Chen Shiyang, Chen Shaohua, Kang Qingyang, Lin Fangzheng, Zheng Shuting, Liu Xixi, Guo Chunhong, Li Yongjin, Lin Dingkun, Zeng Xiaolong
The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Orthopedics Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China.
Front Bioeng Biotechnol. 2024 Dec 9;12:1514516. doi: 10.3389/fbioe.2024.1514516. eCollection 2024.
Anterior tibial laxity is considered to be a risk factor for knee injuries, including anterior cruciate ligament ruptures. The anterior cruciate ligament reconstruction also aims to restore anterior tibial laxity. While anterior tibial laxity is considered to be linked to dynamic knee stability, the mechanisms connecting anterior tibial laxity to these stability issues are not fully understood. The purpose of this study was to investigate the kinematic alterations between different anterior tibial laxity in healthy subjects. We hypothesized that anterior tibial laxity affects the anteroposterior tibial displacement during dynamic movements.
This study involved thirty-five healthy subjects. There were twenty males and fifteen females with an average age of 18.91 ± 0.78 years. Their knees were categorized into "Tight" (the smallest 50%) and "Lax" (the largest 50%) groups based on anterior tibial laxity measurements using a Kneelax3 arthrometer. Kinematic data were collected using a three-dimensional motion capture system when they performed level walking, upslope walking, and vertical jumping. The knee kinematics were recorded for statistical analysis. We used independent sample t-tests to analyze key kinematic differences between groups.
The "Lax" group exhibited increased posterior tibial translation during upslope walking (5.4 ± 2.22 mm at swing max flexion, = 0.018) and vertical jumping (8.5 ± 2.78 mm at propulsion max flexion, = 0.003; 7.6 ± 3.17 mm at landing max flexion, = 0.019) than the "Tight" group. Significant differences in tibial internal rotation were observed during initial contact of the gait cycle of level walking (1.9° ± 0.95°, = 0.049) and upslope walking (2.1° ± 1.03°, = 0.041) in the "Lax" group compared to the "Tight" group. No significant differences in adduction/abduction or medial/lateral tibial translation were found between groups.
The study revealed that high anterior tibial laxity resulted in increased posterior tibial translation and tibial internal rotation. High anterior tibial laxity resulted in dynamic instability of knees during motions, especially in high-demanding activities like upslope or vertical jumping. However, further research is needed to explore the clinical functional effects of knee laxity.
胫骨前移松弛被认为是膝关节损伤的危险因素，包括前交叉韧带断裂。前交叉韧带重建的目的也在于恢复胫骨前移松弛。虽然胫骨前移松弛被认为与膝关节动态稳定性有关，但连接胫骨前移松弛与这些稳定性问题的机制尚未完全明确。本研究的目的是调查健康受试者不同胫骨前移松弛情况下的运动学改变。我们假设胫骨前移松弛会影响动态运动过程中胫骨的前后位移。
本研究纳入了35名健康受试者。其中男性20名，女性15名，平均年龄为18.91±0.78岁。使用Kneelax3关节测量仪测量胫骨前移松弛度，并将他们的膝关节分为“紧致”组（最小的50%）和“松弛”组（最大的50%）。当他们进行平地行走、上坡行走和垂直跳跃时，使用三维运动捕捉系统收集运动学数据。记录膝关节运动学数据以进行统计分析。我们使用独立样本t检验分析两组之间的关键运动学差异。
与“紧致”组相比，“松弛”组在上坡行走（摆动最大屈曲时为5.4±2.22毫米，P = 0.018）和垂直跳跃（推进最大屈曲时为8.5±2.78毫米，P = 0.003；着陆最大屈曲时为7.6±3.17毫米，P = 0.019）过程中胫骨后移增加。在平地行走（1.9°±0.95°，P = 0.049）和上坡行走（2.1°±1.03°，P = 0.041）的步态周期初始接触阶段，“松弛”组与“紧致”组相比，胫骨内旋存在显著差异。两组之间在内收/外展或胫骨内外侧平移方面未发现显著差异。
该研究表明，胫骨前移高度松弛会导致胫骨后移增加和胫骨内旋。胫骨前移高度松弛会导致运动过程中膝关节动态不稳定，尤其是在上坡或垂直跳跃等高要求活动中。然而，需要进一步研究来探索膝关节松弛的临床功能影响。
