von Lewinski G, Hurschler C, Allmann C, Wirth C J
Orthopaedic Department, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hannover, Germany.
Knee Surg Sports Traumatol Arthrosc. 2006 May;14(5):425-36. doi: 10.1007/s00167-005-0704-z. Epub 2005 Nov 22.
The purpose of the present study was to determine the effect of biological in-growth and pre-tensioning on the load transmission function of meniscal transplants. The ability of meniscal transplants to transfer load to the tibial plateau was measured in an animal model. Thirty-six sheep were divided into six groups: group A was the sham group, in group B a medial meniscectomy was performed, and in groups C-F a medial meniscal transplantation with an autograft was carried out. In groups C-F, different levels of pre-tensioning force were applied via bone tunnel sutures (C=0, D=20, E=40, and F=60 N, respectively). The animals were killed after 6 months. The excised knees were mounted in a materials testing machine at 30, 60, and 90 degrees of flexion, and loaded through the femoral axis to 500 N. A thin film pressure measuring transducer (K-scan, Tekscan) was positioned underneath the meniscus in the medial compartment in order to determine contact area and pressure. The mean contact pressure (MCP) of the sham group (A) and the groups with the transplanted meniscus (C-F) was significantly lower in relation to the meniscectomized knees (B). Significant increases in contact area and reductions in peak contact pressure were also observed. Only the meniscal transplantation group with 40 N (E) pre-tension consistently showed a significant or strong trend toward increased contact area, compared to the meniscectomized knees (B) at all flexion angles tested. All meniscal transplanted groups with the exception of the 0 N group (C) showed a significant reduction in peak contact pressure in comparison to the meniscectomized group (B). The results indicate that meniscal transplantation reduces the MCP on the tibial plateau independent of the level of intraoperative pre-tensioning. Furthermore, the menisci pre-tensioned to 40 N showed significantly increased contact area and reduced peak contact pressure in comparison to the meniscectomized knees at all flexion angles tested, and revealed results similar to those reported in the literature for meniscal allografts fixated with bone plugs.
本研究的目的是确定生物长入和预张紧对半月板移植体负荷传递功能的影响。在动物模型中测量半月板移植体将负荷传递至胫骨平台的能力。36只绵羊被分为6组：A组为假手术组，B组行内侧半月板切除术，C - F组行内侧半月板自体移植术。在C - F组中，通过骨隧道缝线施加不同水平的预张紧力（C组 = 0 N，D组 = 20 N，E组 = 40 N，F组 = 60 N）。6个月后处死动物。将切除的膝关节安装在材料试验机上，分别在屈曲30°、60°和90°时，通过股骨干施加500 N的负荷。在膝关节内侧间室半月板下方放置一个薄膜压力测量传感器（K - scan，Tekscan），以确定接触面积和压力。与半月板切除的膝关节（B组）相比，假手术组（A组）和半月板移植组（C - F组）的平均接触压力（MCP）显著降低。还观察到接触面积显著增加，峰值接触压力降低。与半月板切除的膝关节（B组）相比，仅40 N（E组）预张紧的半月板移植组在所有测试屈曲角度下均持续显示出接触面积显著增加或有强烈增加趋势。除0 N组（C组）外，所有半月板移植组与半月板切除组（B组）相比，峰值接触压力均显著降低。结果表明，半月板移植可降低胫骨平台上的平均接触压力，与术中预张紧水平无关。此外，与半月板切除的膝关节相比，预张紧至40 N的半月板在所有测试屈曲角度下均显示出接触面积显著增加，峰值接触压力降低，其结果与文献中报道的用骨栓固定的半月板同种异体移植的结果相似。
