Abstract:
Posterolateral corner knee injuries are clinically significant, and often require surgical reconstruction. The optimal knee brace following posterolateral corner reconstructions has not yet been determined via clinical nor biomechanical study. We sought to evaluate the stiffness of six types of knee braces to determine the ideal brace type for reducing varus forces, which may have clinical utility for posterolateral corner knee reconstruction rehabilitation. Six different groups of knee braces underwent mechanical testing: cruciate braces, cruciate braces with a valgus bend, medial unloaders, articulating sleeves, hinged braces, and tri-panel immobilizers. Each brace was fitted to the same fiberglass leg model and was secured to the testing apparatus. Force was applied under four-point bending to generate a varus moment about the artificial knee. The stiffness in Newtons per millimeter (N/mm) of each brace was calculated from the slope of the force-displacement curve. The cruciate brace with a valgus bend had the highest average stiffness at 192.61 N/mm (SD 28.53). The articulating sleeve was the least stiff with an average stiffness of 49.86 N/mm (SD 8.99). Stiffness of the cruciate brace was not statistically different compared to cruciate valgus (p = 0.083) or medial unloader (p = 0.098). In this experimental design, a cruciate brace with a valgus bend was shown to have the highest overall stiffness, while an articulating sleeve had the lowest stiffness. Future work will investigate whether this translates into clinical performance.
摘要:
后外侧角膝关节损伤具有临床意义,通常需要手术重建。尚未通过临床或生物力学研究确定后外侧角重建后的最佳膝关节支架。我们试图评估六种类型的膝盖支架的刚度,以确定减少内翻力量的理想支架类型,这可能具有临床实用性后外侧角膝关节重建康复。六组不同的膝盖支架进行了机械测试:十字支架,带有外翻弯曲的交叉牙套,内侧卸货器,铰接套筒,铰链支架,和三面板固定器。每个支架安装到相同的玻璃纤维腿模型上,并固定到测试设备上。在四点弯曲下施加力以在人造膝盖上产生内翻力矩。从力-位移曲线的斜率计算每个支架的以牛顿/毫米(N/mm)为单位的刚度。具有外翻弯曲的十字形支架具有最高的平均刚度,为192.61N/mm(SD28.53)。铰接套筒的刚度最小,平均刚度为49.86N/mm(SD8.99)。与交叉外翻(p=0.083)或内侧卸载器(p=0.098)相比,交叉支具的刚度没有统计学差异。在这个实验设计中,具有外翻弯曲的十字形支架被证明具有最高的整体刚度,而铰接套筒的刚度最低。未来的工作将调查这是否转化为临床表现。