Guettler Joseph H, Demetropoulos Constantine K, Yang King H, Jurist Kenneth A
Sports Medicine Service, William Beaumont Hospital, Royal Oak, Michigan, USA.
Arthroscopy. 2005 Jun;21(6):715-20. doi: 10.1016/j.arthro.2005.03.001.
To dynamically evaluate contact pressure about the periphery of the lateral femoral condyle in intact knees, to qualify the effects of osteochondral donor graft harvest on this contact pressure, and to quantify the effects of lateral release on contact pressure after graft harvest.
Cadaveric analysis.
Digital electronic pressure-sensing cells were used to measure contact pressure over the periphery of the lateral femoral condyle in 10 fresh-frozen knee specimens. Nonweightbearing resistive extension was simulated as the knees were placed through a functional range of motion. Dynamic pressure readings were evaluated over intact cartilage, around the rims of four 5-mm osteochondral defects, and after lateral release.
The pressure cells were all subjected to contact pressures as the knees were placed through a functional range of motion. Average maximal contact pressure progressed distally as the knees were flexed. The creation of 5-mm osteochondral defects did not lead to a significant increase in rim stress concentration over the surrounding cartilage. Lateral release resulted in small decreases in contact pressure over the osteochondral defects.
The creation of 5-mm donor defects about the lateral aspect of the lateral femoral condyle does not lead to significant alterations in local contact pressure.
Our biomechanical findings may have important implications relating to cartilage restoration using osteochondral autografting procedures. Donor-site morbidity may be minimized if donor-site defects are limited to 5 mm and smaller.
动态评估完整膝关节中外侧股骨髁周围的接触压力，确定骨软骨移植供体取材对该接触压力的影响，并量化取材后外侧松解对接触压力的影响。
尸体分析。
使用数字电子压力传感单元测量10个新鲜冷冻膝关节标本中外侧股骨髁周围的接触压力。当膝关节在功能活动范围内活动时，模拟非负重抵抗伸展。评估完整软骨、四个5毫米骨软骨缺损边缘周围以及外侧松解后的动态压力读数。
当膝关节在功能活动范围内活动时，压力传感单元均承受接触压力。随着膝关节屈曲，平均最大接触压力向远端进展。5毫米骨软骨缺损的形成并未导致周围软骨边缘应力集中显著增加。外侧松解导致骨软骨缺损处的接触压力略有降低。
在外侧股骨髁外侧创建5毫米的供体缺损不会导致局部接触压力发生显著改变。
我们的生物力学研究结果可能对使用自体骨软骨移植进行软骨修复具有重要意义。如果供体部位缺损限制在5毫米及更小，则供体部位的发病率可能会降至最低。
