半月板不同切除术对膝关节胫骨旋转角度的影响  

Effects of different meniscectomies on tibial rotation of the knee

作　　者：孙辉[1] 白波[2] 廖壮文[2] 陈艺[2] 张妹江[2] 

机构地区：[1]南方医科大学附属南海市人民医院,广东省佛山市528200 [2]广州医学院第一附属医院骨科

出　　处：《中华创伤骨科杂志》2012年第5期429-432,共4页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（30570458）;广东省骨科矫形技术及植入材料承点实验室建设基金（20071075）

摘　　要：目的探讨半月板不同部位及不同程度切除后对膝关节胫骨旋转角度的影响。方法取6具新鲜尸体共12个膝关节标本，分为对照组（完整膝关节标本）和实验组，实验组又分为半月板部分切除组（内侧半月板前角切除组、内侧半月板后切除组、外侧半月板前角切除组）和半月板全切除组（内侧半月板全切除组、外侧半月板全切除组），每组测量4个标本，标本重复使用。应用Staubli机器人模拟生理状态下膝关节站立至下蹲屈膝过程，采用日本Nenicon角度测量仪测量各组标本在膝关节屈曲0～90°过程中胫骨旋转角度的变化。结果对照组（完整膝关节标本）在膝关节屈曲0、10°、20°、30°、60°、90°时胫骨旋转角度平均分别为4．9°±0．8°、9．2°±0．8°、11．4°±0．8°、12．1°±0．5°、12．4°±0．5°。在膝关节屈曲0～90°过程中，半月板部分切除组与对照组、半月板部分切除组之间胫骨旋转角度比较差异均无统计学意义（P〉0．05）；半月板全切除组与半月板部分切除组及半月板金切除组之间胫骨旋转角度比较差异均有统计学意义（P〈0．05）。半月板全切除组与对照组在膝关节屈曲0—30°时胫骨旋转们度比较差异有统计学意义（P〈0．05），而在膝关节屈曲30°～90°时比较差异无统计学意义（P〉0．05）。结论半月板部分切除对伴随屈曲运动的胫骨旋转运动形式无明显影响。但膝关节屈曲0～30°过程中，半月板全切除对胫骨旋转角度有明显影响。Objective To investigate the effects of different extents and parts of meniseeetomy on Methods Six pairs of fresh intact eadaverie knees without surgical history were used in this investigation. They were randomly divided into a enntrol group （group A） and 5 experimental groups （B, C, D, E and F）. Group A was tor intact control, group B for medial partial menisceetomy of the anterior horn, group C for medial partial menisceetomy of the posterior horn, group D for lateral partial menisceetomy of the anterior horn, group E for total medial meniscectomy and group F for total lateral menisceetomy. For each group 4 speeimens were used, for the 4 knees first used in groups A, B and D were then used in groups C. E and F, respectively. The full isokinetie knee cycle from extension to flexion was simulated by a Staubli robot. The tibial rntations were measured by an angle measnring instrument （Nemieon, Japan） before and after different meniscectomies. Results The tibial rotations at the knee flexion of 0°, 10°, 20°, 30°, 60° and 90° were respectively 4. 9°±0.8°, 9.2°±0.8°, 11.4°±0.8°, 12.1 °±0.5° and 12.4°±0. 5° in the control group. The tibial rotations at the knee flexion of 0° to 90° were not significantly different between the control and partial meniseeetomy groups and between the partial meniseectomy groups as well （ P 〉 0. 05）, but were significantly different between the total meniscectomy groups and the partial meniseeetomy groups and between the total meniseectomy groups as well（ P 〈0. 05）. The tibial rotations were not signifieantly different between the control and total meniscectomy groups at the knee flexion of 30° to 90° （ P 〉 0. 05）, but were significantly different between the 2 groups at the knee flexion of 0° to 30° （ P 〈 0.05） . Conclusions The partial meniseeetomy may not have a sign i ficant impact on the tibial rotation when the knee is in flexingmotiotion. The total meniscectomy may have a significant impact on the tibial rotation when

关 键 词：膝关节 半月板 胫骨 生物力学 旋转 

分 类 号：R687.4[医药卫生—骨科学]