Biomechanics of Multi-ligament Knee Injuries (MLKI) and Effects on Gait.

Mark V Paterno, Timothy E Hewett
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Abstract

Stability at the knee joint is provided by both the static structures, including the ligaments and joint capsule and the coordinated activation of dynamic structures surrounding the joint. These dual stabilizers allow for functional movements, such as gait, to occur safely, effectively, and efficiently. In the presence of a multi-ligament knee injury (MLKI) an absence of static stability can result in an increased reliance on the dynamic knee stabilizers. If sufficient stability is not provided, the potential for an increase in abnormal movements in the knee joint can result. These potential gait alterations that may be associated with a MLKI can result in abnormally high stresses on healing tissues and potentially high shearing forces on articular cartilage, resulting in early breakdown. Early recognition of gait abnormalities and an appropriate implementation of a gait re-training program to control abnormal forces in a patient following an MLKI or a surgical intervention for a MLKI are critical for successful long-term outcomes.

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膝关节多韧带损伤的生物力学及对步态的影响。
膝关节的稳定性由静态结构(包括韧带和关节囊)和关节周围动态结构的协调激活提供。这些双稳定器允许功能运动,如步态,安全,有效和高效地发生。在存在多韧带膝关节损伤(MLKI)的情况下,静态稳定性的缺乏会导致对动态膝关节稳定剂的依赖增加。如果不提供足够的稳定性,则可能导致膝关节异常运动增加。这些潜在的步态改变可能与MLKI相关,可导致愈合组织的异常高压力和关节软骨的潜在高剪切力,导致早期破裂。早期识别步态异常和适当实施步态再训练计划以控制MLKI或MLKI手术干预后患者的异常力量对于成功的长期结果至关重要。
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