背景:前交叉韧带(ACL)破裂的患者中,前外侧韧带(ALL)的损伤相当常见。在考虑修复或重建ALL之前,必须考虑缺乏有关该韧带生物力学行为的知识。本研究的目的是分析不同屈曲角度下胫骨内旋引起的ALL应变,并找出应变分布特征。
方法:解剖10个新鲜冷冻尸体膝关节的ALL。所有标本在30°时从0°到25°进行胫骨内旋,60°,90°,膝关节弯曲120°。通过数字图像相关(DIC)记录ALL在内部旋转过程中的应变分布。测量总体菌株和次区域菌株。
结果:ALL的应变随着胫骨内旋的增加而增加。内旋25°,每个屈曲角度的总应变为12.89±2.73%(30°),15.32±2.50%(60°),18.94±2.34%(90°),20.10±3.27%(120°)。在所有屈曲角度下,次区域应变均显着不同。ALL远端1/3的应变最大,其次是中间的1/3,而近侧的1/3最小(均P<0.001)。
结论:ALL抵抗胫骨的内旋,随着旋转的增加变得更加紧张。在ALL的胫骨插入部位附近的远端部分观察到明显的高应变。这可能表明该区域容易因过度内旋而受伤。
BACKGROUND: Injuries of the anterolateral ligament (ALL) are fairly common in patients with ruptures of the anterior cruciate ligament (ACL). Before considering repair or reconstruction of the ALL, the lack of knowledge with regard to the biomechanical behavior of this ligament must be considered. The purpose of this study was to analyze the strain of the ALL induced by tibial internal rotation at different flexion angles and find out the strain distribution features.
METHODS: The ALLs of ten fresh-frozen cadaver knees were dissected. All specimens underwent tibial internal rotation from 0° to 25° at 30°, 60°, 90°, and 120° of knee flexion. Strain distribution of the ALL during internal rotation was recorded by digital image correlation (DIC). The overall strain and sub-regional strain were measured.
RESULTS: The strain of the ALL increased with increasing tibial internal rotation. With 25° of internal rotation, the overall strain at each flexion angle was 12.89 ± 2.73% (30°), 15.32 ± 2.50% (60°), 18.94 ± 2.34% (90°), and 20.10 ± 3.27% (120°). The sub-regional strain was significantly different at all flexion angles. The strain of the distal 1/3 of the ALL was the greatest, followed by the middle 1/3, while the proximal 1/3 was the smallest (all P < 0.001).
CONCLUSIONS: The ALL resisted internal rotation of the tibia by becoming more tense with increasing rotation. A significantly high strain was observed in the distal portion near the tibial insertion site of the ALL, which may suggest that this region is prone to injury with excessive internal rotation.