A study on anterior cruciate ligament injury and knee
stability with a silicon mesh brace

doi:10.3969/j.issn.2095-4344.1927

Abstract

Abstract:

BACKGROUND: Knee braces have been shown to improve knee mechanics in the case of slow walking, but most studies lack the data regarding the effects of a brace on knee injury in the case of lack of movement.

OBJECTIVE: Jumping, emergency stop, rotation which easily induce knee joint injury during the rapid exercise were simulated to investigate whether silicon mesh braces can provide stable support for the knee joint and provide data support for the protection against anterior cruciate ligament injury.

METHODS: Twelve healthy subjects were selected to perform three movements: squatting, one-leg jump and steering jump respectively with and without a brace. Reflection markers were placed on the feet, calves, thighs, and pelvis of the subjects. A Qualisys motion capture system was used to obtain kinematic data of the knee joints. Knee joint motion was compared between with and without a brace. This study was performed by Medical Ethics Committee of Guizhou College of Traditional Chinese Medicine on August 8, 2018 (approval No. 2018661).

RESULTS AND CONCLUSION: There were significant differences in the angle and angular velocity of the knee joint among sagittal plane, coronal plane, and horizontal plane. The knee joint valgus and internal rotation angle were reduced when wearing a brace in particular in one-leg jump and steering jump. The angular velocity of horizontal surface rotation also decreased obviously when wearing a brace. These findings suggest that wearing a brace can affect the motion mechanics of the knee joint in the coronal and horizontal planes. This suggests that knee joint can effectively control the stability when wearing a brace in the process of dynamic movement, and wearing a brace can improve the control of knee peak valgus angular velocity and external rotation angular velocity, which can help effectively prevent anterior cruciate ligament injury of patients with anterior cruciate ligament defects.

Key words: knee joint, anterior cruciate ligament, sports injury, brace, chondromalacia patella, runner’s knee, knee osteoarthritis, patella

CLC Number:

Jing Xiaowei, Mu Yingxiu. A study on anterior cruciate ligament injury and knee stability with a silicon mesh brace[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(4): 505-510.

Figures/Tables 2

冠状面上，屈膝下蹲和转向跳动作在穿戴支具时膝关节角度和角速度显著性差异下降。屈膝下蹲和单腿跳动作在穿戴支具时内外翻角速度显著性下降，单腿跳和转向跳在穿戴支具时外翻角度和活动范围显著性差异下降，见表2。转向跳和单腿跳在冠状面角速度相似，明显大于屈膝下蹲动作角速度，见表2。水平面上，穿戴支具时除了屈膝下蹲动作和单腿跳动作最大内/外旋角度，以及单腿跳和转向跳的内旋角速度峰值之外，所有动作间的膝关节角度和角速度都显著性下降，见表2。转向跳在水平面出现最大膝关节角度，单腿跳和转向跳的水平面角速度相似，均明显大于屈膝下蹲动作，见表2。 2.3 膝关节不同部位及不同运动的运动学特征的差异硅网支具对矢状面运动学影响轻微，但对冠状面和水平面的数据影响显著。表2中，穿戴支具情况下膝关节内翻和外翻角度均显著性下降，穿戴支具时膝关节在冠状面外翻角度范围减少了30%，均值差2.4°，差异有显著性意义(P=0.023)。是否穿戴支具和试验动作膝关节外翻角度存在非常高度显著性交互作用(P=0.001)；通过事后分析，在有、无膝关节支具情况下，受试者进行屈膝下蹲动作时差异无显著性意义，然而穿戴支具进行单腿跳动作时膝关节外翻角度显著下降(P=0.018)，均值差为2.7°，转向跳均值差为3.8°(P=0.002)。穿戴支具时3个动作膝内翻角度显著性增加(P=0.035)，均值差为1.5°；进一步的事后分析显示，穿戴支具时屈膝下蹲动作(P=0.108)和转向跳动作(P=0.359)内翻角度差异无显著性意义；单腿跳动有非常显著性差异(P=0.008)，均值差为2.1°。冠状面内是否穿戴支具与试验动作在膝关节活动范围方面的交互作用显著；进一步事后分析显示，屈膝下蹲动作(P=0.065)和单腿跳动作(P=0.364)在穿戴支具情况下差异无显著性意义。穿戴支具时转向跳动作的膝关节内翻/外翻活动范围显著下降(P=0.007)，均值差为3.0°，活动范围下降了25%；膝关节内旋角度峰值显著降低(P=0.035)，均值差为2.4°，活动范围减少了21%。是否穿戴支具与3个动作膝关节内旋角度峰值有显著性交互作用；事后分析显示，穿戴支具情况下屈膝下蹲动作(P=0.716)和单腿跳动作(P=0.106)膝关节内旋角度峰值差异无显著性意义，但是转向跳动作在穿戴支具情况下膝关节内旋角度峰值显著下降(P=0.002)，均值差为5.2°。穿戴支具时膝关节内旋/外旋活动范围从11.5°降至9.3° (P=0.003)；是否穿戴支具和3个动作之间发生了显著性交互作用；进一步的事后检测显示屈膝下蹲(P=0.662)和单腿跳(P=0.682)内旋/外旋活动范围差异无显著性意义，然而穿戴支具时转向跳动作膝关节内旋/外旋活动范围却由19.6°减少至13.5°，减少了31%(P=0.005)。 2.4 有、无支具的运动学特征的差异表3中，矢状面和冠状面最小/最大膝关节角速度和角速度范围，在是、否穿戴支具情况下不存在显著性差异，但是在水平面穿戴支具时膝关节外旋角速度显著下降(P=0.008)，角速度由 122.7 (°)/s下降至94.0 (°)/s，是否穿戴支具情况下膝关节外旋角速度与3个动作之间的交互作用显著；进一步的事后分析显示差异无显著性意义，屈膝下蹲的均值差为4.3，单腿跳的均值差为8.9，然而在穿戴支具时，转向跳动作相较没有穿戴支具时膝关节外旋角速度平均减少72.9 (°)/s(P < 0.001)。是否穿戴支具情况下内/外旋转膝关节角速度范围无显著性差异，但是穿戴与否与3个动作间的交互作用非常显著(P=0.007)。进一步的事后分析显示，屈膝下蹲动作在是否穿戴支具情况下差异有显著性意义(P=0.036)，均值差为值为8.6 (°)/s，穿戴支具后减少25%；转向跳均值差为106.8 (°)/s，穿戴支具时减少24%(P=0.022)。是否穿戴支具进行单腿跳动作时膝关节内/外旋转角速度差异无显著性意义。此外，在水平面转向跳动作中，是否穿戴支具对膝关节落地姿态差异有显著性意义(P=0.002)。表2中，没有穿戴支具落地时，膝关节的内旋角度为7.6°，而在穿戴支具的情况下，膝关节内旋角度为0.4°，更接近中性位置。转向跳或单腿跳在矢状面中膝关节角度、落地姿态与是否穿戴支具差异无显著性意义。 "

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