CAJ | 학술논문

目的探讨半月板不同部位及不同程度切除后对膝关节胫骨旋转角度的影响.方法取6具新鲜尸体共12个膝关节标本,分为对照组(完整膝关节标本)和实验组,实验组又分为半月板部分切除组(内侧半月板前角切除组、内侧半月板后角切除组、外侧半月板前角切除组)和半月板全切除组(内侧半月板全切除组、外侧半月板全切除组),每组测量4个标本,标本重复使用.应用Staubli机器人模拟生理状态下膝关节站立至下蹲屈膝过程,采用日本Nenicon角度测量仪测量各组标本在膝关节屈曲0～90°过程中胫骨旋转角度的变化. 结果对照组(完整膝关节标本)在膝关节屈曲0、10°、20°、30°、60°、90°时胫骨旋转角度平均分别为4.9°±0.8°、9.2°±0.8°、11.4°±0.8°、12.1°±0.5°、12.4°±0.5°.在膝关节屈曲0～ 90°过程中,半月板部分切除组与对照组、半月板部分切除组之间胫骨旋转角度比较差异均无统计学意义(P＞0.05)；半月板全切除组与半月板部分切除组及半月板全切除组之间胫骨旋转角度比较差异均有统计学意义(P＜0.05).半月板全切除组与对照组在膝关节屈曲0～30°时胫骨旋转角度比较差异有统计学意义(P＜0.05),而在膝关节屈曲30°～90°时比较差异无统计学意义(P＞0.05). 结论半月板部分切除对伴随屈曲运动的胫骨旋转运动形式无明显影响.在膝关节屈曲0～30°过程中,半月板全切除对胫骨旋转角度有明显影响.
목적 탐토반월판불동부위급불동정도절제후대슬관절경골선전각도적영향.방법 취6구신선시체공12개슬관절표본,분위대조조(완정슬관절표본)화실험조,실험조우분위반월판부분절제조(내측반월판전각절제조、내측반월판후각절제조、외측반월판전각절제조)화반월판전절제조(내측반월판전절제조、외측반월판전절제조),매조측량4개표본,표본중복사용.응용Staubli궤기인모의생리상태하슬관절참립지하준굴슬과정,채용일본Nenicon각도측량의측량각조표본재슬관절굴곡0～90°과정중경골선전각도적변화. 결과 대조조(완정슬관절표본)재슬관절굴곡0、10°、20°、30°、60°、90°시경골선전각도평균분별위4.9°±0.8°、9.2°±0.8°、11.4°±0.8°、12.1°±0.5°、12.4°±0.5°.재슬관절굴곡0～ 90°과정중,반월판부분절제조여대조조、반월판부분절제조지간경골선전각도비교차이균무통계학의의(P＞0.05)；반월판전절제조여반월판부분절제조급반월판전절제조지간경골선전각도비교차이균유통계학의의(P＜0.05).반월판전절제조여대조조재슬관절굴곡0～30°시경골선전각도비교차이유통계학의의(P＜0.05),이재슬관절굴곡30°～90°시비교차이무통계학의의(P＞0.05). 결론 반월판부분절제대반수굴곡운동적경골선전운동형식무명현영향.재슬관절굴곡0～30°과정중,반월판전절제대경골선전각도유명현영향.
Objective To investigate the effects of different extents and parts of meniscectomy on tibial rotation of the knee. Methods Six pairs of fresh intact cadavcric knees without surgical history were used in this investigation.They were randomly divided into a control group (group A) and 5 experimental groups (B,C,D,E and F).Group A was for intact control,group B for medial partial meniscectomy of the anterior horn,group C for medial partial meniscectomy of the posterior horn,group D for lateral partial meniscectomy of the anterior horn, group E for total medial meniscectomy and group F for total lateral meniscectomy.For each group 4 specimens were used,for the 4 knees first used in groups A,B and D were then used in groups C,E and F,respectively.The full isokinetic knee cycle from extension to flexion was simulated by a Staubli robot.The tibial rotations were measured by an angle measuring instrument (Nemicon,Japan) before and after different meniscectomies. Results The tibial rotations at the knee flexion of 0°,10°,20°,30°,60° and 90° were respectively 4.9°±0.8°,9.2°±0.8°,11.4°±0.8°,12.1°±0.5°and 12.4°± 0.5° in the control group.The tibial rotations at the knee flexion of 0° to 90° were not significantly different between the control and partial meniscectomy groups and between the partial meniscectomy groups as well ( P ＞ 0.05),but were significantly different between the total meniscectomy groups and the partial meniscectomy groups and between the total meniscectomy groups as well(P ＜0.05).The tibial rotations were not significantly different between the control and total meniscectomy groups at the knee flexion of 30° to 90° ( P ＞ 0.05),but were significantly different between the 2 groups at the knee flexion of 0°to 30°( P ＜ 0.05). Conclusions The partial meniscectomy may not have a significant impact on the tibial rotation when the knee is in flexing motion.The total meniscectomy may have a significant impact on the tibial rotation when the knee is in flexing motion of 30°to 90°.