| Knee joint is the most complex joint and can be injured easily. In the traffic accident, and sports training, both direct and indirect forces can cause knee joint injury, but the direct force caused injury is very common during daily lift. The knowledge of the function of the ligament and the mechanism of impact injury is very important for clinic to treat or diagnose the knee joint injury.Foreign researchers cut the ligament which they are interested in and measured the variation of range of motion (ROM) of the knee. Most of the knee impact injury studies are interested in lateral impact. And the results were quite different from one to another because of the age variation. For the couple motion were limited in most of the studies, and they can not link the knee impact injury with the knee stability, the ROM of the knee joint after impact was not reported.We chose knees, where impact injury happened most often, as our study object. All of the specimens were obtain from fresh adults' cadavers. The relationships among the function of ligaments, the knee stability and the mechanism of impact injury were studied with biomechanical methods. The purpose of this study include: establish a three-dimensional movement model of human knee; analysis the function of the different ligaments on knee joint stability; establish a direct impact injury model of knee joint; identify the injury threshold of knee impact injury; analysis the relationship between impact energy and degrees of injury, and study the mechanism of knee joint impact injury.Materials and MethodsThe specimens were obtained from fresh human cadavers. All the skin, muscles were cut off, and only the knee ligaments and capsular were keep intact. The specimens were kept in a refrigerator at - 20℃ after embedded.Twenty-eight specimens were divided into 4 groups at random. On the three-dimensional movement experiment machine, we measured the ROM ofadduction, abduction, internal and external rotation, and extension of the knee joint. Then the ligaments were cut in following orders: anterior cruciate ligament (ACL)→material collateral ligament (MCL)→ posterior cruciate ligament (PCL) → lateral collateral ligament (LCL); PCL→ LCL→ ACL→ MCL; MCL→ ACL→ LCL→ PCL; LCL→ PCL→ MCL→ ACL. After each section, we measured the ROM once. Thus, we got the ROM of the normal and sectioned knee joint, and the roles of each ligament on the stability of a human knee were analysis.Fourteen specimens were divided into 2 groups at random and were impacted with 80J, 160J separately on CZZ-II impact machine. We measured the ROM and the anterior-posterior laxity of the knee joint before and after each impact. Macro anatomy was observed on injured ligaments. Then, we conclude the injury threshold of knee joint, and find out which part was injured easily, and the relationships among the impact energy, the injury degree and the stability of the knee.From Apr. 1997 to Dec. 2000, 43 cases of knee impact patients have been selected. First, the clinical diagnosis be made after clinical physical test, X-ray, CT and MRI. Then to the abnormal patients, the operative treatment have been done, and combined with the conclusion of chapter one and tow, the clinical effective of the conclusion be evaluated.Results1 The ROM of adduction, abduction, internal and external rotation, extension are 4.19°±3.36° , 3.89° ± 3.16° , 26.33° ± 4.90° , 23.38° ± 4.06° , 20.20° ± 9.57° separately. The ROM of abduction and adduction were almost the same (p>0.30) in one knee, but the ROM of external and internal rotation had statistic significance (p<0.001). There is no different between the right and left knee.2 The ROM of knee increased after one ligament section. After MCL sectioned,-5-the ROM of abduction, internal and external rotation increased significantly. After LCL sectioned, the ROM of adduction and external rotation increased significantly. There have no markedly increased after ACL or PCL sectioned.3 The ROM of abduction increased more sign...
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