Seedholm B B, Takeda T, Tsubuku M, Wright V
Ann Rheum Dis. 1979 Aug;38(4):307-16. doi: 10.1136/ard.38.4.307.
This paper investigates the possible role of mechanical stress in the development of the osteoarthrotic lesions frequently observed in the patellofemoral compartment of the knee joint. First the location of these destructive lesions was determined by studying the location and pattern of contact in the patellofemoral joint. The study was carried out on 39 cadaveric knees for the range of flexion 0 degrees -120 degrees. It was shown that the lesions were localised to the areas corresponding to the range of flexion 40 degrees -80 degrees. These areas have been shown to be subjected to a low stress for most of the time and to a much higher stress for only part of the time. This mode of stressing this area of the cartilage is a consequence of the style of life of the average Western man in which the most predominant activity is level walking, during which the load and in turn the stress are much lower than they are during other ambulatory activities such as ramp and stair ascent and descent. The same area of the cartilage seems to be subject to a similar mode of stress during sedentary occupations. It is suggested that this mode of stressing the cartilage conditions it chemically, and hence mechanically, to transmit low stresses, so that when the much less frequent but higher stresses are applied it cannot transmit them without sustaining some damage.
本文研究了机械应力在膝关节髌股关节腔中常见的骨关节炎性病变发展过程中可能发挥的作用。首先，通过研究髌股关节的接触位置和模式来确定这些破坏性病变的位置。该研究在39具尸体膝关节上进行，屈伸范围为0度至120度。结果表明，病变位于对应于40度至80度屈伸范围的区域。已表明这些区域大部分时间承受低应力，仅在部分时间承受高得多的应力。软骨这个区域的这种应力模式是西方普通人生活方式的结果，其中最主要的活动是平地行走，在此期间负荷以及相应的应力远低于其他诸如斜坡和楼梯上下行走等动态活动期间的负荷和应力。在久坐职业中，软骨的同一区域似乎也受到类似的应力模式影响。有人提出，这种对软骨施加应力的模式在化学上，进而在机械上，使软骨适应传递低应力，因此当施加频率低得多但更高的应力时，软骨在不遭受一些损伤的情况下就无法传递这些应力。
