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关节传入神经对膝关节平移的敏感性。

The sensitivity of joint afferents to knee translation.

作者信息

Cole K J, Brand R A, Daley B J

机构信息

Department of Exercise Science, University of Iowa, Iowa City, USA.

出版信息

Iowa Orthop J. 1995;15:168-73.

Abstract

The cruciate ligaments contain mechanoreceptors which putatively contribute to knee function and dysfunction. However, the interpretation of studies showing neural responses to traction loads applied to the cat cranial cruciate ligament (CCL-analogous to the anterior cruciate ligament in humans) depends upon demonstrating that non-CCL periarticular receptors are not stimulated. We assessed the capability to rigidly fix the knee against traction loads applied to the feline CCL. The tibia and femur were fixed either with clamps or Steinmann pins. Motion of the bones was monitored with liquid metal strain gauges (LMSG) and the activity of the posterior articular nerve (PAN) was recorded while traction loads of up to 20-30 N were applied to the CCL. Joint afferents recorded from the PAN were insensitive to the CCL loads in the rigidly fixed preparation. Motion of the proximal tibia and distal femur was less than 100 micrometers for both methods of fixation, with neither method demonstrating more rigid fixation. In contrast, we observed vigorous discharges with focused light pressure on the capsule and under conditions allowing 200-500 micrometers of tibial displacement on the femur. This suggests that clinically undetectable instability may give rise to aberrant mechanoreceptor activity contributing to dysfunction.

摘要

十字韧带含有机械感受器,推测其对膝关节功能及功能障碍有影响。然而,对显示猫颅十字韧带(CCL,类似于人类的前十字韧带)在承受牵引负荷时神经反应的研究进行解读,取决于能否证明非CCL关节周围感受器未受到刺激。我们评估了在猫CCL承受牵引负荷时将膝关节牢固固定的能力。胫骨和股骨用夹子或斯氏针固定。使用液态金属应变仪(LMSG)监测骨骼运动,并在向CCL施加高达20 - 30 N的牵引负荷时记录后关节神经(PAN)的活动。在牢固固定的标本中,从PAN记录到的关节传入神经对CCL负荷不敏感。两种固定方法下,胫骨近端和股骨远端的运动均小于100微米,两种方法均未显示出更牢固的固定效果。相比之下,我们观察到在对关节囊施加聚焦光压力以及在允许胫骨在股骨上位移200 - 500微米的条件下,会出现强烈的放电活动。这表明临床上难以检测到的不稳定性可能会导致异常的机械感受器活动,进而导致功能障碍。

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本文引用的文献

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The sensory innervation of the medial ligament of the knee joint.膝关节内侧韧带的感觉神经支配。
J Physiol. 1954 Feb 26;123(2):241-50. doi: 10.1113/jphysiol.1954.sp005047.
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Advances in the understanding of knee ligament injury, repair, and rehabilitation.
Med Sci Sports Exerc. 1984 Oct;16(5):427-43. doi: 10.1249/00005768-198410000-00002.

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