Peña-Trabalon Alejandro, Perez-Blanca Ana, Moreno-Vegas Salvador, Estebanez Campos M Belen, Prado-Novoa Maria
Clinical Biomechanics Laboratory of Andalusia (BIOCLINA), University of Malaga, Málaga, Spain.
Front Bioeng Biotechnol. 2024 Jan 5;11:1249982. doi: 10.3389/fbioe.2023.1249982. eCollection 2023.
To preserve knee function, surgical repair is indicated when a meniscal root disinsertion occurs. However, this surgery has not yet achieved complete recovery of the joint´s natural biomechanics, with the meniscus-suture interface identified as a potentially determining factor. Knowing the deformation and resistance behavior of the sutured meniscal horn and whether these properties are preserved as the patient ages could greatly contribute to improving repair outcomes. A cadaveric experimental study was conducted on human sutured menisci classified into three = 22 age groups (young ≤55; 55 < middle-aged ≤75; 75 < old) were subjected to load-to-failure test by suture pulling. Meniscal thickness at the suture hole was measured and the applied traction force and tissue deformation in the suture area in the direction of traction were recorded during the test. The traction load that initiated the meniscal cut-out, , maximum load borne by the meniscus, , tissue stress at the cut-out initiation, , and equivalent stiffness modulus at the suture area, , were calculated. At the tissue level, the resistance in terms of decrease with age (young: 47.2 MPa; middle-aged: 44.7 MPa; old: 33.8 MPa) being significantly different between the young and the old group ( = 0.015). Mean meniscal thickness increased with age (young: 2.50 mm; middle-aged: 2.92 mm; old: 3.38 mm; = 0.001). Probably due to thickening, no differences in resistance were found at the specimen level, i.e., in (overall mean 58.2 N) and (overall mean 73.6 N). As for elasticity, was lower in the old group than in the young group (57.5 MPa vs. 113.6 MPa, = 0.02) and the middle-aged one (57.5 MPa vs. 108.0 MPa, = 0.04). Regarding the influence of age on the sutured meniscal horn tissue, experimentation revealed that meniscal horn specimens older than 75 years old had a more elastic tissue which was less resistant to cut-out than younger menisci at the suture hole area. However, a thickening of the meniscal horns with age, which was also found, leveled out the difference in the force that initiated the tear, as well as in the maximum force borne by the meniscus in the load-to-failure test.
为保留膝关节功能，当半月板根部附着处分离时需进行手术修复。然而，该手术尚未完全恢复关节的自然生物力学，半月板缝合界面被认为是一个潜在的决定性因素。了解缝合半月板角的变形和阻力行为，以及这些特性是否随患者年龄增长而保留，可能对改善修复效果有很大帮助。对人体缝合半月板进行了一项尸体实验研究，将其分为三个年龄组（年轻组≤55岁；中年组55＜年龄≤75岁；老年组75＜年龄），每组n = 22，通过缝线牵拉进行破坏载荷试验。测量缝线孔处的半月板厚度，并在试验过程中记录施加的牵引力以及缝线区域在牵引方向上的组织变形。计算引发半月板切出的牵引载荷、半月板承受的最大载荷、切出起始时的组织应力以及缝线区域的等效刚度模量。在组织层面，以最大载荷表示的阻力随年龄增长而降低（年轻组：47.2MPa；中年组：44.7MPa；老年组：33.8MPa），年轻组和老年组之间存在显著差异（P = 0.015）。半月板平均厚度随年龄增长而增加（年轻组：2.50mm；中年组：2.92mm；老年组：3.38mm；P = 0.001）。可能由于增厚，在标本层面未发现阻力差异，即最大载荷（总体平均值58.2N）和破坏载荷（总体平均值73.6N）方面无差异。至于弹性，老年组的等效刚度模量低于年轻组（57.5MPa对113.6MPa，P = 0.02）和中年组（57.5MPa对108.0MPa，P = 0.04）。关于年龄对缝合半月板角组织的影响，实验表明，年龄大于75岁的半月板角标本组织弹性更大，在缝线孔区域比年轻半月板更不易抗切出。然而，研究还发现半月板角随年龄增厚，这消除了破坏载荷试验中引发撕裂的力以及半月板承受的最大力的差异。
