股四头肌对髌股关节影响的临床和实验观察

目的　从临床和实验二个方面研究股四头肌对髌股关节运动的影响。方法　对一组 2 6例 5 2膝患者进行动力性CT检查 ,了解股四头肌收缩状态对髌股关节排列的影响 ;对一组标本进行生物力学实验 ,用压敏片技术直观地测得股四头肌肌力变化对髌股关节接触压力的影响。结果　静力性CT检查发现有 12膝髌骨半脱位和 14膝髌骨外倾 ,其余病例动力性CT检查又发现有 2 1膝在股四头肌收缩状态下髌骨半脱位 ,9膝髌骨外倾。力学实验中发现随股内侧肌肌力下降髌股接触面趋向外侧。结论　股四头肌各肌组的肌力不平衡对髌股关节的接触压力及髌骨位置有较大的影响 ,临床上应重视对股四头肌肌力的恢复。

Clinical and Experimental Observation on the Effect of Quadriceps on Patellofemoral Joint

Objective To observe the effect of quadriceps on the patellofemoral motion in clinical and experimental aspects Methods The measurements of 26 cases with (52 knees) were obtained from dynamic CT scanning for understanding the effect of contraction of the quadriceps on the patellofemoral alignment A series of human knees specimens were studied with the biomechanical test Using the pressure measuring film technique the intra-articular pressure of patellofemoral joint could be directly measured with the influence of quadriceps forces Results The static CT images showed that there were 12 knees with the patellar lateral subluxation and 14 knees with patellar lateral tilt Among the remaining cases,there were 21 knees with the dynamic patellar subluxation and 9 knees with dynamic patellar tilt during the CT scanning with the contraction of quadriceps In the test,the contact of patellar tilt during the CT scanning with the lateral facet with the force of the vastus medialis strength descending Conclusion The unbalanced quadriceps forces may influence the patellar stability,the normal contact and pressure distribution of the patellofemoral joint The rehabilitation of the quadriceps forces should be paid more attention