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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Analysis of Internal Knee Forces Allows for the Prediction of Rupture Events in a Clinically Relevant Model of Anterior Cruciate Ligament Injuries
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Analysis of Internal Knee Forces Allows for the Prediction of Rupture Events in a Clinically Relevant Model of Anterior Cruciate Ligament Injuries

机译：内部膝部力分析允许预测临床相关模型在临床相关模型中的临床相关模型

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Background: A recently developed mechanical impact simulator induced an anterior cruciate ligament (ACL) rupture via the application of a combination of inverse dynamics–based knee abduction moment (KAM), anterior tibial shear force (ATS), and internal tibial rotation moment with impulsive compression in a cohort of cadaveric limbs. However, there remains an opportunity to further define the interaction of internal forces and moments at the knee and their respective influence on injury events. Purpose: To identify the influence of internal knee loads on an ACL injury event using a cadaveric impact simulator. Study Design: Controlled laboratory study. Methods: Drop-landing simulations were performed and analyzed on 30 fresh-frozen cadaveric knees with a validated mechanical impact simulator. Internal forces and moments at the knee joint center were calculated using data from a 6-axis load cell recorded on the femur during testing. Kinetic data from a total of 1083 trials that included 30 ACL injury trials were used as inputs for principal component (PC) analysis to identify the most critical features of loading waveforms. Logistic regression analysis with a stepwise selection was used to select the PCs that predicted an ACL injury. Injurious waveforms were reconstructed with selected PCs in logistic regression analysis. Results: A total of 3 PCs were selected in logistic regression analysis that developed a significant model ( P & .001). The external loading of KAM was highly correlated with PC1 (ρ & –0.8; P & .001), which explained the majority (&69%) of the injurious waveforms reconstructed with the 3 selected PCs. The injurious waveforms demonstrated a larger internal knee adduction moment and lateral tibial force. After the ACL was ruptured, decreased posterior tibial force was observed in injury trials. Conclusion: These findings give us a better understanding of ACL injury mechanisms using 6-axis kinetics from an in vitro simulator. An ACL rupture was correlated with an internal knee adduction moment (external KAM) and was augmented by ATS and lateral tibial force induced by an impact, which distorted the ACL insertion orientation. Clinical Relevance: The ACL injury mechanism explained in this study may help target injury prevention programs to decrease injurious knee loading (KAM, ATS, and lateral tibial force) during landing tasks.
机译：背景：最近开发的机械冲击模拟器通过应用逆动力学的膝关节时刻（kam），前胫骨剪切力（ATS）和内部胫骨旋转力矩的应用诱导前十字韧带（ACL）破裂。压缩尸体肢体队列。然而，仍然有机会进一步确定内部力和膝关节时刻的相互作用及其对损伤事件的各自影响。目的：使用尸体冲击模拟器识别内部膝盖载荷对ACL损伤事件的影响。研究设计：受控实验室研究。方法：用经过验证的机械冲击模拟器对30个新鲜冷冻的尸体膝盖进行下降落地模拟。膝关节中心的内部力和瞬间使用来自在测试期间股骨上的6轴称重传感器的数据计算。来自总共1083项试验的动力学数据包括30 ACL损伤试验的试验被用作主成分（PC）分析的输入，以确定加载波形的最关键的特征。使用逐步选择的Logistic回归分析用于选择预测ACL损伤的PC。在Logistic回归分析中重建有害波形。结果：在逻辑回归分析中选择总共3个PC，其开发出显着的模型（P＆ .001）。 KAM的外部负载与PC1（ρ-.0.8; P＆）高度相关，这解释了与3所选择的PC重建的大多数（＆ 69％）的有害波形。有害波形展示了更大的内部膝盖内部瞬间和侧胫骨力。在ACL破裂后，在损伤试验中观察到后胫骨力下降。结论：这些调查结果让我们通过来自体外模拟器的6轴动力学更好地了解ACL损伤机制。 ACL破裂与内部膝关节内容（外部KAM）相关，并且通过抗冲击的ATS和横向胫骨力增强，这使得ACL插入取向变形。临床相关性：本研究中解释的ACL损伤机制可能有助于瞄准预防计划，以减少着陆任务期间减少有害的膝关节荷载（KAM，ATS和侧胫势）。

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