胫骨旋转对髌股关节应力分布的影响

目的探明胫骨旋转状态对髌股关节应力分布的影响。方法选取7个新鲜离体膝关节，在屈膝30°、60°、90°状态下，分别用压敏片测量胫骨中立位、内旋10°、20°、30°和外旋10°、20°、30°时的内、外侧髌股关节接触压力与峰值。结果外旋过程中，外侧髌股关节的接触压均值和接触压峰值呈非线性递增趋势，内侧呈非线性递减趋势；内旋过程中，外侧髌股关节的接触压均值和峰值逐渐减小，内侧则增加显著。上述变化在内旋20°到外旋20°的范围内较有规律。结论胫骨旋转畸形使髌股关节应力分布严重失衡，可能是引起髌股关节退变的重要因素。

AN EXPERIMENTAL STUDY OF TIBIAL MALROTATION ON THE CONTACT PRESSURE DISTRIBUTION OF PATELLOFEMORAL

To investigate the pathogenesis of patellofemoral degenerative arthrosis caused by tibial malrotation. Seven human knee joints from 7 fresh cadavers were used in vitro to test the contact pressure and the peak Pressure with Fuji Pressure sensitive film in the conditions of normal status, 10°, 20°, 30° both external tibial rotation and internal tibial rotation under the isometric tension of 196 N attached to the quadriceps tendon for 30°, 60° and 90° knee flexion. Results showed that the increase of the degree of external tibial rotation resulted in a nonlinear incline up in patellofemoral contact pressure on the lateral facet of patellar, while a nonlinear decline on the medial facet. However, the internal tibial rotation resulted in gradual decreasing of contact pressure on lateral facet and marked increasing on medial facet. These changes were regular during the range of 20° external rotation to 20° internal rotation. All of these prompted that tibial malrotation might bring out the patellofemoral degenerative althrosis by serious disorder of contact pressure distribution.