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连续半月板切除术后的股胫关节接触力学和半月板应变

Femorotibial contact mechanics and meniscal strain after serial meniscectomy.

作者信息

Pozzi Antonio, Tonks Catherine A, Ling Hang-Yin

机构信息

Comparative Orthopaedics Biomechanics Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.

出版信息

Vet Surg. 2010 Jun;39(4):482-8. doi: 10.1111/j.1532-950X.2010.00668.x. Epub 2010 Mar 24.

Abstract

OBJECTIVE

To evaluate changes in femorotibial contact areas (CA) and pressures and meniscal strain after serial meniscectomies of the caudal pole of the medial meniscus.

STUDY DESIGN

Ex vivo biomechanical study.

SAMPLE POPULATION

Unpaired pelvic limbs from 8 adult dogs weighing 28-35 kg.

METHODS

All specimens underwent sequentially, a 30% radial width partial meniscectomy, a 75% radial width partial meniscectomy, and a segmental caudal pole hemi-meniscectomy. Digital pressure sensors were used to measure lateral and medial peak and mean contact pressures and areas before and after serial meniscectomies. Meniscal strain was measured under load in the intact meniscus and after 30% and 75% radial width meniscectomy. Repeated measures analysis of variance with a post hoc Bonferroni's test (P<.05) was used for statistical analysis.

RESULTS

A 30% radial width meniscectomy had no significant effect on contact mechanics. A 75% radial width caused a 60.9% increase and hemi-meniscectomy an 87.4% increase in peak contact pressures compared with control. Medial CA decreased by 34.7% after 75% radial width meniscectomy and 47.2% after hemi-meniscectomy. A 30% radial width meniscectomy resulted in 38.5%, and a 75% radial width meniscectomy a 69.2%, decrease in medial meniscal strain compared with control, but these differences were not statistically significant.

CONCLUSIONS

In this cadaveric model, smaller (30%) partial meniscectomies had minimal effect on the biomechanics of meniscal function, whereas larger partial (75%) and segmental meniscectomies resulted in significant changes in meniscal and femorotibial contact mechanics.

CLINICAL RELEVANCE

This ex vivo data should be considered in clinical decision making for treatment of meniscal problems in dogs.

摘要

目的

评估内侧半月板后极连续半月板切除术后股胫接触面积(CA)、压力及半月板应变的变化。

研究设计

体外生物力学研究。

样本群体

8只体重28 - 35千克成年犬的非配对骨盆肢。

方法

所有标本依次进行30%径向宽度部分半月板切除术、75%径向宽度部分半月板切除术及节段性后极半月板切除术。使用数字压力传感器测量连续半月板切除术前、后外侧和内侧的峰值及平均接触压力和面积。在完整半月板及30%和75%径向宽度半月板切除术后,测量负荷下的半月板应变。采用重复测量方差分析及事后Bonferroni检验(P <.05)进行统计分析。

结果

30%径向宽度半月板切除术对接触力学无显著影响。与对照组相比,75%径向宽度切除术使峰值接触压力增加60.9%,半月板切除术使峰值接触压力增加87.4%。75%径向宽度半月板切除术后内侧CA减少34.7%,半月板切除术后减少47.2%。与对照组相比,30%径向宽度半月板切除术使内侧半月板应变降低38.5%,75%径向宽度半月板切除术使内侧半月板应变降低69.2%,但这些差异无统计学意义。

结论

在该尸体模型中,较小(30%)的部分半月板切除术对半月板功能的生物力学影响最小,而较大的部分(75%)和节段性半月板切除术导致半月板和股胫接触力学发生显著变化。

临床意义

在犬半月板问题的临床治疗决策中应考虑该体外数据。

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