Department of Traumatic Orthopaedics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Department of Orthopaedics, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Department of Orthopaedics, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Injury. 2022 Jul;53(7):2446-2453. doi: 10.1016/j.injury.2022.05.027. Epub 2022 May 19.
The proximal tibiofibular joint (PTFJ) is easily ignored, although many diseases of the knee are caused by PTFJ injuries. Therefore, studying PTFJ biomechanics is very important. The effects of PTFJ injury on ankle function have been reported. However, few studies have assessed the effects of PTFJ injury on the knee joint. This study was performed to describe the biomechanical effects of PTFJ on the knee joint according to a three-dimensional finite element model.
The knee joint of a healthy volunteer was scanned by CT and MRI. CT and MRI scanning data in DICOM format were imported into Mimics software. Subsequently, 3D models of the normal and PTFJ injured knee, including the bone, cartilage, meniscus and ligament structures were established, and their validity was verified on the basis of available studies in literature. The biomechanical changes in the two knee models under different conditions were compared.
The validity of the intact model was verified. No significant difference was observed in tibial mobility in the two models under the conditions of 134 N forward, 10 N·m internal rotation and 10 N·m valgus load. After application of 134 N backward, 10 N·m varus and external rotation load with respect to the tibia, the posterior movement of the tibia and the varus and external rotation angles of the tibia were 3.583±0.892 mm, 4.799±0.092° and 18.963±0.027° in the normal knee model, and 5.127±1.224 mm, 5.277±0.104° and 21.399±0.031° in the PTFJ injury model, respectively, and a significant statistical difference was observed.
PTFJ played an important role in maintaining the posterolateral stability of the knee joint and thus deserves more attention in clinical operations.
尽管许多膝关节疾病是由胫腓关节（PTFJ）损伤引起的，但很容易忽视 PTFJ。因此，研究 PTFJ 生物力学非常重要。已经报道了 PTFJ 损伤对踝关节功能的影响。然而，很少有研究评估 PTFJ 损伤对膝关节的影响。本研究旨在根据三维有限元模型描述 PTFJ 对膝关节的生物力学影响。
对一名健康志愿者的膝关节进行 CT 和 MRI 扫描。以 DICOM 格式将 CT 和 MRI 扫描数据导入 Mimics 软件。随后，建立了正常和 PTFJ 损伤膝关节的 3D 模型，包括骨骼、软骨、半月板和韧带结构，并根据文献中可用的研究验证其有效性。比较了两种膝关节模型在不同条件下的生物力学变化。
完整模型的有效性得到了验证。在 134N 前向、10N·m 内旋和 10N·m 外翻负荷下，两种模型的胫骨活动度无显著差异。在胫骨施加 134N 后向、10N·m 内翻和外旋负荷后，正常膝关节模型中胫骨后移和胫骨内翻、外旋角度分别为 3.583±0.892mm、4.799±0.092°和 18.963±0.027°，PTFJ 损伤模型中分别为 5.127±1.224mm、5.277±0.104°和 21.399±0.031°，差异有统计学意义。
PTFJ 在维持膝关节后外侧稳定性方面起着重要作用，因此在临床操作中值得更多关注。
