对女子手球运动员膝关节屈伸肌群进行等速测试

目的对广东省女子手球队运动员膝关节进行等速向心测试,探讨手球项目运动员膝关节屈伸肌群等速测试特征,为手球项目运动员的力量训练和相关的体育科研提供参考。方法运用CON-TREX等速测试系统对14名广东省女子手球运动员的膝关节进行等速向心测试,选取相对峰力矩、屈伸肌峰力矩比值、平均功率、总功和疲劳指数5个指标来研究手球项目运动员膝关节屈伸肌群的等速测试特征。选取独立样本t检验比较屈肌和伸肌的测试结果。结果膝关节伸肌相对峰力矩值在慢速测试(60°/s)和快速测试(240°/s)时均明显大于屈肌(P<0.01);女手队员膝关节屈伸肌峰力矩比值在快速测试(240°/s)时为76%左右;膝关节屈伸肌平均功率和总功在慢速测试(60°/s)时表现为伸肌大于屈肌(P<0.01),在快速测试(240°/s)时表现为左膝关节伸肌大于屈肌(P<0.05);女手队员膝关节屈伸肌疲劳指数范围在0～0.49之间。结论女手队员膝关节伸肌的最大力量和快速力量大于屈肌;女手队员膝关节屈伸肌峰力矩比值在快速测试(240°/s)时略微偏低,说明女手队员膝关节屈肌快速力量偏低;女手队员膝关节伸肌的快速力量和肌肉工作能力均大于屈肌;女手队员膝关节屈伸肌疲劳指数偏低,说明女手队员膝关节屈伸肌的力量耐力水平比较低。     

女子曲棍球运动员膝关节屈伸肌群等速测试与分析

背景：等速测试系统已广泛应用来评价不同项目运动员关节肌群的力量特征。 目的：测试广东省女子曲棍球运动员的膝关节进行等速向心,观察曲棍球项目运动员膝关节屈伸肌群的等速向心测试力量特征。 方法：运用CON-TREX等速测试系统对广东省14名现役女子曲棍球运动员的膝关节进行等速向心测试。检测指标为相对峰力矩、关节肌群屈伸肌峰力矩比值、平均功率、总功和疲劳指数。 结果与结论：在60 (°/s)慢速测试时,女子曲棍球队员的两侧膝关节肌群相对峰力矩值表现为伸肌大于屈肌(P < 0.01);左膝关节屈伸肌峰力矩比值在3种不同测试速度下的范围为66%~77%,右膝关节屈伸肌峰力矩比值为82%~88%;左膝关节伸肌平均功率值均大于屈肌(P < 0.01);左右膝关节伸肌的总功值均大于屈肌(P < 0.01);膝关节屈伸肌疲劳指数范围在0.24~0.48之间。膝关节伸肌的最大力量大于屈肌,屈伸肌峰力矩比值在240 (°/s)快速测试时略微偏低,而右膝关节屈伸肌峰力矩比值在慢速测试时偏高,说明女子曲棍球队员左膝关节屈肌快速力量偏低,右膝关节伸肌最大力量比较低,伸肌的快速力量大于屈肌,伸肌的工作能力强于屈肌,屈伸肌的力量耐力水平比较低。     

膝关节封闭实验在膝关节骨性关节炎微创术治疗中的应用价值

目的　探讨膝关节封闭实验在膝关节骨性关节炎（KOA）微创术治疗中的应用价值。 方法　回顾分析71例行微创治疗的KOA患者的临床资料，根据术前封闭治疗效果分为有效组和无效组，比较两组治疗不同时期VAS评分，观察两组临床疗效，分析两组术后肢体肿胀、关节活动功能及生活质量评分（SF-36）差异。 结果　封闭有效组患者封闭后及微创术后1个月VAS评分均显著低于无效组，P＜0.05。有效组患者治疗总有效率、关节Lysholm评分及SF-36评分均优于无效组，P＜0.05。有效组关节肿胀度小于无效组，P＜0.05。有效组患者封闭指数与关节肿胀度呈负相关，与Lysholm评分及SF-36评分均呈正相关，P＜0.05。 结论　有效的膝关节封闭能够提高KOA患者行微创手术的临床疗效，降低疼痛程度，改善关节功能及患者术后生活质量。     

膝关节封闭实验在膝关节骨性关节炎微创术治疗中的应用价值

目的　探讨膝关节封闭实验在膝关节骨性关节炎（KOA）微创术治疗中的应用价值。 方法　回顾分析71例行微创治疗的KOA患者的临床资料,根据术前封闭治疗效果分为有效组和无效组,比较两组治疗不同时期VAS评分,观察两组临床疗效,分析两组术后肢体肿胀、关节活动功能及生活质量评分（SF-36）差异。 结果　封闭有效组患者封闭后及微创术后1个月VAS评分均显著低于无效组,P＜0.05。有效组患者治疗总有效率、关节Lysholm评分及SF-36评分均优于无效组,P＜0.05。有效组关节肿胀度小于无效组,P＜0.05。有效组患者封闭指数与关节肿胀度呈负相关,与Lysholm评分及SF-36评分均呈正相关,P＜0.05。 结论　有效的膝关节封闭能够提高KOA患者行微创手术的临床疗效,降低疼痛程度,改善关节功能及患者术后生活质量。     

等速肌力测试膝、踝关节及腰背肌力量的评价

背景：等速肌力测试已普遍用来作为运动员肌肉系统的机能状态和运动损伤的治疗效果评定的一种客观指标。 目的：探讨作为足球运动专项肌群的腰背肌、膝关节以及踝关节肌力特征。 方法：运用Cybex-Norm等速肌力测试与训练系统评价足球运动员在不同角速度下的膝、踝关节及腰背肌群屈伸肌峰力矩、相对峰力矩以及耐力水平。 结果与结论：运动员膝、踝关节左右两侧肌力发展较为均衡(< 5%),膝关节伸肌峰力矩和相对峰力矩偏低,屈肌峰力矩和相对峰力矩偏高,左侧膝关节表现尤为突出,不利于比赛时有效地控球、踢球和纵跳等动作的完成;腰背肌群相对峰力矩值相对较弱,容易在运动过程中发生损伤,引起下背痛类疾病;膝、踝关节以及腰背肌群的速度耐力水平均有较大提高空间。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

一期双膝关节与单膝关节置换的早期评价

背景：膝关节置换一期双侧置换还是单膝分期置换一直存在着争议。 目的：评价双膝关节疾病患者一期双侧全膝关节置换与选择性单侧全膝关节置换后早期临床疗效及SF-36健康问卷调查差异。 方法：初次行全膝关节置换的患者144例190膝,均采用施乐辉公司假体行一期双膝全膝关节置换(双膝组)及一期选择性单膝全膝关节置换(单膝组)。观察患者膝关节置换前后活动范围 、HSS 评分及疼痛评分、置换后并发症及置换后SF-36量表调查结果。 结果与结论：随访1年,9例失访,135例进入结果分析。膝关节置换后双膝组1例发生一过性腓总神经麻痹,1例获得性免疫缺陷综合征,1例发生切口愈合不良;单膝组发生2例切口愈合不良。膝关节置换后1年,SF-36 量表调查,两组除生理职能比较差异有显著性意义(P < 0.05) 外,其余7方面比较差异均无显著性意义(P > 0.05);两组活动范围比较差异无显著性意义(P > 0.05);两组HSS 评分比较差异无显著性意义(P > 0.05);双膝组疼痛评分显著低于单膝组(P < 0.05)。结果证实,双膝组膝关节置换后早期在疼痛评分方面优于单膝组,但SF-36 量表评价、HSS膝关节功能评分及关节活动范围等方面较单膝组无明显优势。     

A knee joint implant

Priorov Central Scientific-Research Institute for Traumatology and Orthopedics (TsITO), Russian Ministry of Health and Medical Industry, Moscow. Translated from Meditsinskaya Tekhnika, No. 6, pp. 33–35, November–December, 1995.     

Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee

OBJECTIVES:

To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA) and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA.

METHODS:

25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test.

RESULTS:

The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function.

CONCLUSIONS:

Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found.     

小学生膝关节屈伸肌力的等速测试

背景：以往对小学生下肢力量发育的评估,主要局限于立定跳远和纵跳摸高等身体素质的测量,缺乏对其肌肉功能的定量性研究。 目的：通过小学生膝关节屈伸肌力发展现状进行测试分析,正确认识小学生关节肌肉力量发育特征。 方法：运用“Kinitech”等速肌力测试系统对随机抽取石家庄市年龄为9~12岁的54名健康小学生(男25例、女29例)膝关节屈伸肌群进行60,120,240 (°)/s三种速度测试。 结果与结论：小学生膝关节屈、伸肌群峰力矩均呈现随测试速度增加而下降的现象;男、女生左侧屈肌群在60,120 (°)/s时及右侧屈肌群在60 (°)/s时,峰力矩低于伸肌群峰力矩(P < 0.01或P < 0.05)。同一测试速度下,在测试速度为240 (°)/s时,男生左侧屈、伸肌群及右侧屈肌群峰力矩明显高于女生(P < 0.01或P < 0.05)。     

Dynamics of spastic knee joint

Goniometric records of a swinging lower leg (pendulum test) provide useful information in assessing the level of hypertonia in normals, spinal cord injured (SCI) patients and hemiparetic patients. A linearised second-order dynamic model without forcing function is proposed for a normal and hypotonic paraplegic leg Forces which appear in the quadriceps muscle in spastic patients are simulated with hypertonia torquest T_h. A combined biomechanical and neural model is proposed to facilitate qualitative discussion of the observed phenomena. Large variability of goniograms in spastic patients as well as lack of detailed knowledge regarding the neurophysiology of spasticity prevents further development of realistic models which should be time varying and nonlinear.     

Sonoelastography of the knee joint

Magnetic resonance imaging (MRI) is generally the preferred method for assessing lesions of the knee cartilage and subchondral bone. There have been a few cartilage imaging studies using real‐time elastosonography (RTE), which has increased in importance and range of use in recent years. The aim of this cadaveric study was to assess the efficacy of a new diagnostic method combining USG and RTE and also to perform intra‐articular examinations together with arthroscopy. A total of 12 fresh unpaired human knees were examined. The laparoscopic ultrasound transducer was deployed using standard anteromedial and anterolateral arthroscopic portals. Iatrogenic defects were examined using mosaicplasty tools in healthy‐looking areas of cartilage, and strain in those areas was measured using RTE. The median strain value of the pathological femoral cartilage region was significantly higher than that of the normal cartilage region (1.23 [0.71–2.24] vs. 0.01 [0.01–0.01], P = 0.002, respectively). Arthroscopic study of cartilage using RTE can be a guide for orthopedic surgeons and use of intra‐articular probes could be universalized. Clin. Anat. 32:99–104, 2019. © 2018 Wiley Periodicals, Inc.     

Assessments of loads in the knee joint

A method of gait analysis was used to estimate the loads in the knee joint. An analysis was made of the repeatability of the measurements for a group of 72 patients. Data from 418 patients were reviewed to show the variation with coronal angle of the knee of the loading.     

膝关节形态学测量在人工膝关节置换领域的价值及意义

背景：对人工膝关节假体形态尺寸进行观察及测量,并对相关测量统计数据进行人工膝关节形态设计,有利于促进膝关节假体植入后的稳定性和组织相容性。 目的：结合文献探讨形态学测量在临床上膝关节置换中的重要性。 方法：以 “膝关节;假体;测量;设计;置换”为中文关键词,以“artificial knee joint; prosthesis;measure;design;replacement” 为英文关键词。采用计算机检索1998-01/2011-12有关人工膝关节假体设计、测量及膝关节假体植入后相容性的文章。 结果与结论：膝关节的形态学测量即膝关节的三维有限元模型、相关参数及角度、生物力学研究与膝关节假体选择及设计有着重要相关性。膝关节的形态测量有二维和三维测量,以三维测量法精确。膝关节线性尺寸之间、身高与线性尺寸之间均有很好的相关性,所测量的数据在临床上均有应用意义。典型的膝关节三维解剖模型,能为膝关节参数的测量提供一种可靠的方法,提高手术的成功。     

Development of the human knee joint

ABSTRACT Background: Many studies have been published on the development of the human knee joint, but different investigators disagree on its morphogenetic time table. Most discrepancies center on the cavitation of the knee joint and the participation of the superior tibiofibular joint in the joint knee system. Methods: We summarize our observations of the development of the knee joint in 50 serially sectioned human embryonic and fetal lower limbs (26 embryos and 24 fetuses). Results: The epiphysis of the femur and tibia become condryfied from O'Rahilly stage 18, and ossification begins during the 13th week of development. The patella appears as a dense blastema during O'Rahilly stage 19, becomes condryfied during O'Rahilly stage 22, and begins its ossification during the 14th week of development. The knee joint cavity appears during O'Rahilly stage 22, initially as the femoropatellar joint. This process begins at the periphery of the articular interzone. The superior tibiofibular joint communicates with the lateral meniscotibial joint between 10 and 11 weeks of development and becomes separated from the 13 week on. The menisci arise from the eccentric portions of the articular interzone during O'Rahilly stage 22; however, until week 9 of development, they are not easily distinguishable. Conclusions: We establish the morphogenetic time table of the human knee joint. Anat. Rec. 248:269-278, 1997. © 1997 Wiley-Liss, Inc.     

Influence of hysteresis on joint position sense in the human knee joint

During muscle lengthening in a movement cycle the firing rate of muscle spindles is higher than during shortening. This phenomenon, known as hysteresis, has implications for movement control. Therefore, it should have an impact on joint position sense (JPS), the subject's awareness of the static position of a joint. JPS has been tested on the human knee joint by means of an angle reproduction test. This task included the following sequences. The leg was moved passively, by means of a motor drive, from two different start positions (15 degrees and 75 degrees) to a certain target angle and, after a time of 8 s, it was returned to the start position; subjects had to reproduce the former target angle. Several target angles, mild flexion (30 degrees), intermediate flexion (45 degrees), and strong flexion (60 degrees), were used. Depending on the start position, the movements matching these targets were flexions or extensions. At least for the intermediate position different threshold values should be expected for flexions and extensions, if hysteresis has an impact. Moreover, the JPS measure should show a dependence on movement velocity and independence on distance. Of the variables tested, only movement direction but not movement velocity or distance had a statistically significant impact on the dependent constant angle error (difference between reproduction and target angle). The target angle of 30 degrees was exactly reproduced (-0.14 degrees), independently of the start position. The 45 degrees target angle was significantly underestimated (-4.39 degrees) when matching that position by flexions (starting at 15 degrees) compared to an overestimation (2.27 degrees) when matching that position by extensions (starting at 75 degrees). The target angle of 60 degrees has been constantly underestimated (-3.80 degrees), independently of the start position. Therefore, hysteresis, the dependency of the movement's direction, neglected in the past, should be considered in future tests of JPS or studies considering the role of movement parameters for motor control.