Hintermann B, Nigg B M
Orthopädische Universitätsklinik Basel.
Schweiz Z Sportmed. 1993 Dec;41(4):151-6.
Excessive foot eversion and abnormal tibial rotation have been associated with knee injuries. Why and whether or not overpronation in athletes leads to overuse injuries at the knee joint, however, is still not understood. It could be that this is related to the mechanical coupling at the ankle joint complex. The purpose of this study was to quantify the movement transferred from calcaneal eversion-inversion into tibial rotation, and vice-versa from tibial rotation into calcaneal eversion-inversion. Fourteen foot-leg specimens were used for investigation. A holding device with six degrees of freedom was constructed which allowed to rotate the calcaneus and to determine the resulting tibial rotation, and vice-versa. The movement transfer between calcaneus and tibia varied substantially, and it was not the same for both input modes. In the case of applied internal tibial rotation no calcaneal eversion was found. Apparently, the movement transfer depends from the individual mechanical coupling at the ankle joint complex. Excessive calcaneal eversion does only result in excessive rotational loading of the knee joint when coupled with a high movement transfer at the ankle joint complex. Finally, the results imply that, during gait, pronation results from ground reaction forces acting on the calcaneus, since internal tibial rotation is not transferred into calcaneal eversion.
足过度外翻和胫骨异常旋转与膝关节损伤有关。然而，运动员过度内旋是否会导致膝关节过度使用损伤以及原因仍不清楚。这可能与踝关节复合体的机械耦合有关。本研究的目的是量化从跟骨外翻-内翻到胫骨旋转的运动传递，以及从胫骨旋转到跟骨外翻-内翻的反向运动传递。使用14个足-腿标本进行研究。构建了一个具有六个自由度的固定装置，该装置允许旋转跟骨并确定由此产生的胫骨旋转，反之亦然。跟骨和胫骨之间的运动传递差异很大，并且两种输入模式下的情况也不相同。在施加胫骨内旋的情况下，未发现跟骨外翻。显然，运动传递取决于踝关节复合体的个体机械耦合。只有当踝关节复合体的运动传递较高时，跟骨过度外翻才会导致膝关节过度旋转负荷。最后，结果表明，在步态中，内旋是由作用于跟骨的地面反作用力引起的，因为胫骨内旋不会传递到跟骨外翻。
