Department of Engineering Mechanics, Institute of Biomechanics and Medical Engineering, Tsinghua University, Beijing, 100084, China.
State Key Laboratory of Tribology, Tsinghua University, Room A1031, Lee Shau Kee Science and Technology Building, Beijing, 100084, China.
Med Biol Eng Comput. 2017 Dec;55(12):2097-2106. doi: 10.1007/s11517-017-1637-7. Epub 2017 May 23.
As one of the most frequently used grafts in anterior cruciate ligament (ACL) reconstruction, hamstring tendon (HT) grafts are prepared with different lengths and fixed by specific fixations in knee joints. However, there are incomplete studies to investigate both the joint kinematics and graft biomechanics in the ACL reconstructions with different HT graft lengths. In this paper, three different graft lengths (i.e., 30, 50, and 70 mm) were developed in the ACL reconstruction and analyzed using finite element method under two usual clinical test loads (i.e., 134 N anterior tibial drawer and pivot shift test load). The different mechanical properties of the corresponding fixations were also considered for each graft length. It was revealed that the change in HT graft length would cause different strain and stress results in the grafts, but did not greatly influence joint stabilities under the two clinical test loads. The graft reaction force at the femoral fixation was always greatly lower than that at the tibial fixation regardless of load and graft length. The comparison of stress and strain results also indicated that more graft tissues inside the femoral and tibial tunnels could decrease the stress and strain values at the femoral and tibial fixation sites, respectively.
作为前交叉韧带 (ACL) 重建中最常使用的移植物之一，腘绳肌腱 (HT) 移植物的长度不同，并通过膝关节中的特定固定装置进行固定。然而，目前还没有研究来全面评估不同 HT 移植物长度的 ACL 重建中的关节运动学和移植物生物力学。在本文中，我们在 ACL 重建中开发了三种不同的移植物长度（即 30、50 和 70mm），并使用有限元方法在两种常用的临床测试负载（即 134N 胫骨前抽屉和枢轴转移测试负载）下进行了分析。还考虑了每种移植物长度对应的不同固定装置的机械性能。结果表明，HT 移植物长度的变化会导致移植物中的应变和应力发生不同的变化，但在两种临床测试负载下，对关节稳定性的影响不大。股骨固定处的移植物反作用力始终远低于胫骨固定处的移植物反作用力，无论负载和移植物长度如何。应力和应变结果的比较也表明，股骨和胫骨隧道内更多的移植物组织可以分别降低股骨和胫骨固定部位的应力和应变值。
