Chowdhury James My, Lineham Beth, Pallett Matthew, Pandit Hemant G, Stewart Todd D, Harwood Paul J
Department of Trauma and Orthopaedics, Leeds General Infirmary, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom.
Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom.
Strategies Trauma Limb Reconstr. 2021 May-Aug;16(2):71-77. doi: 10.5005/jp-journals-10080-1530.
This study was designed to test and compare the mechanical performance of the biplanar ArthroSave KneeReviver and a circular frame construct with the intended use of providing a mechanically favourable environment for cartilage regeneration across a knee joint.
Three similar constructs of the two devices were applied to biomechanical testing sawbones, with the knee distracted by 8 mm. The constructs were vertically loaded to 800 N in an Instron testing machine at 20 mm/minute. Tests were conducted in neutral hip flexion and at 12° of hip flexion and extension, to mimic leg position in gait. Displacement measurements were taken from the Instron machine, and three-dimensional joint motion was recorded using an Optotrak Certus motion capture system.
Overall axial rigidity was similar between the two devices (circular frame, 81.6 N/mm ± 5.9; and KneeReviver, 79.5 N/mm ± 25.1 with hip neutral) and similar in different hip positions. At the point of joint contact, the overall rigidity of the circular frame increased significantly more than the KneeReviver (491 N/mm ± 27 and 93 N/mm ± 32, respectively, <0.001). There was more variability between models in the KneeReviver. There was more off-axis motion in the KneeReviver, mainly due to increasing knee flexion on loading. This was exacerbated with the hip in flexion and extension but remained small, with the maximal off-axis displacement being 7 mm/3°.
The circular frame provides a similar mechanical environment to the novel KneeReviver device, for which most clinical data are available. These findings suggest that both devices appear a viable option for knee joint distraction (KJD). Further clinical data will help inform mode of application.
KJD is a relatively novel technique for use in osteoarthritis (OA), and it remains unclear which distraction devices provide appropriate mechanics. Our testing gives evidence to support either option for further use.
Chowdhury JMY, Lineham B, Pallett M, . Comparison of Mechanical Performance between Circular Frames and Biplanar Distraction Devices for Knee Joint Distraction. Strategies Trauma Limb Reconstr 2021;16(2):71-77.
本研究旨在测试并比较双平面ArthroSave KneeReviver与圆形框架结构的力学性能，其预期用途是为膝关节软骨再生提供力学上有利的环境。
将两种装置的三个相似结构应用于生物力学测试锯骨模型，膝关节撑开8毫米。在Instron测试机中以20毫米/分钟的速度将结构垂直加载至800牛。测试在髋关节中立位屈曲以及髋关节屈曲和伸展12°时进行，以模拟步态中的腿部位置。从Instron机器获取位移测量值，并使用Optotrak Certus运动捕捉系统记录三维关节运动。
两种装置的整体轴向刚度相似（圆形框架，81.6牛/毫米±5.9；KneeReviver，髋关节中立位时为79.5牛/毫米±25.1），且在不同髋关节位置时也相似。在关节接触点，圆形框架的整体刚度增加幅度明显大于KneeReviver（分别为491牛/毫米±27和93牛/毫米±32，<0.001）。KneeReviver各模型之间的变异性更大。KneeReviver存在更多的离轴运动，主要是由于加载时膝关节屈曲增加。髋关节屈曲和伸展时这种情况会加剧，但仍然较小，最大离轴位移为7毫米/3°。
圆形框架为新型KneeReviver装置提供了相似的力学环境，KneeReviver有更多临床数据。这些发现表明，两种装置似乎都是膝关节撑开（KJD）的可行选择。更多临床数据将有助于明确应用方式。
KJD是一种用于骨关节炎（OA）的相对新技术，目前尚不清楚哪种撑开装置能提供合适的力学性能。我们的测试为进一步使用这两种选择提供了支持证据。
Chowdhury JMY, Lineham B, Pallett M, . 膝关节撑开的圆形框架与双平面撑开装置力学性能比较。创伤肢体重建策略2021；16(2):71 - 77。
