小心处理：髋关节前囊在日常髋关节功能中起关键作用。
Handle With Care: The Anterior Hip Capsule Plays a Key Role in Daily Hip Performance.
作者信息
Duquesne Kate, Pattyn Christophe, Vanderstraeten Barbara, Audenaert Emmanuel A
机构信息
Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.
出版信息
Orthop J Sports Med. 2022 Mar 24;10(3):23259671221078254. doi: 10.1177/23259671221078254. eCollection 2022 Mar.
BACKGROUND
Passive energy storage and return has long been recognized as one of the central mechanisms for minimizing the energy cost needed for terrestrial locomotion. Although the iliofemoral ligament (IFL) is the strongest ligament in the body, its potential role in energy-efficient walking remains unexplored.
PURPOSE
To identify the contribution of the IFL to the amount of work performed by the hip muscles for normal, straight-level walking.
STUDY DESIGN
Controlled laboratory study.
METHODS
Straight-level walking of 50 healthy and injury-free adults was simulated using the AnyBody Modeling System. For each participant, the bone morphology and soft tissue properties were nonuniformly scaled. The superior and inferior parts of the IFL were represented by 2 springs each, and a linear force-strain relation was defined. A parameter study was conducted to account for the uncertainty surrounding the mechanical properties of the IFL. The work required from the gluteus, quadriceps, iliopsoas, and sartorius with and without inclusion of the IFL was calculated. Analysis of variance with subsequent post hoc paired test was used to test the significance of IFL presence on the required mechanical work.
RESULTS
During walking, the strain in the IFL reached a median of 18.7% (95% CI, 8.0%-26.5%), with the largest values obtained at toe-off. With the IFL undamaged and fully operational, the effort required by the hip flexor muscles was reduced by a median of 54% (99% CI, 45%-62%) for the iliopsoas and by a median of 41% (99% CI, 27%-54%) for the sartorius muscles. The inclusion of the IFL did not significantly alter the work required by the gluteus and the quadriceps.
CONCLUSION
The findings emphasized the key role the IFL plays in hip flexion by working synergistically with the hip musculature.
CLINICAL RELEVANCE
The importance of the contribution of the IFL to the hip flexors warrants careful handling and repair of these ligaments in cases of surgery and structural damage.
背景
长期以来，被动能量储存与回馈一直被认为是将陆地运动所需能量成本降至最低的核心机制之一。尽管髂股韧带（IFL）是人体中最强壮的韧带，但其在节能行走中的潜在作用仍未得到探索。
目的
确定髂股韧带对正常直线行走时髋部肌肉所做工作量的贡献。
研究设计
对照实验室研究。
方法
使用AnyBody建模系统模拟50名健康且无损伤的成年人的直线行走。对于每位参与者，骨骼形态和软组织特性进行非均匀缩放。髂股韧带的上部和下部分别由两个弹簧表示，并定义了线性力-应变关系。进行参数研究以考虑围绕髂股韧带力学性能的不确定性。计算了包含和不包含髂股韧带时臀肌、股四头肌、髂腰肌和缝匠肌所需的功。使用方差分析及随后的事后配对检验来测试髂股韧带的存在对所需机械功的显著性。
结果
在行走过程中，髂股韧带的应变中位数达到18.7%（95%可信区间，8.0%-26.5%），在离地时达到最大值。在髂股韧带未受损且完全起作用的情况下，髂腰肌所需的努力中位数减少了54%（99%可信区间，45%-62%），缝匠肌所需的努力中位数减少了41%（99%可信区间，27%-54%）。包含髂股韧带并未显著改变臀肌和股四头肌所需的功。
结论
研究结果强调了髂股韧带通过与髋部肌肉协同工作在髋部屈曲中所起的关键作用。
临床意义
髂股韧带对髋部屈肌的贡献的重要性使得在手术和结构损伤情况下对这些韧带进行仔细处理和修复成为必要。
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