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不同屈曲角度下部分内侧半月板切除术后胫股关节的生物力学特性:有限元分析

Biomechanical characteristics of tibio-femoral joint after partial medial meniscectomy in different flexion angles: a finite element analysis.

作者信息

Zhang Xiaohui, Yuan Shuo, Wang Jun, Liao Bagen, Liang De

机构信息

Guangzhou University of Chinese Medicine, 12 Airport Road, Guangzhou, 510405, Guangdong Province, China.

Gaosun Medical Imaging Diagnosis Center of Guangdong Province, 117 Liuhua Road, Guangzhou, 515500, Guangdong Province, China.

出版信息

BMC Musculoskelet Disord. 2021 Apr 2;22(1):322. doi: 10.1186/s12891-021-04187-8.

Abstract

BACKGROUND

Recent studies have pointed out that arthroscopy, the commonly-used surgical procedure for meniscal tears, may lead to an elevated risk of knee osteoarthritis (KOA). The biomechanical factors of KOA can be clarified by the biomechanical analysis after arthroscopic partial meniscectomy (APM). This study aimed to elucidate the cartilage stress and meniscus displacement of the tibiofemoral joint under flexion and rotation loads after APM.

METHODS

A detailed finite element model of the knee bone, cartilage, meniscus, and major ligaments was established by combining computed tomography and magnetic resonance images. Vertical load and front load were applied to simulate different knee buckling angles. At the same time, by simulating flexion of different degrees and internal and external rotations, the stresses on tibiofemoral articular cartilage and meniscus displacement were evaluated.

RESULTS

Generally, the contact stress on both the femoral tibial articular cartilage and the meniscus increased with the increased flexion degree. Moreover, the maximum stress on the tibial plateau gradually moved backward. The maximum position shift value of the lateral meniscus was larger than that of the medial meniscus.

CONCLUSION

Our finite element model provides a realistic three-dimensional model to evaluate the influence of different joint range of motion and rotating tibiofemoral joint stress distribution. The decreased displacement of the medial meniscus may explain the higher pressure on the knee components. These characteristics of the medial tibiofemoral joint indicate the potential biomechanical risk of knee degeneration.

摘要

背景

近期研究指出,关节镜检查作为治疗半月板撕裂的常用外科手术,可能会导致膝关节骨关节炎(KOA)风险升高。关节镜下部分半月板切除术(APM)后的生物力学分析可阐明KOA的生物力学因素。本研究旨在阐明APM后在屈伸和旋转负荷下胫股关节的软骨应力和半月板位移情况。

方法

通过结合计算机断层扫描和磁共振图像,建立了包含膝关节骨骼、软骨、半月板和主要韧带的详细有限元模型。施加垂直负荷和前负荷以模拟不同的膝关节屈曲角度。同时,通过模拟不同程度的屈伸以及内旋和外旋,评估胫股关节软骨的应力和半月板位移情况。

结果

一般来说,股胫关节软骨和半月板上的接触应力均随屈曲程度增加而增大。此外,胫骨平台上的最大应力逐渐向后移动。外侧半月板的最大位置偏移值大于内侧半月板。

结论

我们的有限元模型提供了一个逼真的三维模型,以评估不同关节活动范围和旋转时胫股关节应力分布的影响。内侧半月板位移的减少可能解释膝关节各部件上更高的压力。胫股内侧关节的这些特征表明膝关节退变存在潜在的生物力学风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d2e/8017646/738983826428/12891_2021_4187_Fig1_HTML.jpg

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