Paulos L E, France E P, Rosenberg T D, Jayaraman G, Abbott P J, Jaen J
Salt Lake Knee and Sports Medicine Clinic, Utah 84103.
Am J Sports Med. 1987 Sep-Oct;15(5):419-29. doi: 10.1177/036354658701500501.
To better understand the role of preventive knee braces in injury prevention, a biomechanical study using fresh frozen cadaveric knees (N = 18) was conducted. Ligament tensions and joint displacements were measured at static, nondestructive valgus forces as well as low-rate destructive forces. After quantifying and establishing individual ligament contributions to valgus restraining function, knees were then braced with two different laterally applied preventive braces, the McDavid Knee Guard and the Omni Anderson Knee Stabler. The effects of lateral bracing were analyzed according to valgus force, joint line opening, and ligament tensions. Valgus applied forces, with or without braces, consistently produced medial collateral ligament (MCL) disruptions at ligament tensions surprisingly higher than the anterior cruciate ligament (ACL) and higher than or equal to the posterior cruciate ligament (PCL). Although large joint displacements were necessary for complete ligament failure, bundle disruption in the MCL, ACL, and PCL was noted at much smaller joint openings. In Part I of this study, no significant protection could be documented with the two preventive braces used. Also, four potentially adverse effects were noted: MCL preload, center axis shift, premature joint line contact, and brace slippage.
为了更好地理解预防性护膝在预防损伤中的作用,我们进行了一项生物力学研究,使用新鲜冷冻的尸体膝关节(N = 18)。在静态、非破坏性外翻力以及低速率破坏性力作用下测量韧带张力和关节位移。在量化并确定各韧带对外翻约束功能的贡献后,然后用两种不同的外侧应用预防性护膝对膝关节进行支撑,即麦克戴维护膝和全向安德森膝关节稳定器。根据外翻力、关节间隙开口和韧带张力分析外侧支撑的效果。无论有无护膝,施加的外翻力在韧带张力下始终会导致内侧副韧带(MCL)断裂,其张力惊人地高于前交叉韧带(ACL),且高于或等于后交叉韧带(PCL)。尽管韧带完全断裂需要较大的关节位移,但在小得多的关节开口时就注意到了MCL、ACL和PCL中的束状断裂。在本研究的第一部分,使用的两种预防性护膝均未显示出显著的保护作用。此外,还注意到四个潜在的不利影响:MCL预负荷、中心轴移位、关节间隙过早接触和护膝滑动。