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水凝胶半月板置换:与天然组织相比,羊模型中的膝关节压力和分布。

A Hydrogel Meniscal Replacement: Knee Joint Pressure and Distribution in an Ovine Model Compared to Native Tissue.

机构信息

School of Biomedical Engineering, Colorado State University, Fort Collins, CO, 80523, USA.

Department of Chemical and Biological Engineering, Colorado State University, Fort Collins, CO, 80523, USA.

出版信息

Ann Biomed Eng. 2018 Nov;46(11):1785-1796. doi: 10.1007/s10439-018-2069-8. Epub 2018 Jun 19.

Abstract

Pressure distribution of the native ovine knee meniscus was compared to a medial meniscectomy and three treatment conditions including a suture reattachment of the native tissue, an allograft, and a novel thermoplastic elastomer hydrogel (TPE) construct. The objective of this study was to assess the efficacy of a novel TPE hydrogel construct at restoring joint pressure and distribution. Limbs were loaded in uniaxial compression at 45°, 60°, and 75° flexion and from 0 to 181 kg. The medial meniscectomy decreased contact area by approximately 50% and doubled the mean and maximum pressure reading for the medial hemijoint. No treatment condition tested within this study was able to fully restore medial joint contact area and pressures to the native condition. A decrease in lateral contact area and increase in pressures with the meniscectomy was also seen; and to some degree, all reattachment and replacement conditions including the novel TPE hydrogel replacement helped to restore lateral pressures. Although the TPE construct did not perform as well as hoped in the medial compartment, it performed as well as, if not better, than the other reattachment and replacement options in the lateral. Further work is necessary to determine the best anchoring and attachment methods.

摘要

比较了天然绵羊半月板在膝关节中的压力分布与内侧半月板切除术以及三种治疗情况,包括天然组织的缝合再附着、同种异体移植物和新型热塑性弹性体水凝胶 (TPE) 构建体。本研究的目的是评估新型 TPE 水凝胶构建体在恢复关节压力和分布方面的效果。肢体在 45°、60°和 75°屈曲以及 0 至 181kg 的单轴压缩下加载。内侧半月板切除术使接触面积减少了约 50%,并使内侧半关节的平均和最大压力读数增加了一倍。在本研究中测试的任何治疗情况都无法完全恢复内侧关节接触面积和压力到天然状态。内侧半月板切除术也导致外侧接触面积减少和压力增加,并且在某种程度上,所有的再附着和替代情况,包括新型 TPE 水凝胶替代物,都有助于恢复外侧压力。尽管 TPE 构建体在中间隔室中的表现不如预期,但它在外侧的表现与其他再附着和替代选择一样好,如果不是更好的话。需要进一步的工作来确定最佳的锚固和附着方法。

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