臨床整形外科53巻7号

2018年07月発行

誌上シンポジウム 膝前十字靱帯のバイオメカニクス

受傷機転—Model-based Image-matching法を用いた解析

著者： 古賀英之¹

所属機関： ¹東京医科歯科大学大学院運動器外科学

ページ範囲：P.563 - P.573

　Model-based image-matching(MBIM)法は，従来，視覚的分析に限られていた受傷シーンのビデオの詳細な解析を可能にし，非接触性ACL損傷のメカニズムの詳細を明らかにした．ACL損傷は接地後40ms付近で生じており，膝外反に伴う外側コンパートメントの圧迫力によって，膝内旋および脛骨前方移動が生じることによりACLが断裂する．また接地時からACL損傷時までの間，股関節は内旋位でほぼ一定であること，また足部は踵接地後足底が地面に固定されることから，接地時において股関節および足部によるエネルギー吸収が不十分となることから膝関節により大きな負荷がかかり，そのことがACL損傷に寄与している．以上から予防プログラムにおいて膝関節と股関節の両方に対するアプローチを行うこと，また接地前から危険を予知し，接地前の膝関節や股関節の動きをコントロールするための“feed-forward strategy”に焦点を当てることが重要と考えられた．

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