Department of Orthopaedic Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjing Road, Guangzhou, 510120, China.
Int Orthop. 2012 May;36(5):987-91. doi: 10.1007/s00264-011-1450-0. Epub 2012 Jan 4.
We investigated the contact pressure and area of the patellofemoral joint both before and after different meniscectomies to provide a biomechanical basis for selecting meniscectomy and its clinical application for meniscus injuries.
Six fresh cadaveric knees were used in the study. Using Staubli robots and an ultra-low-min-type pressure-sensitive tablet, changes in contact area and stress in the patellofemoral joint were measured at various flexion angles following different parts and degrees of meniscectomy.
The patellofemoral contact area enlarged with the increase of knee flexion angle. From the values obtained from contact areas and average contact pressure of the patellofemoral joint, we found no significant difference between partial meniscectomy and intact knees, but a significant difference was found between total meniscectomy and intact knees. The contact area after lateral meniscectomy was statistically less than that of intact knees. The mean patellofemoral contact pressure after lateral meniscectomy was larger than in intact knees at each angle of flexion. No significant difference in contact area was observed between intact knees and medial meniscectomy. The average patellofemoral contact pressure after medial meniscectomy was larger than in intact knees from 0° ~ 30° of knee flexion, and no significant differences were found between intact knees and medial meniscectomy while knee bending from 60° to 90°.
Different meniscectomies result in high contact pressure or disordered distribution of contact pressure, which may be the cause of postoperative patellofemoral degenerative arthrosis.
研究不同半月板切除术前后髌股关节的接触压力和面积，为半月板切除术的选择及其在半月板损伤中的临床应用提供生物力学依据。
本研究使用 Staubli 机器人和超低敏型压敏片，测量了在不同程度和部位的半月板切除术后，在各个膝关节弯曲角度下髌股关节接触面积和压力的变化。
髌股关节接触面积随膝关节弯曲角度的增加而增大。从髌股关节接触面积和平均接触压力值来看，部分半月板切除术与完整膝关节之间无显著差异，但全半月板切除术与完整膝关节之间有显著差异。外侧半月板切除术后的髌股关节接触面积明显小于完整膝关节。外侧半月板切除术后各弯曲角度的髌股接触平均压力均大于完整膝关节。完整膝关节和内侧半月板切除术之间的髌股关节接触面积无显著差异。内侧半月板切除术后，从膝关节 0°30°弯曲时，髌股接触平均压力大于完整膝关节，而从膝关节 60°90°弯曲时，与完整膝关节相比，两者之间无显著差异。
不同的半月板切除术会导致高接触压力或接触压力分布紊乱，这可能是术后髌股关节退行性骨关节炎的原因。
