Pflieger Iris, Stolberg-Stolberg Josef, Foehr Peter, Kuntz Lara, Tübel Jutta, Grosse Christian U, Burgkart Rainer
Department of Orthopaedics and Sports Orthopaedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, Germany; Department of Trauma Surgery, Trauma Center Murnau, Professor-Küntscher-Str. 8, 82418 Murnau, Germany.
Department of Orthopaedics and Sports Orthopaedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, Germany; Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149 Muenster, Germany.
Clin Biomech (Bristol). 2019 Jul;67:1-7. doi: 10.1016/j.clinbiomech.2019.04.015. Epub 2019 Apr 24.
Clinical cartilage repair strategies can be tested using the sheep model as suggest by the European Medicines Agency. To characterize variation within the joint a full biomechanical mapping is necessary. The aim of this study is to establish a loading model, to map regional differences within the knee and determine reference areas for area specific replacement techniques.
A porous indenter was selected to evaluate 22 defined test locations (femoral condyles, tibia plateau, patella, femoral groove) on ovine knees (n = 7). A high-dynamic force-controlled micro creep and creep-recovery indentation test system applied five loading (0.11 MPa) and unloading (5.6 kPa) cycles for 60 s each and recorded creep-recovery. Needle indentation was used to measure cartilage thickness and calculate total strain.
Steady state behaviour was observed from the third cycle and further evaluated. Little variation of stiffness in N/mm was found within the patella (4.3SD0.5) and femoral groove (8.1SD0.7) compared to larger variations in the femur (7.9SD2.0) and tibia (7.5SD3.2). Creep indentation showed values of 14.5%(SD2.7%) for the patella and 17.4%(SD3%) for the femoral grove opposed to 13.4%(SD4.3%) for the femoral condyles and 21.8%(SD6.6%) for the tibia plateau. Similar trends were observed analysing creep-recovery. Values were normalized to cartilage thickness which ranged between 0.36 mm and 1.14 mm.
Our setup allows a reliable evaluation of zonal differences. Homogenous biomechanical behaviour is found within the patella and femoral groove whereas significant biomechanical variation within the femoral condyles and tibia plateau indicates the need for site-specific cartilage repair products.
欧洲药品管理局建议,可以使用绵羊模型来测试临床软骨修复策略。为了描述关节内的变异情况,进行全面的生物力学测绘是必要的。本研究的目的是建立一个加载模型,描绘膝关节内的区域差异,并确定区域特异性置换技术的参考区域。
选择一个多孔压头来评估绵羊膝关节(n = 7)上22个定义好的测试位置(股骨髁、胫骨平台、髌骨、股骨沟)。一个高动态力控微蠕变和蠕变恢复压痕测试系统施加五个加载(0.11兆帕)和卸载(5.6千帕)循环,每个循环持续60秒,并记录蠕变恢复情况。使用针压痕测量软骨厚度并计算总应变。
从第三个循环开始观察到稳态行为并进一步评估。与股骨(7.9±2.0)和胫骨(7.5±3.2)的较大变异相比,髌骨(4.3±0.5)和股骨沟(8.1±0.7)内以N/mm为单位的刚度变化很小。蠕变压痕显示,髌骨的值为14.5%(标准差2.7%),股骨沟为17.4%(标准差3%),而股骨髁为13.4%(标准差4.3%),胫骨平台为21.8%(标准差6.6%)。分析蠕变恢复时观察到类似趋势。数值已根据软骨厚度进行归一化,软骨厚度在0.36毫米至1.14毫米之间。
我们的设置允许对区域差异进行可靠评估。在髌骨和股骨沟内发现了均匀的生物力学行为,而股骨髁和胫骨平台内显著的生物力学变异表明需要针对特定部位的软骨修复产品。