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The CFL fails before the ATFL immediately after combined ligament repair in a biomechanical cadaveric model.

生物力学尸体模型中联合韧带修复后即刻ATFL前CFL失效。

  • 影响因子:3.28
  • DOI:10.1007/s00167-019-05626-9
  • 作者列表:"D'Hooghe P","Pereira H","Kelley J","Anderson N","Fuld R","Kumparatana P","Baldini T","Hunt KJ
  • 发表时间:2020-01-01
Abstract

PURPOSE:To assess the impact on ankle stability after repairing the ATFL alone compared to repairing both the ATFL and CFL in a biomechanical cadaver model. METHODS:Ten matched pairs of intact, fresh frozen human cadaver ankles (normal) were mounted to a test machine in 20.0° plantar flexion and 15.0° of internal rotation. Each ankle was loaded to body weight and then tested from 0.0° to 20.0° of inversion. The data recorded were torque at 20.0° and stiffness, peak pressure and contact area in the ankle joint using a Tekscan sensor, rotation of the talus and calcaneus, and translation of the calcaneus using a three-dimensional motion capture system. Ankles then underwent sectioning of the ATFL and CFL (injured), retested, then randomly assigned to ATFL-only Broström repair or combined ATFL and CFL repair. Testing was repeated after repair then loaded in inversion to failure (LTF). RESULTS:The stiffness of the ankle was not significantly increased compared to the injured condition by repairing the ATFL only (n.s.) or the ATFL/CFL (n.s.). The calcaneus had significantly more rotation than the injured condition in the ATFL-only repair (p = 0.037) but not in the ATFL/CFL repair (n.s.). The ATFL failed at 40.3% higher torque than the CFL, at 17.4 ± 7.0 N m and 12.4 ± 4.1 N m, respectively, and 62.0% more rotation, at 43.9 ± 5.6° and 27.1 ± 6.8°, respectively. CONCLUSIONS:There was a greater increase in stiffness following combined ATFL/CFL repair compared to ATFL-only repair, although this did not reach statistical significance. The CFL fails before the ATFL, potentially indicating its vulnerability immediately following repair. LEVEL OF EVIDENCE:III, case-control therapeutic study.

摘要

目的: 在生物力学尸体模型中,与修复ATFL和CFL相比,评估单独修复ATFL后对踝关节稳定性的影响。 方法: 十个配对的完好,新鲜冰冻人尸体脚踝 (正常) 被安装到test机器在 20.0 ° 跖屈和 15.0 ° 的旋转.每个脚踝加载到体重,然后从 0.0 ° 到 20.0 ° 倒置进行测试。记录的数据是使用Tekscan传感器的踝关节中的 20.0 ° 扭矩和刚度、峰值压力和接触面积,距骨和跟骨的旋转,和使用三维运动捕捉系统的跟骨平移。然后对踝关节进行ATFL和CFL (受伤) 切片,重新测试,然后随机分配到ATFL-only brostr ö m修复或ATFL和CFL联合修复。修复后重复测试,然后加载反转至失败 (LTF)。 RE S ULT S: s tiffne s s踝关节wa s不是s显著水平有增加s ed相比受伤情况通过修复ATFL (n.s.) 或ATFL/CFL (n。s.)。跟骨s在ATFL-only修复术 (p = 0.037) 中的旋转度比损伤情况明显多 (p =),但在ATFL/CFL修复术 (s.) 中没有。ATFL在比CFL高 40.3% 的扭矩下失败,分别在 17.4 ± 7.0 N m和 12.4 ± 4.1 N m下,旋转增加 62.0%,分别在 43.9 ± 5.6 ° 和 27.1 ± 6.8 °。 结论: 与仅ATFL修复相比,ATFL/CFL联合修复后刚度增加更大,尽管这没有达到统计学意义。CFL在ATFL之前失败,可能表明其在修复后立即存在漏洞。 证据水平: III,病例对照治疗研究。

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发表时间:2020-01-01
DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

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