Sutter E Grant, Widmyer Margaret R, Utturkar Gangadhar M, Spritzer Charles E, Garrett William E, DeFrate Louis E
Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.
Am J Sports Med. 2015 Feb;43(2):370-6. doi: 10.1177/0363546514559821. Epub 2014 Dec 10.
Altered local mechanical loading may disrupt normal cartilage homeostasis and play a role in the progression of osteoarthritis. Currently, there are limited data quantifying local cartilage strains in response to dynamic activity in normal or injured knees.
PURPOSE/HYPOTHESIS: To directly measure local tibiofemoral cartilage strains in response to a dynamic hopping activity in normal healthy knees. We hypothesized that local regions of cartilage will exhibit significant compressive strains in response to hopping, while overall compartmental averages may not.
Controlled laboratory study.
Both knees of 8 healthy subjects underwent magnetic resonance imaging before and immediately after a dynamic hopping activity. Images were segmented and then used to create 3-dimensional surface models of bone and cartilage. These pre- and postactivity models were then registered using an iterative closest point technique to enable site-specific measurements of cartilage strain (defined as the normalized change in cartilage thickness before and after activity) on the femur and tibia.
Significant strains were observed in both the medial and lateral tibial cartilage, with each compartment averaging a decrease of 5%. However, these strains varied with location within each compartment, reaching a maximum compressive strain of 8% on the medial plateau and 7% on the lateral plateau. No significant averaged compartmental strains were observed in the medial or lateral femoral cartilage. However, local regions of the medial and lateral femoral cartilage experienced significant compressive strains, reaching maximums of 6% and 3%, respectively.
Local regions of both the femur and tibia experienced significant cartilage strains as a result of dynamic activity. An understanding of changes in cartilage strain distributions may help to elucidate the biomechanical factors contributing to cartilage degeneration after joint injury.
Site-specific measurements of in vivo cartilage strains are important because altered loading is believed to be a factor contributing to the development and progression of osteoarthritis. Specifically, this methodology and data could be used to evaluate the effects of soft tissue injuries (such as ligament or meniscus tears) on cartilage strains in response to dynamic activities of daily living.
局部机械负荷改变可能破坏正常软骨内环境稳定,并在骨关节炎进展中起作用。目前,关于正常或受伤膝关节在动态活动时局部软骨应变的量化数据有限。
目的/假设:直接测量正常健康膝关节在动态单腿跳活动时局部胫股关节软骨应变。我们假设,软骨局部区域在单腿跳时会出现显著压缩应变,而整体间室平均值可能不会。
对照实验室研究。
8名健康受试者的双膝在动态单腿跳活动前后均接受磁共振成像检查。对图像进行分割,然后用于创建骨骼和软骨的三维表面模型。然后使用迭代最近点技术对这些活动前和活动后的模型进行配准,以便对股骨和胫骨上的软骨应变(定义为活动前后软骨厚度的归一化变化)进行特定部位测量。
在内侧和外侧胫骨软骨中均观察到显著应变,每个间室平均下降5%。然而,这些应变在每个间室内随位置而异,在内侧平台达到最大压缩应变8%,在外侧平台达到7%。在内侧或外侧股骨软骨中未观察到显著的平均间室应变。然而,内侧和外侧股骨软骨的局部区域经历了显著压缩应变,分别达到最大值6%和3%。
由于动态活动,股骨和胫骨的局部区域均经历了显著的软骨应变。了解软骨应变分布的变化可能有助于阐明关节损伤后导致软骨退变的生物力学因素。
体内软骨应变的特定部位测量很重要,因为负荷改变被认为是导致骨关节炎发生和进展的一个因素。具体而言,这种方法和数据可用于评估软组织损伤(如韧带或半月板撕裂)对日常生活动态活动时软骨应变的影响。