Li Jia, Wei Yu, Wei Min
Department of Orthopedics, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Med Sci Monit. 2020 Aug 21;26:e921823. doi: 10.12659/MSM.921823.
BACKGROUND Talus cartilage injury leads to changes in biomechanics of the ankle joint and ultimately affects ankle joint function, but which talus cartilage defects require surgery is still uncertain. This research used a finite element method to simulate the effect of different depth of talus cartilage defects on the stress and stability of the ankle joint in a certain area. MATERIAL AND METHODS A three-dimensional finite element model with different depths of osteochondral defects was created to simulate and calculate joint stress and displacement of the articular surface of the distal tibia and the proximal talus while the ankle joint was in the push-off, midstance, and heel-strike phases. RESULTS The equivalent stress of the proximal talus did not change significantly at a defect depth of 1 mm, whereas the equivalent stress of the upper talus increased significantly at a defect depth of ≥3 mm or more, reaching a maximum value at a defect depth of 10 mm. The equivalent stress of the tibial cartilage and the equivalent stress and displacement in the corresponding forces in the midstance phase and heel-strike phase were significantly different from those in the normal group, but the difference in stress in each defect group was not obvious. CONCLUSIONS The effect of cartilage defects of the talus on biomechanics of the ankle is clear, especially in the midstance and push-off phases. When the defect reaches the subchondral bone (at a depth of 3 mm), the most obvious change in ankle joint stability occurs, and it does not increase linearly with the increase in depth of the defect.
背景 距骨软骨损伤会导致踝关节生物力学改变,最终影响踝关节功能,但哪些距骨软骨缺损需要手术仍不明确。本研究采用有限元方法模拟距骨软骨缺损不同深度对踝关节特定区域应力和稳定性的影响。
材料与方法 建立具有不同深度骨软骨缺损的三维有限元模型,以模拟和计算踝关节在蹬离期、站立中期和足跟撞击期时胫骨远端和距骨近端关节面的关节应力和位移。
结果 缺损深度为1mm时,距骨近端的等效应力无明显变化,而缺损深度≥3mm及以上时,距骨上部的等效应力显著增加,在缺损深度为10mm时达到最大值。胫骨软骨的等效应力以及站立中期和足跟撞击期相应力中的等效应力和位移与正常组有显著差异,但各缺损组间应力差异不明显。
结论 距骨软骨缺损对踝关节生物力学的影响明显,尤其是在站立中期和蹬离期。当缺损累及软骨下骨(深度为3mm)时,踝关节稳定性变化最为明显,且并不随缺损深度增加呈线性增加。