后十字韧带完整性对股骨内髁生物力学特性的影响  

Effect of PCL integrity on biomechanical features of the medial femoral condyle

作　　者：高曙光[1] 李康华[1] 雷光华[1] 李宇晟[1] 俞芳[1] 赵瑞波[1] 章灿[1] 徐迈[1] 姜未[1] 

机构地区：[1]中南大学湘雅医院骨科,长沙410008

出　　处：《中华骨科杂志》2011年第8期897-903,共7页Chinese Journal of Orthopaedics

基　　金：湖南省博士生科研创新项目（编号：CX20108102）

摘　　要：目的探讨后十字韧带（posterior cruciate ligament，PCL）及其各分束的生物力学功能，以及PCL完整性对股骨内髁生物力学特性的影响。方法12具新鲜成人尸体膝关节标本在不同轴向载荷（0-800N）和不同屈曲角度（膝关节屈曲0°、30°、60°和90°）进行生物力学测试。依PCL完整、前外侧束（anterol ateral bundle，ALB）切断、后内侧束（posteromedial bundle，PMB）切断和PCL完全切断顺序进行生物力学测试，分别测量加载后股骨内髁中部的应变。结果0°位，各级载荷下PMB切断和PCL完全切断均引起股骨内髁应变增加，ALB切断对股骨内髁应变无明显影响，且在各级载荷下PCL完全切断组股骨内髁的应变绝对值较PMB切断组无明显增加。30°、60°和90°位，大载荷下ALB切断和各级载荷下PCL完全切断均引起股骨内髁应变增加，小载荷下ALB切断和各级载荷下PMB切断对股骨内髁应变无明显影响，且大部分载荷下PCL完全切断组股骨内髁的应变绝对值较ALB切断组明显增加。结论在膝关节屈伸过程中ALB和PMB均有一定的稳定作用，伸直位PMB对稳定起绝大部分作用，而屈曲位ALB对稳定起大部分作用，且PCL部分或完全断裂在屈伸过程中对股骨内髁均可产生不良的毕物力学影响．Objective To explore the biomechanical function of PCL and its different bundles and examine the biomechanieal impact of posterior cruciate ligament （PCL） integrity on the medial femoral condyle. Methods Twelve fresh human cadaverie knee specimens were subjected to different axial load （0-800N） at 0°, 30°, 60°, and 90°of knee flexion. Four surgical treatments were carried out for biomechanieal testing： PCL intact, anterolateral bundle （ALB） rupture, posteromedial bundle （PMB） rupture and PCL rup- ture. During the test, strains of middle part of the medial femoral condyle were calculated. Results At 0° knee flexion, increasing strain of the medial femoral condyle was detected in PMB rupture and PCL rupture under all loading conditions. No significant difference of strain of the medial femoral condyle was noted be- tween PCL intact and ALB rupture under any loading conditions. Compared to PMB rupture, PCL rupture had not higher strain of the medial femoral condyle under all loading conditions. At 30°, 60° and 90° knee flexion, increasing strain of the medial femoral condyle was noted in ALB rupture under higher loading con- ditions and PCL rupture under all loading conditions. ALB rupture under lower loading conditions and PMB rupture under all loading conditions did not significantly increased strain of the medial femoral condyle. PCL rupture had higher strain of the medial femoral condyle than ALB rupture under most of loading conditions. Conclusion The data suggest that PMB is the major stabilizing bundle of PCL in full extension, ALB is the major stabilizing bundle of PCL in knee flexion, and both bundles function through the ROM in a codomi- nant fashion. Partial and complete ruptures of PCL may have hazardous biomechanical impacts on the medial femoral condyle during normal movement.

关 键 词：后交叉韧带 破裂 生物力学 

分 类 号：R687.3[医药卫生—骨科学]