Robotics and Mechatronics Lab, Technical Medical (TechMed) Centre, University of Twente, Building Carré, Room CR 3607, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
Radboud Institute for Health Sciences, Orthopaedic Research Lab, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands.
Med Biol Eng Comput. 2020 Jun;58(6):1341-1355. doi: 10.1007/s11517-020-02158-0. Epub 2020 Apr 11.
Despite all the efforts to optimize the meniscus prosthesis system (geometry, material, and fixation type), the success of the prosthesis in clinical practice will depend on surgical factors such as intra-operative positioning of the prosthesis. In this study, the aim was therefore to assess the implications of positional changes of the medial meniscus prosthesis for knee biomechanics. A detailed validated finite element (FE) model of human intact and meniscal implanted knees was developed based on a series of in vitro experiments. Different non-anatomical prosthesis positions were applied in the FE model, and the biomechanical response during the gait stance phase compared with an anatomically positioned prosthesis, as well as meniscectomized and also the intact knee model. The results showed that an anatomical positioning of the medial meniscus prosthesis could better recover the intact knee biomechanics, while a non-anatomical positioning of the prosthesis to a limited extent alters the knee kinematics and articular contact pressure and increases the implantation failure risk. The outcomes indicate that a medial or anterior positioning of the meniscus prosthesis may be more forgiving than a posteriorly or laterally positioned prosthesis. The outcome of this study may provide a better insight into the possible consequences of meniscus prosthesis positioning errors for the patient and the prosthesis functionality. Graphical abstract.
尽管人们已经尽力优化半月板假体系统（几何形状、材料和固定类型），但假体在临床实践中的成功将取决于手术因素，例如假体的术中定位。因此，本研究旨在评估内侧半月板假体位置变化对膝关节生物力学的影响。本研究基于一系列体外实验，开发了详细的、经过验证的、完整膝关节和半月板植入物的有限元（FE）模型。在 FE 模型中应用了不同的非解剖假体位置，并与解剖定位假体、半月板切除术和完整膝关节模型进行了步态站立阶段的生物力学响应比较。结果表明，内侧半月板假体的解剖定位可以更好地恢复完整膝关节的生物力学，而假体的非解剖定位在一定程度上改变了膝关节运动学和关节接触压力，并增加了植入物失效的风险。研究结果表明，半月板假体的内侧或前侧定位可能比后侧或外侧定位更宽容。本研究的结果可以更好地了解半月板假体定位错误对患者和假体功能的可能后果。
