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外侧半月板切除术和外侧股骨髁骨软骨移植对接触力学的影响:犬的尸体研究。

Effect of lateral meniscectomy and osteochondral grafting of a lateral femoral condylar defect on contact mechanics: a cadaveric study in dogs.

机构信息

Department of Small Animal Clinical Sciences, Comparative Orthopaedics and Biomechanics Laboratory, University of Florida, College of Veterinary Medicine, 2015 SW 16th Ave, Gainesville, FL 32610, USA.

出版信息

BMC Vet Res. 2013 Mar 22;9:53. doi: 10.1186/1746-6148-9-53.

Abstract

BACKGROUND

Osteochondral autograft transfer (OAT) aims at restoring normal articular cartilage surface geometry and articular contact mechanics. To date, no studies have evaluated the contact mechanics of the canine stifle following OAT. Additionally, there are no studies that evaluated the role of the meniscus in contact mechanics following OAT in human or canine femorotibial joints. The objective of this study was to measure the changes in femorotibial contact areas (CA), mean contact pressure (MCP) and peak contact pressure (PCP) before and after osteochondral autograft transplantation (OAT) of a simulated lateral femoral condylar cartilage defect with an intact lateral meniscus and following lateral meniscectomy.

RESULTS

With an intact lateral meniscus, creation of an osteochondral defect caused a decrease in MCP and PCP by 11% and 30%, respectively, compared to the intact stifle (p < 0.01). With an intact meniscus, implanting an osteochondral graft restored MCP and PCP to 96% (p = 0.56) and 92% (p = 0.41) of the control values. Lateral meniscectomy with grafting decreased CA by 54% and increased PCP by 79% compared to the intact stifle (p < 0.01).

CONCLUSIONS

OAT restored contact pressures in stifles with a simulated lateral condylar defect when the meniscus was intact. The lateral meniscus has a significant role in maintaining normal contact pressures in both stifles with a defect or following OAT. Meniscectomy should be avoided when a femoral condylar defect is present and when performing OAT.

摘要

背景

骨软骨自体移植(OAT)旨在恢复正常的关节软骨表面几何形状和关节接触力学。迄今为止,尚无研究评估 OAT 后犬膝关节的关节接触力学。此外,尚无研究评估半月板在 OAT 后人类或犬股骨胫骨关节的关节接触力学中的作用。本研究的目的是测量外侧股骨髁软骨缺损模拟 OAT 前后的股骨胫骨接触面积(CA)、平均接触压力(MCP)和峰值接触压力(PCP)的变化,同时评估外侧半月板完整和外侧半月板切除后的变化。

结果

在外侧半月板完整的情况下,与完整的膝关节相比,形成骨软骨缺损会使 MCP 和 PCP 分别降低 11%和 30%(p < 0.01)。在半月板完整的情况下,植入骨软骨移植物可使 MCP 和 PCP 恢复至对照值的 96%(p = 0.56)和 92%(p = 0.41)。与完整的膝关节相比,半月板切除和移植会使 CA 减少 54%,而 PCP 增加 79%(p < 0.01)。

结论

当半月板完整时,OAT 可恢复模拟外侧髁状突缺损膝关节的接触压力。外侧半月板在有缺陷或行 OAT 后维持正常接触压力方面具有重要作用。当股骨髁状突存在缺陷或行 OAT 时,应避免半月板切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fe6/3620912/93034d67e48c/1746-6148-9-53-1.jpg

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