Krebs D E, Robbins C E, Lavine L, Mann R W
MGH Institute of Health Professions, Boston, MA 02114-4719, USA.
J Orthop Sports Phys Ther. 1998 Jul;28(1):51-9. doi: 10.2519/jospt.1998.28.1.51.
The literature is devoid of complete descriptions of hip biomechanics during gait. We present for the first time simultaneously acquired in vivo acetabular contact pressures, ground reaction forces, kinematics, hip torques, and electromyographic (EMG) activity during gait with and without a cane from an 85-year-old male with a left instrumented femoral head prosthesis. Highest acetabular contact pressures occurred in all gait trials at the posterosuperior acetabulum, just prior to peak EMG, adductor torque, and ground reaction force during late stance phase. Contralateral cane use reduced both peak acetabular contact pressure and gluteus medius EMG but not adductor torque or ground reaction force. These data identify a small area of high acetabular and femoral head stress that could occur during each of a human's millions of gait cycles annually and indicate that muscle activity, rather than solely body weight, drives hip loading, Clinicians who desire to limit hip loads should reduce both hip muscle contraction and weight bearing in late stance.
文献中缺乏对步态期间髋关节生物力学的完整描述。我们首次展示了一名85岁左侧植入股骨头假体男性在使用和不使用手杖行走时，同时获取的体内髋臼接触压力、地面反作用力、运动学、髋关节扭矩和肌电图（EMG）活动情况。在所有步态试验中，最高髋臼接触压力出现在后上髋臼，恰好在晚期站立相肌电图、内收肌扭矩和地面反作用力达到峰值之前。使用对侧手杖可降低髋臼接触压力峰值和臀中肌肌电图，但对内收肌扭矩或地面反作用力无影响。这些数据确定了每年人类数百万个步态周期中可能出现的髋臼和股骨头高应力小区域，并表明肌肉活动而非单纯体重驱动髋关节负荷，希望限制髋关节负荷的临床医生应在晚期站立相减少髋关节肌肉收缩和负重。
