Zheng Liying, Carey Robert, Thorhauer Eric, Tashman Scott, Harner Christopher, Zhang Xudong
Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA; Health Effects Lab Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA.
Med Eng Phys. 2018 Jan;51:41-48. doi: 10.1016/j.medengphy.2017.10.014. Epub 2017 Nov 6.
We investigated the effects of isolated meniscectomy on tibiofemoral skeletal kinematics and cartilage contact arthrokinematics in vivo. We recruited nine patients who had undergone isolated medial or lateral meniscectomy, and used a dynamic stereo-radiography (DSX) system to image the patients' knee motion during decline walking. A volumetric model-based tracking process determined 3D tibiofemoral kinematics from the recorded DSX images. Cartilage contact arthrokinematics was derived from the intersection between tibial and femoral cartilage models co-registered to the bones. The kinematics and arthrokinematics were analyzed for early stance and loading response phase (30% of a gait cycle), comparing the affected and intact knees. Results showed that four patients with medial meniscectomy had significantly greater contact centroid excursions in the meniscectomized medial compartments while five patients with lateral meniscectomy had significantly greater cartilage contact area and lateral shift of contact centroid path in the meniscectomized lateral compartments, comparing to those of the same compartments in the contralateral intact knees. No consistent difference however was identified in the skeletal kinematics. The current study demonstrated that cartilage-based intra-articular arthrokinematics is more sensitive and insightful than the skeletal kinematics in assessing the meniscectomy effects.
我们在体内研究了单纯半月板切除术对胫股关节骨骼运动学和软骨接触关节运动学的影响。我们招募了9例接受单纯内侧或外侧半月板切除术的患者,并使用动态立体放射成像(DSX)系统对患者下坡行走时的膝关节运动进行成像。基于体积模型的跟踪过程从记录的DSX图像中确定三维胫股关节运动学。软骨接触关节运动学是从与骨骼配准的胫骨和股骨软骨模型之间的交点得出的。对早支撑期和负荷反应期(一个步态周期的30%)的运动学和关节运动学进行分析,比较患侧和健侧膝关节。结果显示,与对侧健侧膝关节相同关节相比,4例内侧半月板切除术患者在半月板切除的内侧关节间有明显更大的接触质心偏移,而5例外侧半月板切除术患者在半月板切除的外侧关节间有明显更大的软骨接触面积和接触质心路径的外侧偏移。然而,在骨骼运动学方面未发现一致的差异。当前研究表明,在评估半月板切除术的效果时,基于软骨的关节内关节运动学比骨骼运动学更敏感、更有洞察力。