UNASSIGNED:提供阻力以防止异常膝关节过度伸展的膝关节的韧带和软组织囊结构尚未确定。这些知识对于膝关节过伸异常的诊断和治疗是必需的。
UNASSIGNED:确定抵抗膝关节过度伸展的膝关节韧带和囊状结构的抵抗力矩。
UNASSIGNED:后内侧和后外侧囊结构的组合功能可提供主要的约束,以防止膝关节异常过度伸展。前交叉韧带和后交叉韧带抵抗膝关节过度伸展,但起辅助约束作用。
未经评估:描述性实验室研究。
UNASSIGNED:一个6自由度的机器人系统确定了24个尸体膝盖从0°到100°的完整松弛极限,为±135N的前后极限,±7N·m时的外收极限,以及±5N·m的外部-内部极限。一种加载方法(n=14膝盖)使用静态加载序列,膝盖过伸至27-N·m扭矩,同时在顺序软组织切割过程中将所有其他自由度保持在零负载。第二种方法(n=10膝)使用循环加载序列来减少在0°延伸处切割软组织的粘弹性效应,然后膝盖过度伸展至27-N·m扭矩,并循环回到0°。选择性软组织切割进行了以下:斜pop韧带,腓骨韧带,后外侧囊,后内侧囊带后斜韧带,交叉韧带,外侧副韧带,波普利特乌斯,前外侧韧带和髂胫带,和浅表和深内侧副韧带。剖切时约束力矩的顺序损失提供了该结构在抵抗膝盖过度伸展方面的功能。
未经评估:膝关节过度伸展的中位阻力,按降序排列,后内侧囊和后斜韧带(21.7%),后外侧韧带和腓骨韧带(17.1%),前交叉韧带和后交叉韧带(13%和12.9%,分别),上和深内侧副韧带(9.6%),交叉韧带(7.7%),外侧副韧带(5.4%)。合并的后囊膜结构提供了总抵抗力矩的54.7%,前后交叉韧带提供了25.3%,以防止膝关节过度伸展。
UNASSIGNED:异常膝关节过度伸展的诊断涉及多个韧带和软组织结构的组合,而没有1次主要约束。后内侧和后外侧囊结构提供了主要的抵抗力矩,以防止膝盖过度伸展。交叉韧带对膝盖过度伸展产生的抵抗力矩较小。
UNASSIGNED:这是第一项全面测量所有膝关节韧带和囊状结构的研究,为异常膝关节过度伸展提供了抵抗力矩。这些数据对于受伤或发育病例后患者异常膝关节过度伸展的病理力学的诊断和治疗策略是必需的。
The ligaments and soft tissue capsular structures of the knee joint that provide a resisting force to prevent abnormal knee hyperextension have not been determined. This knowledge is required for the diagnosis and treatment of knee hyperextension abnormalities.
To determine the resisting moment of knee ligament and capsular structures that resist knee hyperextension.
The combined posteromedial and posterolateral capsular structures function to provide a major restraint to prevent abnormal knee hyperextension. The anterior and posterior cruciate ligaments resist knee hyperextension but function as secondary restraints.
Descriptive laboratory study.
A 6 degrees of freedom robotic system determined intact laxity limits in 24 cadaveric knees from 0° to 100° of knee flexion for anteroposterior limits at ±135 N, abduction-adduction limits at ±7 N·m, and external-internal limits at ±5 N·m. One loading method (n = 14 knees) used a static loading sequence with knee hyperextension to 27-N·m torque while maintaining all other degrees of freedom at zero load during sequential soft tissue cutting. The second method (n = 10 knees) used a cyclic loading sequence to decrease viscoelastic effects with soft tissue cutting at 0° of extension, followed by knee hyperextension to 27-N·m torque and cycled back to 0°. Selective soft tissue cuttings were performed of the following: oblique popliteal ligament, fabellofibular ligament, posterolateral capsule, posteromedial capsule with posterior oblique ligament, cruciate ligaments, lateral collateral ligament, popliteus, anterolateral ligament and iliotibial band, and superficial plus deep medial collateral ligaments. The sequential loss in the restraining moment with sectioning provides the function of that structure in resisting knee hyperextension.
The median resisting force to knee hyperextension, in descending order, was the posteromedial capsule and posterior oblique ligament (21.7%), posterorolateral ligament and fabellofibular ligament (17.1%), anterior and posterior cruciate ligaments (13% and 12.9%, respectively), superior and deep medial collateral ligament (9.6%), oblique popliteal ligament (7.7%), and lateral collateral ligament (5.4%). The combined posterior capsular structures provided 54.7% and the anterior and posterior cruciate ligaments 25.3% of the total resisting moment to prevent knee hyperextension.
Diagnosis of abnormal knee hyperextension involves a combination of multiple ligament and soft tissue structures without 1 primary restraint. The posteromedial and posterolateral capsular structures provided the major resisting moment to prevent knee hyperextension. The cruciate ligaments produced a lesser resisting moment to knee hyperextension.
This is the first study to comprehensively measure all of the knee ligaments and capsular structures providing a resisting moment to abnormal knee hyperextension. These data are required for diagnostic and treatment strategies on the pathomechanics of abnormal knee hyperextension in patients after injury or developmental cases.