432 膝关节内侧韧带多平面加载时的韧带参与和原位力

Andrew Pechstein, Paul J. Christos, C. Imhauser
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引用次数: 0

摘要

目的/目标:膝关节内侧韧带(MKL)在膝关节屈曲弧线上的负荷分担情况尚不十分清楚。本研究的目的是描述膝关节内侧副韧带深层和浅层(dMCL、sMCL)以及后斜韧带(POL)在外部施加多平面负荷时的韧带啮合和原位力。方法/研究对象:将 10 个人类尸体膝关节(5 男 5 女,年龄 32±7 (25-42) [平均±SD(范围最小-最大)]岁)安装到力传感器和 6 自由度机械臂上。在对 sMCL、dMCL 和 POL 进行连续解剖之前和之后,在施加孤立外旋、外翻角度和胫骨前力矩时记录 0-30 度的膝关节运动学数据,并通过叠加原理测量每个结构所承受的力(牛顿,N)。将通过配对 t 检验和重复测量方差分析以及 Tukey 后检验,对每个膝关节和每个屈曲角度下的 dMCL、sMCL 和 POL 负荷进行比较。在 p=0.05 的条件下,十个膝关节将提供大于 99% 的力量来检测 5N ± 3% 的差异,这被认为是具有临床意义的力量差异的临界值。结果/预期结果:我们的预期结果包括在膝关节屈曲 0、15 和 30 度时,dMCL、sMCL 和 POL 对外加外翻角度、胫骨外旋和胫骨前向加载的原位力的平均值和标准偏差的特征。我们的统计分析将确定在不同膝关节屈曲角度下,每条韧带内的负荷是否存在有临床意义的差异(5N ± 3%),还将提供每种外力情况下不同韧带相对参与度的数据,这表明在膝关节受力和受扭时,每种结构对膝关节稳定性的贡献百分比。讨论/意义:有关韧带啮合和原位力的数据将帮助临床医生在观察到受伤患者膝关节病理性松弛时更好地诊断潜在的韧带损伤。我们的研究结果还将为未来有关损伤机制、个体解剖变异和手术规划的计算机建模研究提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
432 Ligament Engagement and In-Situ Force During Multiplanar Loading of the Medial Knee Ligaments
OBJECTIVES/GOALS: Load sharing across the arc of knee flexion of the medial knee ligaments (MKLs) is not well understood. The goal of this research is to characterize ligament engagement and in-situ force within the deep and superficial medial collateral ligament (dMCL, sMCL) and the posterior oblique ligament (POL) in response to externally applied multiplanar loads. METHODS/STUDY POPULATION: Ten human cadaveric knees, 5 male and 5 female, age 32±7 (25-42) [mean±SD (range min-max)] years, were mounted to a force sensor and a 6-degree-of-freedom robotic arm. Knee kinematics, before and after serial dissection of the sMCL, dMCL, and POL, were recorded from 0-30 degrees during applied isolated external rotation, valgus angulation, and anterior tibial moments, and the force (Newtons, N) borne by each structure was measured via the principle of superposition. Loads in the dMCL, sMCL, and POL will be compared across each knee and at each flexion angle with paired t-tests and repeated-measures analysis of variance with Tukey post hoc testing. Ten knees will provide >99% power to detect differences of 5N ± 3% at p=0.05, which is considered the threshold for clinically meaningful force differences. RESULTS/ANTICIPATED RESULTS: Our anticipated results include characterization of the means and standard deviations of the in-situ forces within the dMCL, sMCL, and POL in response to externally applied valgus angulation, tibial external rotation, and anterior-directed tibial loading at 0, 15, and 30 degrees of knee flexion. Our statistical analysis will determine if there are clinically meaningful differences (5N ± 3%) in the loads within each ligament at different knee flexion angles and will also provide data regarding differential relative ligament engagement for each applied force scenario, which is an indication of the percentage of contribution that each structure contributes to knee stability during application of forces and torques to the knee. DISCUSSION/SIGNIFICANCE: Data on ligament engagement and in-situ forces will help clinicians better diagnose potentially injured ligaments when they observe pathological knee laxity in an injured patient. Our results will also inform future computer modeling studies on injury mechanisms, individual anatomical variability, and surgical planning.
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