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部分半月板切除术对猪膝关节附着力、表面应变和接触力学的影响。

Influence of partial meniscectomy on attachment forces, superficial strain and contact mechanics in porcine knee joints.

作者信息

Freutel Maren, Seitz Andreas M, Ignatius Anita, Dürselen Lutz

机构信息

Institute of Orthopaedic Research and Biomechanics, Centre of Musculoskeletal Research, University of Ulm, Helmholtzstr. 14, 89081, Ulm, Germany,

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Jan;23(1):74-82. doi: 10.1007/s00167-014-2951-3. Epub 2014 Mar 27.

Abstract

PURPOSE

Numerous studies investigated the reasons for premature osteoarthritis due to partial meniscectomy (PM). However, the influence of meniscectomy on attachment forces and superficial strain of the tibial meniscus is unclear. It is hypothesised that these parameters depend on the degree of PM.

METHODS

Six porcine medial menisci were placed in a custom made apparatus, and each meniscal attachment was connected to a force sensor. After printing markers onto the tibial meniscal surfaces, the menisci were positioned on a glass plate enabling optical superficial strain measurement. Additionally, contact area and pressure were investigated. Each meniscus was axially loaded up to 650 N using its respective femoral condyle. Testing was conducted intact and after 50 and 75% PM of the posterior horn and extending 75% PM to the anterior horn.

RESULTS

With increasing meniscectomy, the attachment forces decreased anteriorly by up to 17% (n.s.) and posteriorly by up to 55% (p = 0.003). The circumferential strain in the peripheral meniscal zones was not affected by the meniscectomy, while in some meniscal zones the radial strain changed from compression to tension. Contact area decreased by up to 23% (p = 0.01), resulting in an increase in 40% (p = 0.02) for the maximum contact pressure.

CONCLUSION

Partial meniscectomy significantly alters the loading situation of the meniscus and its attachments. Specifically, the attachment forces decreased with increasing amount of meniscal tissue loss, which reflects the impaired ability of the meniscus to transform axial joint load into meniscal hoop stress.

摘要

目的

众多研究探讨了部分半月板切除术(PM)导致过早发生骨关节炎的原因。然而,半月板切除术对胫骨半月板附着力和表面应变的影响尚不清楚。据推测,这些参数取决于部分半月板切除术的程度。

方法

将六个猪内侧半月板置于定制装置中,每个半月板附着处连接到一个力传感器。在胫骨半月板表面打印标记后,将半月板放置在玻璃板上,以便进行光学表面应变测量。此外,还研究了接触面积和压力。使用各自的股骨髁对每个半月板进行轴向加载,直至650 N。测试在完整状态下进行,以及在后角进行50%和75%的部分半月板切除术后,以及将75%的部分半月板切除术扩展至前角后进行。

结果

随着半月板切除术程度的增加,前部附着力下降高达17%(无统计学意义),后部下降高达55%(p = 0.003)。半月板周边区域的周向应变不受半月板切除术的影响,而在一些半月板区域,径向应变从压缩变为拉伸。接触面积减少高达23%(p = 0.01),导致最大接触压力增加40%(p = 0.02)。

结论

部分半月板切除术显著改变了半月板及其附着处的负荷情况。具体而言,附着力随着半月板组织损失量的增加而下降,这反映了半月板将轴向关节负荷转化为半月板环向应力的能力受损。

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