膝後外側支持機構の再建術における再建靭帯の Isometricity の検討  [in Japanese] Ligamentous Isometry Assessment in the Posterolateral Aspect of the Knee  [in Japanese]

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Abstract

靭帯再建において, 再建靭帯の固定部位は術後成績を左右する重要な要因の1つである。膝関節後外側支持機構の陳旧損傷に対し, 種々の再建術が報告されているが, その靭帯の固定部位に関しては詳細な研究は報告されていない。そこで, 再建靭帯の大腿骨側固定部位を検討するため, 新鮮凍結膝を用いて, 腓骨頭上の参照点 (腓骨頭の前, 後縁, 及び外側側副靭帯付着部の3点) からみた大腿骨外顆の Isometry Map を作成した。また, 膝の伸展運動に伴う, 靭帯の長さ変化パターンを調べた。靭帯の長さ変化の少ない領域は, 前後方向に細長く分布し, 参照点の前後方向の移動により, 傾きが変化した。全く長さの変化しない点 (isometric Point) は存在しなかった。同領域を境に, 靭帯の長さ変化パターンが異なっていた。大腿骨外顆の近位後方では, 靭帯の長さは膝屈曲位で短く, 伸展するに伴い長くなるパターンを示した。

Graft attachment location is one of the important factors which affects the results of ligament reconstruction. However, reconstruction for the posterolateral structures of the knee is usually performed without the detailed information of ligamentous isometricity. In this cadaveric study, length changes between possible graft attachment sites were measured in a reconstructive procedure for the posterolateral structures of the knee. The three dementional knee motion during active knee extension was recorded and the bony surface was degitized using magnetic position sensor. The ligamentous isometry map for the lateral femoral condyle was constructed. The most isometric area was found to locate at a few milimeter anterior-distal to the lateral femoral epicondyle. The graft length change pattern during knee motion was found to vary depending upon the femoral attachment site. With the femoral attachment site located more posterior-proximal to the most isometric area, the graft length showed physiologic tension pattern, where the graft becomes loose with knee flexion and tight with knee extension.

Journal

Medical journal of Kobe University   [List of Volumes]

Medical journal of Kobe University 61(1・2・3), 21-26, 2000-12-20  [Table of Contents]

Kobe University

Codes

  • NII Article ID (NAID) :
    110004652927
  • NII NACSIS-CAT ID (NCID) :
    AN00085973
  • Text Lang :
    JPN
  • ISSN :
    00756431
  • Databases :
    NII-ELS