Q角对髌股关节接触力学的影响

本研究应用染色法和压敏片法,对8例新鲜尸体膝关节在不同Q角和屈膝角度时的髌股接触部位、面积和应力分布进行测试。结果表明:在生理Q角状态下,随着屈膝角度的增大,髌股接触从髌后关节面下极逐渐向上极移行,接触面积也逐渐增大,接触应力呈渐进缓慢增加:并在屈膝80°—90°时出现腱股接触现象,这种现象对保护关节软骨,避免局部软骨压力过高有重要意义。Q角改变后,接触区向内或向外侧偏移,接触面积无明显改变,但接触应力变化显著。作者认为异常的Q角是导致髌股疾病的一个潜在因素,无论是手术矫治还是运动员选材时都应予以重视。

The Effects of Q-angles on the Contact Biomechanics of Patellofemoral Joint

The contact location, contact area and stress distribution of the patellofemoral joint were tested with the Fuji pressure sensitive film and the dyeing method in eight fresh human cadaver knee joints under the states of variety Q-angles and knee flexion angles. The results indicated that, at physiological Q-angles, the patellofemoral contact location moved gradually from inferior pole to superior pole on the retropa-tellar articular surface, the contact area also enlarged with the increase of knee flexion angle, but the contact stress distribution kept uniform. The tendofemoral contact occured after the knee flexion reached 80-90 degree. These phenomena were important in protecting the articular cartilage from being damaged. As Q-angle increased or decreased, the contact location also diverged laterally or medially, the contact area did not change remarkably, but the contact stress distribution became uneven. So the abnormal Q-angles should be thought as one of the potential pathogenic factors to the patellofemoral joint disorders, which should be considered both in the procedure of patella realignment operation and in athletes selection.