Anterior cruciate ligament injuries are commonly combined with meniscal tears. This study was performed to analyze the kinematics and kinetics of knees with anterior cruciate ligament deficiency with or without a combined medial or/and lateral meniscal injury during level walking. In all, 29 patients with unilateral anterior cruciate ligament deficiency and 15 healthy male volunteers were recruited. Among these patients, 12 had isolated unilateral anterior cruciate ligament injuries (ACLD group), 5 had combined anterior cruciate ligament and lateral meniscal injuries (ACLDL group), 5 had combined anterior cruciate ligament and medial meniscal injuries (ACLDM group), and 7 had combined anterior cruciate ligament and medial/lateral meniscal injuries (ACLDML group). A subject-specific musculoskeletal multibody dynamics model was utilized to estimate the tibiofemoral joint kinematic and kinetic behaviors based on the experimental data measured by using an optical tracking system. Regardless of the presence or absence of meniscal injury, the knees with anterior cruciate ligament deficiency exhibited significantly less extension than the control knees at the terminal stance (range of extension: ACLD, 4.84° ± 4.31°; ACLDL, 6.65° ± 5.73°; ACLDM, 5.21° ± 4.77°; ACLDML, 6.91° ± 4.30°; control, 12.35° ± 5.52°; P < 0.05). A lower extension moment and adduction moment in all anterior cruciate ligament deficiency affected knees were detected during the terminal stance when compared with control knees (P < 0.05). The ACLDML group showed significantly lower proximal-distal compressive forces and anterior-posterior shear forces (approximately 0.5-1.5 body weight; P < 0.05) compared to the other 4 groups, while the anterior-posterior and medial-lateral shear forces tended to increase in the ACLD, ACLDL, and ACLDM groups at the mid to terminal stance. Significant lower adduction-abduction and internal-external moment peaks were observed in ACLDML groups, but not in the ACLD, ACLDL and ACLDM groups. These results indicate that the combination of an anterior cruciate ligament injury and meniscal injury could alter the kinematics and kinetics of anterior cruciate ligament deficiency affected knees depending on the presence and type of the meniscal tear.

中文翻译：

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前十字韧带缺乏症伴半月板外侧和/或内侧半月板损伤，导致水平行走过程中运动学和动力学异常。

前十字韧带损伤通常合并半月板撕裂。这项研究的目的是分析在水平行走过程中伴有或不伴有内侧或/和外侧半月板损伤的前交叉韧带不足的膝盖的运动学和动力学。总共招募了29名单侧前交叉韧带缺乏症患者和15名健康男性志愿者。在这些患者中，12例单侧前交叉韧带损伤（ACLD组），5例合并前交叉韧带和外侧半月板损伤（ACLDL组），5例合并前交叉韧带和半月板内侧损伤（ACLDM组），7例合并前交叉韧带和内侧/外侧半月板损伤（ACLDML组）。基于光学跟踪系统测量的实验数据，利用特定于对象的肌肉骨骼多体动力学模型估算胫股关节的运动学和动力学行为。无论是否存在半月板损伤，前交叉韧带缺损的膝关节在站立时的伸展程度均明显低于对照膝关节（伸展范围：ACLD，4.84°±4.31°； ACLDL，6.65°±5.73°； ACLDM，5.21°±4.77°; ACLDML，6.91°±4.30°;对照，12.35°±5.52°; P <0.05）。与对照膝相比，末位站立时在所有前交叉韧带不足的患膝中都有较低的伸展力矩和内收力矩（P <0.05）。与其他4组相比，ACLDML组显示出近-远侧压缩力和前后剪切力显着降低（大约0.5-1.5体重； P <0.05），而前后和内侧-外侧剪切力趋于增加在ACLD，ACLDL和ACLDM组中处于中间到最终位置。在ACLDML组中观察到明显较低的内收-外展和内外力矩峰值，但在ACLD，ACLDL和ACLDM组中未观察到。这些结果表明，前交叉韧带损伤和半月板损伤的组合可改变前交叉韧带不足影响膝关节的运动学和动力学，具体取决于半月板撕裂的存在和类型。而ACLD，ACLDL和ACLDM组中至末位的前后剪切力和内剪切力趋于增加。在ACLDML组中观察到明显较低的内收-外展和内外力矩峰值，但在ACLD，ACLDL和ACLDM组中未观察到。这些结果表明，前交叉韧带损伤和半月板损伤的组合可改变前交叉韧带不足影响膝关节的运动学和动力学，具体取决于半月板撕裂的存在和类型。而ACLD，ACLDL和ACLDM组中至末位的前后剪力趋于增加。在ACLDML组中观察到明显较低的内收-外展和内外力矩峰值，但在ACLD，ACLDL和ACLDM组中未观察到。这些结果表明，前交叉韧带损伤和半月板损伤的组合可改变前交叉韧带不足影响膝关节的运动学和动力学，具体取决于半月板撕裂的存在和类型。