Soudry M, Walker P S, Reilly D T, Kurosawa H, Sledge C B
J Arthroplasty. 1986;1(1):35-45. doi: 10.1016/s0883-5403(86)80008-0.
Ten fresh knee specimens with prosthetic components inserted were tested in a loading rig. Compressive and shear force were applied to the femur with the tibia held fixed. The location of the femoral-tibial contact points was measured. The contact reaction forces, the shear forces, and the rocking moments transmitted to the tibial component were calculated. The variations in the test conditions were: high and low compressive force, flexion angles of 0 degree, 45 degrees, and 90 degrees, three curvatures of tibial plastic inserts, and the posterior cruciate retained or resected. When the posterior cruciate was retained, the contact points were close to the center of the component; for cruciate resection, the contacts were close to the anterior of the component. The shear forces and rocking moments were higher for cruciate resection, but the contact reaction forces were lower. There is a wide variety of knee prosthesis designs, but the amount of inherent stability between the femoral and tibial surfaces, and whether the posterior cruciate ligament is retained or sacrificed, are two of the most important design variables. This study shows that cruciate resection increases the shear forces and the rocking moments to the tibial components and that additional fixation means may be necessary to compensate. On the other hand, cruciate retention with low conformity gives higher contact forces, which may lead to more wear in the long term. Cruciate sacrificing designs with intercondylar guiding surfaces are a separate category of design and were not considered in this study.
对十个已植入假体部件的新鲜膝关节标本在加载装置中进行测试。在固定胫骨的情况下，对股骨施加压缩力和剪切力。测量股骨 - 胫骨接触点的位置。计算传递到胫骨部件的接触反作用力、剪切力和摇摆力矩。测试条件的变化包括：高、低压缩力，0度、45度和90度的屈曲角度，胫骨塑料插件的三种曲率，以及后交叉韧带保留或切除。当保留后交叉韧带时，接触点靠近部件中心；对于交叉韧带切除，接触点靠近部件前部。交叉韧带切除时的剪切力和摇摆力矩较高，但接触反作用力较低。膝关节假体设计种类繁多，但股骨和胫骨表面之间的固有稳定量以及后交叉韧带是保留还是牺牲，是两个最重要的设计变量。本研究表明，交叉韧带切除会增加胫骨部件的剪切力和摇摆力矩，可能需要额外的固定手段来补偿。另一方面，低匹配度下保留交叉韧带会产生更高的接触力，从长远来看可能导致更多磨损。具有髁间导向面的牺牲交叉韧带设计是另一类设计，本研究未对此进行考虑。
