Miller R K, Goodfellow J W, Murray D W, O'Connor J J
Nuffield Orthopaedic Centre, Headington, Oxford, UK.
J Bone Joint Surg Br. 1998 Sep;80(5):900-6. doi: 10.1302/0301-620x.80b5.8460.
Using a new, non-invasive method, we measured the patellofemoral force (PFF) in cadaver knees mounted in a rig to simulate weight-bearing. The PFF was measured from 20 degrees to 120 degrees of flexion before and after implanting three designs of knee prosthesis. Medial unicompartmental arthroplasty with a meniscal-bearing prosthesis and with retention of both cruciate ligaments caused no significant change in the PFF. After arthroplasty with a posterior-cruciate-retaining prosthesis and division of the anterior cruciate ligament, the PFF decreased in extension and increased by 20% in flexion. Implantation of a posterior stabilised prosthesis and division of both cruciate ligaments produced a decrease in the PFF in extension but maintained normal load in flexion. There was a direct relationship between the PFF and the angle made with the patellar tendon and the long axis of the tibia. The abnormalities of the patellar tendon angle which resulted from implantation of the two total prostheses explain the observed changes in the PFF and show how the mechanics of the patellofemoral joint depend upon the kinematics of the tibiofemoral articulation.
我们采用一种新的非侵入性方法，对安装在模拟负重装置中的尸体膝关节的髌股关节力（PFF）进行了测量。在植入三种膝关节假体设计之前和之后，测量了从20度到120度屈曲范围内的PFF。采用半月板承载假体且保留两条交叉韧带的内侧单髁置换术未导致PFF发生显著变化。在采用后交叉韧带保留型假体进行关节置换并切断前交叉韧带后，伸直位时PFF降低，屈曲位时PFF增加20%。植入后稳定型假体并切断两条交叉韧带后，伸直位时PFF降低，但屈曲位时保持正常负荷。PFF与髌腱和胫骨长轴所成角度之间存在直接关系。两种全膝关节假体植入后导致的髌腱角度异常解释了观察到的PFF变化，并显示了髌股关节力学如何依赖于胫股关节的运动学。
