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目的 探讨胫骨旋转状态对髌股关节应力分布的影响.方法 选取7 个新鲜离体膝关节,维持屈膝30°,在196 N 的股四头肌牵引力牵引下,用压敏片测量胫骨中立位、内旋10°、20°、30°和外旋10°、20°、30°时的内、外侧髌股关节面接触压均值、峰值与承压面积.结果 非旋转状态下髌股关节面承压面积外侧显著大于内侧,接触压均值与峰值内、外侧差异不显著;胫骨外旋时,外侧髌股关节面的接触压均值、峰值和承压面积呈非线性递增趋势,内侧呈非线性递减趋势;内旋时,外侧髌股关节面的接触压均值、峰值和承压面积均逐渐减小,内侧则明显增大.结论 胫骨旋转畸形使髌股关节应力分布严重失衡,可能是引起髌股关节退变的重要因素之一.“,”Objective Toinvestigate the pathogenesis of patello femoral degenerative arthrosis caused by tibial m alrotation . Methods Seven fresh cadaver specim ens of knee joint were used to test the contact pressure ,peak pressure and contact area with Fuji pressure sensitive film in the conditions of normal status , 10°,20°,30°of external tibial rotation as well as 10°,20°,30°of internal tibial rotation under the isom etric tension of 196 Nin the quadriceps tendon for 30°knee flexion . Results There was no marked difference between thelateraland medialfacetexceptthe contact area without tibialrotation . The increasein the degree of external tibial rotation resulted in a nonlinearincrease in patello femeral contact pressure and contact area on the lateral facet of patellar , while a nonlinear decrease on the medialfacet. However ,the internal tibial rotation resulted in gradual decrease of contact pressure and area on lateralfacet and marked increase on me dial facet. Conclusion Tibial rotation can bring about serious disorder of contact pressure distribution , w hich may be one ofthe im portant basic pathogenesis of patello fem oral degenerative arthrosis .