Department of Orthopedics, Affiliated Hospital of North China University of Science and Technology, Hebei, PR China.
Department of Orthopedics, Affiliated Hospital of North China University of Science and Technology, Hebei, PR China.
Med Eng Phys. 2022 Sep;107:103855. doi: 10.1016/j.medengphy.2022.103855. Epub 2022 Jul 19.
Incidence of osteoarthritis and genu valgus is higher after partial meniscectomy of the discoid lateral meniscus. We aimed to provide a biomechanical reference for slowing the development of osteoarthritis and genu valgus after complete discoid lateral meniscus (CDLM) surgery.
Computed tomography and magnetic resonance images of the knee were used to establish a finite element model of the knee. The discoid lateral meniscus model was cut at 2-mm intervals to obtain 10 lateral meniscus models of different widths (2-20 mm). The instantaneous stress peak and knee valgus angle were obtained by finite element analysis under the same coaxial load.
When the residual width of the lateral meniscus was greater than 12 mm, the peak stress of the knee joint and angle of genu valgus did not significantly change from preoperative levels. The contact stress peak increased slightly as the width decreased from 12 to 8 mm. When the width was reduced from 8 to 0 mm, the contact stress peak increased significantly.
For partial meniscectomy in CDLM patients, meniscus width of 8-10 mm provides a better biomechanical environment. This may reduce risk of early knee degeneration and valgus from excessive meniscectomy in conventional surgery.
盘状外侧半月板部分切除术会增加骨关节炎和膝内翻的发生率。本研究旨在为盘状外侧半月板（CDLM）全切除术提供生物力学参考，以减缓骨关节炎和膝内翻的发展。
利用膝关节 CT 和 MRI 建立膝关节有限元模型。将盘状外侧半月板模型每隔 2mm 切开，获得 10 个不同宽度（2-20mm）的外侧半月板模型。在相同的同轴载荷下，通过有限元分析获得瞬时峰值应力和膝内翻角。
当外侧半月板的残余宽度大于 12mm 时，膝关节的峰值应力和膝内翻角度与术前相比没有明显变化。当宽度从 12mm 减小到 8mm 时，接触应力峰值略有增加。当宽度从 8mm 减小到 0mm 时，接触应力峰值显著增加。
对于 CDLM 患者的部分切除术，8-10mm 的半月板宽度提供了更好的生物力学环境。这可能会降低常规手术中过度半月板切除导致早期膝关节退变和膝内翻的风险。
