高度局部化的峰值压力。关节囊重建手术（内侧折叠、外侧折叠、外侧松解和双侧松解）并未导致压力持续降低或产生更均匀的压力分布。特别是，外侧关节囊松解术作为一种常用的外科手术，在三个膝关节中没有导致压力变化，而在其他七个膝关节中产生了四种不同的压力模式。
