通过单足静态胫骨前移定义矢状面膝关节表型：第一部分 将负重矢状位转化为临床风险特征
简介
该研究提出了一种可重复的单腿负重位放射学参数——静态胫骨前移（sATT），用于反映胫股关节在生理负荷下的矢状面功能平衡状态，区别于传统被动松弛度检查。关键发现包括：sATT升高可归纳为三种临床表型——骨性前移（主要与胫骨后倾角增大和ACL缺失相关）、获得性软组织前移（慢性损伤后矢状面失代偿，尤其半月板功能丧失）和先天性软组织前移（全身性韧带松弛）。研究建立了…
英文摘要
Static anterior tibial translation (sATT) is a reproducible monopodal weight-bearing radiographic parameter that reflects the resting sagittal position of the tibiofemoral joint. Distinct from manual laxity tests that quantify passive displacement limits, sATT captures the functional equilibrium of the tibia under physiological load, representing the cumulative interplay of bony morphology, neuromuscular control, meniscal containment and time-dependent adaptations. Current literature frequently conflates passive laxity with weight-bearing sagittal position, leading to an incomplete understanding of why isolated soft-tissue reconstructions fail in biomechanically hostile environments. Elevated sATT manifests in three clinically distinct sagittal phenotypes with specific pathomechanisms: osseous anteriorization primarily related to increased posterior tibial slope and loss of the anterior cruciate ligament; acquired soft-tissue anteriorization resulting from sagittal decompensation due to chronic injury and secondary stabilizer, particularly meniscal deficiency; and inherent soft-tissue anteriorization characteristic of generalized hyperlaxity. This paper, Part 1 of a two-part series, establishes the biomechanical 'set-point' theory, highlights the necessity of strict monopedal imaging to unmask instability and defines how distinct sagittal phenotypes may converge, creating cumulative or synergistic risk patterns that increase the mechanical burden on the central pivot. LEVEL OF EVIDENCE: Level V.