Wang Sentong, Hase Kazunori, Kita Shunsuke, Ogaya Shinya
Human-Mechanical System Laboratory, Graduate School of Systems Design, Tokyo Metropolitan University, Hachioji, Japan.
Human-Mechanical System Laboratory, Faculty of Systems Design, Tokyo Metropolitan University, Hachioji, Japan.
Front Bioeng Biotechnol. 2022 Oct 10;10:957435. doi: 10.3389/fbioe.2022.957435. eCollection 2022.
The biomechanical variation in the knee during walking that accompanies medial meniscal radial tears stemming from knee osteoarthritis (OA) has not been explored. This study introduced a finite element musculoskeletal model using concurrent lower limb musculoskeletal dynamics and knee joint finite element analysis in a single framework and expanded the models to include knees with medial meniscal radial tears and total medial meniscectomy. The radial tears involved three locations: anterior horn, midbody, and posterior horn with grades of 33%, 50%, and 83% of the meniscus width. The shear and hoop stresses of the tear meniscus and tibial cartilage contact load, accompanying tears, and postmeniscectomy were evaluated during the stance phase of the gait cycle using the models. In the 83% width midbody tear group, shear stress at the end of the tear was significantly greater than in the intact meniscus and other tear groups, and the maximum shear stress was increased by 310% compared to the intact meniscus. A medial meniscus radial tear has a much smaller effect on the tibial cartilage load (even though in the 83% width tear, the cartilage/total load ratio increased by only 9%). However, the contact force on the tibial cartilage with total postmeniscectomy was increased by 178.93% compared with a healthy intact meniscus, and the peak contact pressure after meniscectomy increased from 11.94 to 12.45 MPa to 17.64 and 13.76 MPa, at the maximum weight acceptance and push-off, respectively. Our study shows that radial tears with larger medial meniscus widths are prone to high stress concentrations at the end of the tears, leading to the potential risk of complete meniscal rupture. Furthermore, although the tears did not change the cartilage load distribution, they disrupted the circumferential stress-transmitting function of the meniscus, thus greatly increasing the likelihood of the onset of knee OA. The significant increase in the tibial cartilage load with total postmeniscectomy indicates a potential risk of OA flare-ups. This study contributes to a better understanding of meniscal tear-induced OA biomechanical changes during human activities and offers some potential directions for surgical guidance of meniscectomies and the prophylaxis and treatment of OA.
膝关节骨关节炎（OA）引发的内侧半月板放射状撕裂在行走过程中膝关节的生物力学变化尚未得到研究。本研究引入了一个有限元肌肉骨骼模型，该模型在单一框架中同时运用下肢肌肉骨骼动力学和膝关节有限元分析，并将模型扩展到包括内侧半月板放射状撕裂和全内侧半月板切除术的膝关节。放射状撕裂涉及三个位置：前角、体部中部和后角，撕裂程度分别为半月板宽度的33%、50%和83%。利用这些模型在步态周期的站立阶段评估了撕裂半月板的剪切应力和环向应力、胫骨软骨接触负荷、伴随撕裂情况以及半月板切除术后的情况。在半月板宽度83%的体部中部撕裂组中，撕裂末端的剪切应力显著大于完整半月板和其他撕裂组，与完整半月板相比，最大剪切应力增加了310%。内侧半月板放射状撕裂对胫骨软骨负荷的影响要小得多（尽管在半月板宽度83%的撕裂中，软骨/总负荷比仅增加了9%）。然而，全半月板切除术后胫骨软骨上的接触力与健康完整半月板相比增加了178.93%，半月板切除术后的峰值接触压力在最大承重和蹬离时分别从11.94和12.45兆帕增加到17.64和13.76兆帕。我们的研究表明，内侧半月板宽度较大的放射状撕裂在撕裂末端容易出现高应力集中，导致半月板完全破裂的潜在风险。此外，尽管撕裂并未改变软骨负荷分布，但它们破坏了半月板的环向应力传递功能，从而大大增加了膝关节OA发病的可能性。全半月板切除术后胫骨软骨负荷的显著增加表明存在OA复发的潜在风险。本研究有助于更好地理解人类活动期间半月板撕裂引起的OA生物力学变化，并为半月板切除术的手术指导以及OA的预防和治疗提供了一些潜在方向。
