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基于三维重建算法的前交叉韧带重建后关节软骨生物力学变化的磁共振成像评估。

Three-Dimensional Reconstruction Algorithm-Based Magnetic Resonance Imaging Evaluation of Biomechanical Changes in Articular Cartilage in Patients after Anterior Cruciate Ligament Reconstruction.

机构信息

Department of Sports Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.

出版信息

Comput Intell Neurosci. 2022 Mar 15;2022:8256450. doi: 10.1155/2022/8256450. eCollection 2022.

Abstract

This study aimed to investigate the evaluation of biomechanical changes in articular cartilage in patients after anterior cruciate ligament (ACL) reconstruction by magnetic resonance imaging (MRI) based on a three-dimensional (3D) finite element model. The data of 90 patients undergoing arthroscopic ACL reconstruction in the hospital were collected and divided into the stable group (54 cases) and the unstable group (36 cases). A load of up to 134N was applied to the 3D finite element model, and the kinematics of knee flexion at 0°, 30°, 60°, and 90° were examined. The tibial anteversion, tibial rotation, and ACL/graft tension were recorded in the 3D finite element model, which was randomly divided into the normal group (intact group,  = 30), the ACL rupture group (deficient group,  = 30), and the anatomical reconstruction group (anatomical group,  = 30). When the graft was fixed at 0°, the anterior tibial translation at 30°, 60°, and 90° in the anatomic group was 8-19% higher than the normal value under 134 N anterior load. The tibial internal rotation in the anatomic group was 18% and 28% higher than the normal value at 30° and 90°. When the graft was fixed at 30°, the anterior tibial translation at 60° and 90° of the anatomic group was 15% higher than the normal value. The tibial internal rotation at 90° of the anatomic group was 16% higher than the normal value, and the above differences had statistical significance ( < 0.05). MRI images were used to assess the bone tunnel angle, and the statistical analysis by the independent-samples -test showed that there were significant differences in the bone tunnel angle between the stable group and the unstable group ( < 0.05). Currently, based on the 3D finite element model, MRI can accurately evaluate the postoperative effect of anatomical ACL reconstruction in the position, diameter, and angle of tibial and femoral bone tunnels, which can be applied to clinical promotion.

摘要

本研究旨在通过三维(3D)有限元模型探讨磁共振成像(MRI)评估前交叉韧带(ACL)重建后关节软骨生物力学变化。收集医院行关节镜 ACL 重建的 90 例患者资料,分为稳定组(54 例)和不稳定组(36 例)。对 3D 有限元模型施加高达 134N 的载荷,检查膝关节 0°、30°、60°和 90°屈曲时的运动学。记录 3D 有限元模型中的胫骨前倾角、胫骨旋转和 ACL/移植物张力,将其随机分为正常组(完整组,n=30)、ACL 断裂组(缺陷组,n=30)和解剖重建组(解剖组,n=30)。当移植物固定在 0°时,解剖组在 134N 前负荷下,30°、60°和 90°时胫骨前向平移分别比正常高 8-19%。解剖组在 30°和 90°时胫骨内旋分别比正常高 18%和 28%。当移植物固定在 30°时,解剖组在 60°和 90°时胫骨前向平移比正常高 15%。解剖组在 90°时胫骨内旋比正常高 16%,差异均有统计学意义( < 0.05)。MRI 图像用于评估骨隧道角度,独立样本 -检验的统计分析显示稳定组和不稳定组之间骨隧道角度存在显著差异( < 0.05)。目前,基于 3D 有限元模型,MRI 可准确评估解剖 ACL 重建术后胫骨和股骨骨隧道位置、直径和角度的术后效果,可应用于临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72e6/8940546/08e7d7b205e3/CIN2022-8256450.001.jpg

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