Bourne R B, Finlay J B, Papadopoulos P, Rorabeck C H, Andreae P
Clin Orthop Relat Res. 1984 Sep(188):285-92.
Six human cadaver legs were tested with strain-gauge rosettes to determine the effects of varus/valgus loading on the distribution of strain on the cortical bone of the proximal tibia at loads of up to 250 kg. Changes in the femorotibial angle of 1.5 degrees and 3.1 degrees, to create varus/valgus deformities, produced significant unloading of the opposite aspect of the normal leg. A varus deformity of 3.1 degrees in the medial compartment osteoarthritic model virtually unloaded the lateral compartment and, because of the bending effect, placed the whole of the lateral aspect of the leg into axial tension. Under these conditions, the axial strains in almost the whole of the medial aspect of the tibia were doubled, from an initial value of 250 microstrain (compressive) to a value of approximately 500 microstrain (compressive). While a change in load-action, to simulate a 3.1 degrees valgus deformity in the medial compartment osteoarthritic model, did not completely unload the medial plateau of the tibia, it was suggested that such unloading could be achieved with slightly greater valgus loading. Successful clinical results, employing valgus osteotomies in patients with medial compartment osteoarthritis, are obtained by unloading the medial compartment while markedly increasing compressive loads on the whole of the lateral aspect of the leg.
对6条人类尸体下肢使用应变片进行测试，以确定在高达250千克负荷下，内翻/外翻负荷对胫骨近端皮质骨应变分布的影响。通过改变1.5度和3.1度的股胫角来制造内翻/外翻畸形，会导致正常下肢相对侧显著卸载。在内侧间室骨关节炎模型中，3.1度的内翻畸形几乎使外侧间室卸载，并且由于弯曲效应，使下肢整个外侧处于轴向拉伸状态。在这些条件下，胫骨几乎整个内侧的轴向应变增加了一倍，从初始值250微应变（压缩）增加到约500微应变（压缩）。虽然在内侧间室骨关节炎模型中改变负荷作用以模拟3.1度的外翻畸形，并没有完全卸载胫骨的内侧平台，但有人认为，稍大的外翻负荷可以实现这种卸载。在内侧间室骨关节炎患者中采用外翻截骨术取得成功的临床结果，是通过卸载内侧间室，同时显著增加下肢整个外侧的压缩负荷来实现的。
