Physical Medicine and Rehabilitation Department, Northwestern University, Chicago, IL, United States of America.
Mechanical Engineering Department, Australian University, East Mushrif, Kuwait.
PLoS One. 2023 Aug 3;18(8):e0287479. doi: 10.1371/journal.pone.0287479. eCollection 2023.
Understanding the mechanics behind knee joint injuries and providing appropriate treatment is crucial for improving physical function, quality of life, and employability. In this study, we used a hybrid molecular dynamics-finite element-musculoskeletal model to determine the level of loads the knee can withstand when landing from different heights (20, 40, 60 cm), including the height at which cartilage damage occurs. The model was driven by kinematics-kinetics data of asymptomatic subjects at the peak loading instance of drop landing. Our analysis revealed that as landing height increased, the forces on the knee joint also increased, particularly in the vastus muscles and medial gastrocnemius. The patellar tendon experienced more stress than other ligaments, and the medial plateau supported most of the tibial cartilage contact forces and stresses. The load was mostly transmitted through cartilage-cartilage interaction and increased with landing height. The critical height of 126 cm, at which cartilage damage was initiated, was determined by extrapolating the collected data using an iterative approach. Damage initiation and propagation were mainly located in the superficial layers of the tibiofemoral and patellofemoral cartilage. Finally, this study provides valuable insights into the mechanisms of landing-associated cartilage damage and could help limit joint injuries and improve training programs.
了解膝关节损伤的力学机制并提供适当的治疗对于改善身体功能、生活质量和就业能力至关重要。在这项研究中，我们使用混合分子动力学-有限元-肌肉骨骼模型来确定膝关节在从不同高度（20、40、60 厘米）着陆时所能承受的负荷水平，包括发生软骨损伤的高度。该模型由无症状受试者在下落着陆的峰值加载时刻的运动学-动力学数据驱动。我们的分析表明，随着着陆高度的增加，膝关节上的力也增加，尤其是在股四头肌和内侧腓肠肌中。髌腱比其他韧带承受更大的应力，内侧平台支撑着大部分胫骨软骨接触力和应力。负荷主要通过软骨-软骨相互作用传递，并随着陆高度增加而增加。通过使用迭代方法外推收集的数据，确定了 126 厘米的临界高度，即软骨损伤开始的高度。损伤的起始和传播主要位于胫骨股骨和髌股软骨的浅层。最后，本研究深入了解了与着陆相关的软骨损伤的机制，并有助于限制关节损伤和改善训练计划。
