Markolf K L, Burchfield D M, Shapiro M M, Shepard M F, Finerman G A, Slauterbeck J L
Department of Orthopaedic Surgery, University of California at Los Angeles, USA.
J Orthop Res. 1995 Nov;13(6):930-5. doi: 10.1002/jor.1100130618.
Injuries to the anterior cruciate ligament frequently occur under combined mechanisms of knee loading. This in vitro study was designed to measure levels of ligament force under dual combinations of individual loading states and to determine which combinations generated high force. Resultant force was recorded as the knee was extended passively from 90 degrees of flexion to 5 degrees of hyperextension under constant tibial loadings. The individual loading states were 100 N of anterior tibial force, 10 Nm of varus and valgus moment, and 10 Nm of internal and external tibial torque. Straight anterior tibial force was the most direct loading mechanisms; the mean ligament force was approximately equal to applied anterior tibial force near 30 degrees of flexion and to 150% of applied tibial force at full extension. The addition of internal tibial torque to a knee loaded by anterior tibial force produced dramatic increases of force at full extension and hyperextension. This loading combination produced the highest ligament forces recorded in the study and is the most dangerous in terms of potential injury to the ligament. In direct contrast, the addition of external tibial torque to a knee loaded by anterior tibial force decreased the force dramatically for flexed positions of the knee; at close to 90 degrees of flexion, the anterior cruciate ligament became completely unloaded. The addition of varus moment to a knee loaded by anterior tibial force increased the force in extension and hyperextension, whereas the addition of valgus moment increased the force at flexed positions. These states of combined loading also could present an increased risk for injury. Internal tibial torque is an important loading mechanism of the anterior cruciate ligament for an extended knee. The overall risk of injury to the ligament from varus or valgus moment applied in combination with internal tibial torque is similar to the risk from internal tibial torque alone. External tibial torque was a relatively unimportant mechanism for generating anterior cruciate ligament force.
前交叉韧带损伤常发生于膝关节负荷的复合机制下。本体外研究旨在测量个体负荷状态双重组合下的韧带力水平，并确定哪些组合会产生高力。在恒定胫骨负荷下，当膝关节从90度屈曲被动伸展至5度过伸时，记录合力。个体负荷状态为100 N的胫骨前向力、10 Nm的内翻和外翻力矩以及10 Nm的胫骨内、外扭矩。直接的胫骨前向力是最直接的负荷机制；在接近30度屈曲时，平均韧带力约等于施加的胫骨前向力，在完全伸展时约为施加胫骨力的150%。在由胫骨前向力加载的膝关节上增加胫骨内扭矩，在完全伸展和过伸时会使力显著增加。这种负荷组合产生了本研究中记录到的最高韧带力，就韧带潜在损伤而言是最危险的。与之形成直接对比的是，在由胫骨前向力加载的膝关节上增加胫骨外扭矩，会使膝关节屈曲位置的力显著降低；在接近90度屈曲时，前交叉韧带完全卸载。在由胫骨前向力加载的膝关节上增加内翻力矩会增加伸展和过伸时的力，而增加外翻力矩会增加屈曲位置的力。这些联合负荷状态也可能增加受伤风险。胫骨内扭矩是伸展膝关节时前交叉韧带的重要负荷机制。与内胫骨扭矩单独作用相比，内胫骨扭矩与内翻或外翻力矩联合作用对韧带造成损伤的总体风险相似。胫骨外扭矩是产生前交叉韧带力的相对不重要的机制。
Zotero 插件