人膝关节后交叉韧带重建后康复治疗的生物力学研究  

The biomechanics of rehabilitation therapy in reconstruction of posterior cruciate ligament in human knee

作　　者：陶澄[1] 兰纯娜[2] 何爱咏[1] 王万春[1] 

机构地区：[1]湖南中南大学湘雅二医院骨科,长沙人民路86号410011 [2]湖南中南大学湘雅二医院康复科,长沙人民路86号410011

出　　处：《中国康复医学杂志》2007年第7期602-604,共3页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:通过对人膝关节后交叉韧带(PCL)及移植物行生物力学测试,探讨韧带张力与屈膝角度和负荷的关系,为临床康复治疗提供理论依据。方法:应用力学实验机对8例新鲜冰冻人膝关节标本进行生物力学实验。在0°、30°、60°、90°、120°五种屈膝角度下,先测量完整PCL在人膝关节未受力和胫骨近端受到100N后向负荷时韧带上纤维的应变变化情况。然后切断PCL,取髌骨-髌腱-胫骨作为移植物行PCL单束纤维重建术,按同样的方法测量膝关节未受力和胫骨近端受到后向负荷时重建韧带上纤维应变。结果:膝关节未受到外力时,在屈曲0°、30°、60°、90°、120°时,正常PCL前外束的应变量分别为0、8.4、8.9、11.7、-3.2με;胫骨上端受到100N后向力量时五种角度下正常PCL前外束的应变量分别为-27.2、9.5、87.5、97.5、-65.6με;PCL单束重建后,膝关节未受到外力时移植物纤维的应变分别为0、10.6、18.6、20.7、-6.5με。胫骨上端受到100N后向力量时,重建移植物的应变量分别为120.7、142.1、203.3、217.1、29.7με。与受力前比较,在各个屈膝角度,差异有显著性意义(P<0.01)。结论:膝关节未受到外力时,PCL几乎没有受到力。膝关节受到后向力量时,移植物张力增加。在0—90°范围内随屈膝角度增加PCL应变逐渐增加,屈膝120°时韧带最松弛。Objective： To study the relations among the knee flexion angles, tensile strength of ligaments and external force by measuring the biomechanics properties of posterior cruciate ligament and graft in human knee to provide theory evidences for rehabilitation therapy in PCL injury. Method： Eight fresh-frozen human knee specimens with intact PCL were tested while there is no external-force applied, then loOn posterior force was applied to the proximal part of tibia, bundle strain were measured as the knee flexion at 0°,30°,60°,90°,120°. After that, PCL was cut and one-bundle PCL reconstruction were done with the patella-patellar tendon-tibia as the graft. Bundle strains was measured with the same way as the knee flexion at different angles without/with external force. Result： While there was no external-force applied, the strain in anterolateral band of normal PCL were 0, 8.4, 8.9, 11.7, -3.2με respectively while the flexion angle were 0°,30°,60°,90°,120°; after one-bundle PCL reconstruction, the strain of the graft fiber were 0, 10.6, 18.6, 20.7, -6.5με correspondently. While loOn posterior force was applied on the upper part of tibia, the strain in anterolateral band of normal PCL were -27.2, 9.5, 87.5, 97.5, -65.6με respectively and the strain of graft after reconstruction were 120.7,142.1,203.3,217.1,29.7με while the flexion angle were 0°,30°,60°,90°,120° correspondently.Conelusion： There is little tension in ligament while no external force is applied on knee joint. The strain of PCL increases corresponding with the increase of flexion angles within 0-90°, but the strain release while flexion angle is 120°. The tension of graft increases while posterior force is applied on knee joint.

关 键 词：后交叉韧带 生物力学 重建 康复 

分 类 号：R687.3[医药卫生—骨科学] R49[医药卫生—外科学]