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骨折愈合过程中组织分化的力学调节模型:间隙大小与负荷分析

A mechano-regulation model for tissue differentiation during fracture healing: analysis of gap size and loading.

作者信息

Lacroix D, Prendergast P J

机构信息

Centre for Bioengineering, Department of Mechanical Engineering, Trinity College, Dublin 2, Ireland.

出版信息

J Biomech. 2002 Sep;35(9):1163-71. doi: 10.1016/s0021-9290(02)00086-6.

Abstract

Bone has a capability to repair itself when it is fractured. Repair involves the generation of intermediate tissues, such as fibrous connective tissue, cartilage and woven bone, before final bone healing can occur. The intermediate tissues serve to stabilise the mechanical environment and provide a scaffold for differentiation of new tissues. The repair process is fundamentally affected by mechanical loading and by the geometric configuration of the fracture fragments. Biomechanical analyses of fracture healing have previously computed the stress distribution within the callus and identified the components of the stress tensor favouring or inhibiting differentiation of particular tissue phenotypes. In this paper, a biphasic poroelastic finite element model of a fracture callus is used to simulate the time-course of tissue differentiation during fracture healing. The simulation begins with granulation tissue (post-inflammation phase) and finishes with bone resorption. The biomechanical regulatory model assumes that tissue differentiation is controlled by a combination of shear strain and fluid flow acting within the tissue. High shear strain and fluid flows are assumed to deform the precursor cells stimulating formation of fibrous connective tissue, lower levels stimulate formation of cartilage, and lower again allows ossification. This mechano-regulatory scheme was tested by simulating healing in fractures with different gap sizes and loading magnitudes. The appearance and disappearance of the various tissues found in a callus was similar to histological observation. The effect of gap size and loading magnitude on the rate of reduction of the interfragmentary strain was sufficiently close to confirm the hypothesis that tissue differentiation phenomena could be governed by the proposed mechano-regulation model.

摘要

骨骼骨折时具有自我修复的能力。修复过程包括在最终骨愈合发生之前生成中间组织,如纤维结缔组织、软骨和编织骨。这些中间组织有助于稳定力学环境,并为新组织的分化提供支架。修复过程从根本上受到机械负荷和骨折碎片几何构型的影响。先前对骨折愈合的生物力学分析计算了骨痂内的应力分布,并确定了有利于或抑制特定组织表型分化的应力张量分量。在本文中,使用骨折骨痂的双相多孔弹性有限元模型来模拟骨折愈合过程中组织分化的时间进程。模拟从肉芽组织(炎症后期)开始,到骨吸收结束。生物力学调节模型假设组织分化由组织内作用的剪切应变和流体流动共同控制。高剪切应变和流体流动被认为会使前体细胞变形,刺激纤维结缔组织的形成,较低水平则刺激软骨形成,更低水平则允许骨化。通过模拟不同间隙大小和负荷大小的骨折愈合来测试这种力学调节方案。骨痂中发现的各种组织的出现和消失与组织学观察相似。间隙大小和负荷大小对骨折碎片间应变降低速率的影响足够接近,以证实组织分化现象可能受所提出的力学调节模型支配这一假设。

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