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日常生活活动中的髋关节盂唇力学:盂唇和组织间液加压的作用。

Hip chondrolabral mechanics during activities of daily living: Role of the labrum and interstitial fluid pressurization.

作者信息

Todd Jocelyn N, Maak Travis G, Ateshian Gerard A, Maas Steve A, Weiss Jeffrey A

机构信息

Department of Bioengineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, United States.

Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, United States.

出版信息

J Biomech. 2018 Mar 1;69:113-120. doi: 10.1016/j.jbiomech.2018.01.001. Epub 2018 Jan 16.

Abstract

Osteoarthritis of the hip can result from mechanical factors, which can be studied using finite element (FE) analysis. FE studies of the hip often assume there is no significant loss of fluid pressurization in the articular cartilage during simulated activities and approximate the material as incompressible and elastic. This study examined the conditions under which interstitial fluid load support remains sustained during physiological motions, as well as the role of the labrum in maintaining fluid load support and the effect of its presence on the solid phase of the surrounding cartilage. We found that dynamic motions of gait and squatting maintained consistent fluid load support between cycles, while static single-leg stance experienced slight fluid depressurization with significant reduction of solid phase stress and strain. Presence of the labrum did not significantly influence fluid load support within the articular cartilage, but prevented deformation at the cartilage edge, leading to lower stress and strain conditions in the cartilage. A morphologically accurate representation of collagen fibril orientation through the thickness of the articular cartilage was not necessary to predict fluid load support. However, comparison with simplified fibril reinforcement underscored the physiological importance. The results of this study demonstrate that an elastic incompressible material approximation is reasonable for modeling a limited number of cyclic motions of gait and squatting without significant loss of accuracy, but is not appropriate for static motions or numerous repeated motions. Additionally, effects seen from removal of the labrum motivate evaluation of labral reattachment strategies in the context of labral repair.

摘要

髋关节骨关节炎可能由机械因素引起,可通过有限元(FE)分析进行研究。对髋关节的有限元研究通常假定在模拟活动期间关节软骨内不存在显著的流体压力损失,并将材料近似为不可压缩和弹性的。本研究考察了在生理运动过程中间质液负荷支撑得以持续的条件,以及盂唇在维持液负荷支撑中的作用及其存在对周围软骨固相的影响。我们发现,步态和下蹲的动态运动在各周期之间维持了一致的液负荷支撑,而静态单腿站立则经历了轻微的流体减压,固相应力和应变显著降低。盂唇的存在对关节软骨内的液负荷支撑没有显著影响,但可防止软骨边缘变形,从而导致软骨中的应力和应变条件降低。通过关节软骨厚度准确呈现胶原纤维取向形态对于预测液负荷支撑并非必要。然而,与简化的纤维增强进行比较突出了其生理重要性。本研究结果表明,对于模拟有限数量的步态和下蹲循环运动,在不显著损失精度的情况下,将材料近似为弹性不可压缩材料是合理的,但不适用于静态运动或大量重复运动。此外,去除盂唇所观察到的影响促使在盂唇修复的背景下评估盂唇重新附着策略。

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