前交叉韧带和外侧半月板损伤及手术干预对胫骨股骨峰值压力大小的影响随屈曲角度的不同而不同

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-08-01 DOI:10.1016/j.asmr.2025.101152

Jackson L. Carver M.A. , Anthony H. Le M.S. , Donald F. Colantonio M.D. , Robert M. Putko M.D. , Daniel L. Rodkey M.D. , Matthew B. Bird Ph.D. , William B. Roach M.D. , Christopher J. Tucker M.D. , Jonathan F. Dickens M.D. , Brad D. Hendershot Ph.D. , Melvin D. Helgeson M.D. , Timothy C. Mauntel Ph.D.

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Pressure magnitudes and locations were measured via submeniscal sensors on the medial and lateral tibial plateaus under 4 conditions (each at 0°, 15°, 30°, 45°, and 60° of knee flexion): native anatomy, first injury (InjPost1), first surgical intervention (SurgPost1), and second surgical intervention (SurgPost2). Linear mixed models compared interactions between group, side, and condition through SurgPost1 and interactions between side and condition for native and SurgPost2 for the magnitude and location of peak pressures.</div></div><div><h3>Results</h3><div>Peak pressure was greater at 0°, 15°, and 30° in the medial compartment than the lateral compartment, regardless of injury condition. For the ACL group, at 0°, peak pressure in the lateral compartment was more posterior than the medial compartment, and at 15°, the meniscus group displayed more posterior peak pressure in the medial compartment than the lateral compartment. 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引用次数: 0

摘要

目的量化前交叉韧带（ACL）和半月板损伤及手术干预后胫股压力峰值的大小和位置的变化。方法对6对匹配的前交叉韧带或外侧半月板损伤的尸体膝关节进行手术干预；标本后来进行了其他损伤和手术干预。伺服液压测试系统在每次干预前后弯曲和拉伸试样100次。通过半月板下传感器测量胫骨内侧和外侧平台在4种情况下（分别为膝关节屈曲0°、15°、30°、45°和60°）的压力大小和位置：原生解剖、首次损伤（InjPost1）、第一次手术干预（SurgPost1）和第二次手术干预（SurgPost2）。线性混合模型通过SurgPost1比较了组、侧和条件之间的相互作用，通过原生和SurgPost2比较了侧和条件之间的相互作用，得出了峰值压力的大小和位置。结果无论损伤情况如何，内侧腔室0°、15°和30°时的开口压力均大于外侧腔室。对于ACL组，在0°时，外侧腔室的峰值压力高于内侧腔室，而在15°时，半月板组内侧腔室的后部峰值压力高于外侧腔室。在15°的位置观察到比原始解剖更大的前峰压。在30°侧腔室中，SurgPost2的峰值压力大于原生压力。对于native和SurgPost2, 15°时内侧腔室的峰值压力大于外侧腔室，60°时外侧腔室的峰值压力大于内侧腔室。结论骶髂韧带与半月板损伤及手术干预导致的前峰压平移相似。维持损伤和手术干预会增加峰值压力值。了解前交叉韧带或外侧半月板损伤和治疗后胫股接触压力峰值的大小和位置变化可能有助于指导治疗决策和康复策略，从而最好地预防膝关节退变。

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Individual and Combined Effects of Anterior Cruciate Ligament and Lateral Meniscus Injuries and Surgical Interventions on Tibiofemoral Peak Pressure Magnitude Vary by Flexion Angle

Purpose

To quantify changes in peak tibiofemoral pressure magnitude and location following anterior cruciate ligament (ACL) and meniscus injuries and surgical interventions after cyclic motion.

Methods

Six matched pairs of cadaveric knees underwent ACL or lateral meniscus injury and surgical intervention; specimens later underwent the other injury and surgical intervention. A servohydraulic testing system flexed and extended specimens 100 times before and following each intervention. Pressure magnitudes and locations were measured via submeniscal sensors on the medial and lateral tibial plateaus under 4 conditions (each at 0°, 15°, 30°, 45°, and 60° of knee flexion): native anatomy, first injury (InjPost1), first surgical intervention (SurgPost1), and second surgical intervention (SurgPost2). Linear mixed models compared interactions between group, side, and condition through SurgPost1 and interactions between side and condition for native and SurgPost2 for the magnitude and location of peak pressures.

Results

Peak pressure was greater at 0°, 15°, and 30° in the medial compartment than the lateral compartment, regardless of injury condition. For the ACL group, at 0°, peak pressure in the lateral compartment was more posterior than the medial compartment, and at 15°, the meniscus group displayed more posterior peak pressure in the medial compartment than the lateral compartment. Greater anterior peak pressure was observed at 15° in SurgPost1 than native anatomy. Peak pressure was greater in SurgPost2 than native in the lateral compartment at 30°. For native and SurgPost2, peak pressure was greater in the medial compartment than the lateral compartment at 15° and greater in the lateral compartment than the medial compartment at 60°.

Conclusions

ACL and meniscus injuries and surgical interventions result in similar anterior peak pressure translation. Sustaining both injuries and surgical interventions increases peak pressure magnitude.

Clinical Relevance

Understanding how peak tibiofemoral contact pressures change in magnitude and location following an ACL or lateral meniscus injury and treatment may help guide treatment decisions and rehabilitation strategies that best prevent knee joint degeneration.

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