Department of Sport Medicine, Beijing DCN Orthopedic Hospital, No.19 Fushi Road, Beijing, 100143, China.
Department of Spinal Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences, Qingdao Municipal Hospital, No.5 Donghai Zhong Road, Qingdao, 266000, China.
BMC Musculoskelet Disord. 2023 Sep 19;24(1):744. doi: 10.1186/s12891-023-06868-y.
To establish a finite element model of meniscus horizontal cleavage and partial resection, to simulate the mechanical changes of knee joint under 4 flexion angles, and to explore what is the optimal surgical plan.
We used Mimics Research, Geomagic Wrap, and SolidWorks computer software to reconstruct the 3D model of the knee joint, and then produced the horizontal cleavage tears model of the internal and lateral meniscus, the suture model, and the partial meniscectomy model. These models were assembled into a complete knee joint in SolidWorks software, and corresponding loads and boundary constraints were added to these models in ANSYS software to simulate the changing trend of pressure and shear force on femoral condylar cartilage, meniscus, and tibial cartilage under the flexion angles of 0°, 10°, 20°, 30° and 40° of the knee joint. At the same time, the difference of force area between medial interventricular and lateral interventricular of knee joint under four states of bending the knee was compared, to explore the different effects of different surgical methods on knee joint after horizontal meniscus tear.
Within the four medial meniscus injury models, the lowest peak internal pressure and shear force of the knee joint was observed in the meniscal suture model; the highest values were found in the bilateral leaflet resection model and the inferior leaflet resection model; the changes of pressure, shear force and stress area in the superior leaflet resection model were the most similar to the changes of the knee model with the meniscal suture model.
Suture repair is the best way to maintain the force relationship in the knee joint. However, resection of the superior leaflet of the meniscus is also a reliable choice when suture repair is difficult.
建立半月板水平撕裂和部分切除的有限元模型，模拟 4 个屈曲角度下膝关节的力学变化，探讨何种手术方案最佳。
利用 Mimics Research、Geomagic Wrap 和 SolidWorks 计算机软件对膝关节进行三维重建，制作内侧和外侧半月板水平撕裂、缝合、部分切除模型，在 SolidWorks 软件中完成半月板模型与膝关节模型的装配，在 ANSYS 软件中对各模型添加相应的载荷和边界约束，模拟膝关节在 0°、10°、20°、30°和 40°屈曲角度下，股骨髁软骨、半月板、胫骨软骨所受压力及剪切力的变化趋势，同时对比膝关节 4 种状态下内外侧间室受力面积的差异，以探讨不同手术方法对半月板水平撕裂后膝关节的不同影响。
在 4 种内侧半月板损伤模型中，膝关节的最低峰值内压和剪切力出现在半月板缝合模型中；最高值出现在双侧叶切除模型和下叶切除模型中；上叶切除模型的压力、剪切力和应力面积的变化与半月板缝合模型的膝关节模型变化最为相似。
缝合修复是维持膝关节力关系的最佳方法。但是，当缝合修复困难时，切除半月板上叶也是可靠的选择。
