Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Knee. 2023 Jun;42:57-63. doi: 10.1016/j.knee.2023.02.013. Epub 2023 Mar 9.
Partial meniscectomy is commonly performed for symptomatic patients with discoid lateral meniscus (DLM) if conservative treatment fails. However, the development of knee osteoarthritis and osteochondral lesion are detrimental postoperative complications. This study aimed to evaluate the effect of the volume of resected DLM on the contact stress of the tibiofemoral joint using a finite element analysis.
Subject-specific finite-element models of the knee joint of a patient with DLM were developed from computed tomographic and magnetic resonance images. To evaluate the effect of partial meniscectomy on the contact stress in the lateral tibiofemoral joint, six knee models were created in the study (the native DLM, and five partially meniscectomized DLMs (according to the preserved width of the meniscus: 12 mm, 10 mm, 8 mm, 6 mm, and 4 mm)).
As the volume of resected DLM increased, higher contact stress was applied to the lateral tibiofemoral joint. Greater contact stress was applied to the preserved lateral meniscus than to the native DLM.
From a biomechanical viewpoint, the native DLM was the most protective against lateral tibiofemoral contact stress in comparison to partially meniscectomized DLMs.
对于保守治疗失败的症状性盘状外侧半月板(DLM)患者,常施行半月板部分切除术。然而,膝关节骨关节炎和软骨下骨病变的发展是有害的术后并发症。本研究旨在使用有限元分析评估切除的 DLM 体积对胫骨股骨关节接触压力的影响。
从 CT 和磁共振成像中为 DLM 患者的膝关节建立特定于个体的有限元模型。为了评估半月板部分切除术对外侧胫骨股骨关节接触压力的影响,在研究中创建了六个膝关节模型(原生 DLM 以及五个部分切除的 DLM(根据半月板的保留宽度:12mm、10mm、8mm、6mm 和 4mm))。
随着切除的 DLM 体积增加,外侧胫骨股骨关节承受的接触压力更高。保留的外侧半月板承受的接触压力大于原生 DLM。
从生物力学的角度来看,与部分切除的 DLM 相比,原生 DLM 对外侧胫骨股骨接触压力的保护作用最大。