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前交叉韧带重建术后膝关节的生物力学

Biomechanics of Knee Joints after Anterior Cruciate Ligament Reconstruction.

作者信息

He Chuan, He Wu, Li Yanlin, Wang Fuke, Tong Lu, Zhang Zhengguang, Jia Di, Wang Guoliang, Zheng Jiali, Chen Guangchao

机构信息

Department of Sports Medicine, No. 1 Affiliated Hospital of Kunming Medical University, Yunnan, China.

Visual Computing and Virtual Reality Key Laboratory of Sichuan Province, College of Movie and Media, Sichuan Normal University, Sichuan, China.

出版信息

J Knee Surg. 2018 Apr;31(4):352-358. doi: 10.1055/s-0037-1603799. Epub 2017 Jun 30.

Abstract

This study aimed to investigate the biomechanical properties of anterior cruciate ligament (ACL); tibial, femoral articular cartilage; and meniscus in knee joints receiving computer-aided or conventional ACL reconstruction. Three-dimensional (3D) knee joint finite element models were established for healthy volunteers (normal group) and patients receiving computer-aided surgery (CAS) or conventional (traditional surgery [TS]) ACL reconstruction. The stress and stress distribution on the ACL, tibial, femoral articular cartilage, and meniscus were examined after force was applied on the 3D knee joint finite element models. No significant differences were observed in the stress on ACL among normal group, CAS group, and TS group when a femoral backward force was loaded. However, when a vertical force of 350 N was loaded on the knee joints, TS group had significant higher stress on the articular cartilage and meniscus than the other two groups at any flexion angle of 0, 30, 60, and 90 degrees. However, no significant differences were observed between CAS group and normal group. In conclusion, computer-aided ACL reconstruction has advantages over conventional surgery approach in restoring the biomechanical properties of knee joints, thus reducing the risk of damage to the knee joint cartilage and meniscus after ACL reconstruction.

摘要

本研究旨在调查接受计算机辅助或传统前交叉韧带(ACL)重建的膝关节中ACL、胫骨和股骨关节软骨以及半月板的生物力学特性。为健康志愿者(正常组)以及接受计算机辅助手术(CAS)或传统(传统手术[TS])ACL重建的患者建立了三维(3D)膝关节有限元模型。在对3D膝关节有限元模型施加力后,检查ACL、胫骨、股骨关节软骨和半月板上的应力及应力分布。当施加股骨向后的力时,正常组、CAS组和TS组之间ACL上的应力未观察到显著差异。然而,当在膝关节上施加350 N的垂直力时,在0、30、60和90度的任何屈曲角度下,TS组关节软骨和半月板上的应力均显著高于其他两组。然而,CAS组和正常组之间未观察到显著差异。总之,计算机辅助ACL重建在恢复膝关节生物力学特性方面优于传统手术方法,从而降低了ACL重建后膝关节软骨和半月板受损的风险。

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