Kneifel Paul, Moewis Philippe, Damm Philipp, Schütz Pascal, Dymke Jörn, Taylor William R, Duda Georg N, Trepczynski Adam
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.
J Biomech. 2023 Apr;151:111549. doi: 10.1016/j.jbiomech.2023.111549. Epub 2023 Mar 16.
Patellar complications frequently limit the success of total knee arthroplasty. In addition to the musculoskeletal forces themselves, patellar tendon elastic properties are essential for driving patellar loading. Elastic properties reported in the literature exhibit high variability and appear to differ according to the methodologies used. Specifically in total knee arthroplasty patients, only limited knowledge exists on in vivo elastic properties and their corresponding loads. For the first time, we report stiffness, Young's modulus, and forces of the patellar tendon, derived from four patients with telemetric total knee arthroplasties using a combined imaging and measurement approach. To achieve this, synchronous in vivo telemetric assessment of tibio-femoral contact forces and fluoroscopic assessment of knee kinematics, along with full body motion capture and ground reaction forces, fed musculoskeletal multi-body models to quantify patellar tendon loading and elongation. Mechanical patellar tendon properties were calculated during a squat and a sit-stand-sit activity, with resulting tendon stiffness and Young's modulus ranging from 511 to 1166 N/mm and 259 to 504 MPa, respectively. During these activities, the patellar tendon force reached peak values between 1.31 and 2.79 bodyweight, reaching levels of just ∼0.5 bodyweight below the tibio-femoral forces. The results of this study provide valuable input data for mechanical simulations of the patellar tendon and the whole resurfaced knee.
髌股并发症常常限制全膝关节置换术的成功。除了肌肉骨骼力量本身外，髌腱的弹性特性对于驱动髌骨负荷至关重要。文献报道的弹性特性具有高度变异性，并且似乎因所使用的方法而异。特别是在全膝关节置换术患者中，关于体内弹性特性及其相应负荷的知识有限。我们首次报告了四名使用遥测全膝关节置换术的患者髌腱的刚度、杨氏模量和力，采用了成像与测量相结合的方法。为了实现这一点，对胫股接触力进行同步体内遥测评估以及对膝关节运动学进行荧光透视评估，同时结合全身运动捕捉和地面反作用力，将数据输入肌肉骨骼多体模型以量化髌腱负荷和伸长。在深蹲和坐 - 站 - 坐活动期间计算髌腱的力学特性，结果髌腱刚度和杨氏模量分别为511至1166 N/mm和259至504 MPa。在这些活动期间，髌腱力达到峰值，介于1.31至2.79倍体重之间，比胫股力低约0.5倍体重。本研究结果为髌腱和整个表面置换膝关节的力学模拟提供了有价值的输入数据。
