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骨软骨栓放置不当可能会在关节软骨中引发异常的应力-应变分布——有限元模拟。

Inadequate placement of osteochondral plugs may induce abnormal stress-strain distributions in articular cartilage --finite element simulations.

作者信息

Wu J Z, Herzog W, Hasler E M

机构信息

National Institute for Occupational Safety & Health, Morgantown, West Virginia 26505, USA.

出版信息

Med Eng Phys. 2002 Mar;24(2):85-97. doi: 10.1016/s1350-4533(01)00122-9.

Abstract

The transplantation of osteochondral (cartilage-bone) plugs is an alternative approach to treat local, full thickness cartilage defects in young patients. It is technically difficult to control the amount of the press fit tolerance and the position of the osteochondral (OC) plug in the recipient hole. Inadequate placement of the OC plugs may produce abnormal stress and strain distributions within the cartilage, and thus influence the regeneration of the injured cartilage site and the maintenance of opposing, healthy cartilage surfaces. In the present study, the influence of press fit tolerance and the placement of the OC plug on the joint contact mechanics was simulated using finite element methods. The joint was assumed to be axi-symmetric with a spherical femur and tibia and a cylindrical OC plug. Our simulations showed that small misplacements of the OC plug induced abnormal tension in the articular cartilage of the opposing, healthy cartilage surface. Such tension might induce unpredictable adaptations, or possibly degenerations, in the opposing cartilage layer. The contact stress profiles in the joint were predicted to change discontinuously across the plug/recipient interface, even when the plug was perfectly placed in the recipient hole, i.e., the plug's surface was aligned with the recipient surface. For a fixed coefficient of friction and a fixed fit tolerance, the maximal sliding force was predicted to vary with the size of the plug and reached a maximum at a specific plug diameter. The present simulations should be helpful for the design of instruments for osteochondral transplantation and placement of OC plugs, for understanding articular cartilage adaptation following osteochondral repair, and for providing insight into the mechanics at the transplant/recipient interface where proper integration of the plug into the joint is most problematic.

摘要

骨软骨(软骨 - 骨)栓移植是治疗年轻患者局部全层软骨缺损的一种替代方法。在技术上,控制压配公差的量以及骨软骨(OC)栓在受体孔中的位置是困难的。OC栓放置不当可能会在软骨内产生异常的应力和应变分布,从而影响受损软骨部位的再生以及相对的健康软骨表面的维持。在本研究中,使用有限元方法模拟了压配公差和OC栓的放置对关节接触力学的影响。假设关节是轴对称的,具有球形的股骨和胫骨以及圆柱形的OC栓。我们的模拟表明,OC栓的小错位会在相对的健康软骨表面的关节软骨中引起异常张力。这种张力可能会在相对的软骨层中引起不可预测的适应性变化,或者可能导致退变。预计即使栓完美地放置在受体孔中,即栓的表面与受体表面对齐,关节中的接触应力分布在栓/受体界面处也会发生不连续变化。对于固定的摩擦系数和固定的配合公差,预计最大滑动力会随栓的尺寸而变化,并在特定的栓直径处达到最大值。本模拟对于骨软骨移植器械的设计和OC栓的放置、理解骨软骨修复后关节软骨的适应性以及深入了解栓与受体界面处的力学情况(此处栓与关节的正确整合最成问题)应该是有帮助的。

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