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创伤性冲击会立即改变关节软骨的力学特性。

A Traumatic Impact Immediately Changes the Mechanical Properties of Articular Cartilage.

作者信息

Blom Robin P, Rahim Danka, Paardekam Erik, Kerkhoffs Gino M M J, Iannuzzi Davide, Smit Theodoor H

机构信息

Department of Orthopedic Surgery and Sports Medicine, Amsterdam University Medical Centers, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, The Netherlands.

Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.

出版信息

Cartilage. 2024 Mar 19:19476035241235633. doi: 10.1177/19476035241235633.

Abstract

OBJECTIVE

To investigate whether and how a single traumatic impact changes the mechanical properties of talar articular cartilage.

DESIGN

A marble was placed on the joint surface and a weight was dropped on both medial and lateral caprine talus to create a well-defined single focal impact. The mechanical properties of intact and impacted talar cartilage were measured with a micro-indenter. Elastic (storage) and viscous (loss) moduli were determined by oscillatory ramp and dynamic mechanical analysis protocols.

RESULTS

We found significant differences between ankles and within the same ankle joint, with the medial talus having significantly higher storage- and loss moduli than the lateral talus. The storage- and loss moduli of intact articular cartilage increased with greater indentation depths. However, postimpact the storage- and loss moduli were significantly and consistently lower in all specimens indicating immediate posttraumatic damage. The deeper regions of talar cartilage were less affected by the impact than the more superficial regions.

CONCLUSIONS

A single traumatic impact results in an immediate and significant decrease of storage- and loss moduli. Further research must focus on the development of non- or minimally invasive diagnostic tools to address the exact microdamage caused by the impact. We speculate that the traumatic impact damaged the collagen fibers that confine the water-binding proteoglycans and thereby decreasing the hydrostatic pressure of cartilage. As part of the treatment directly after a trauma, one could imagine a reduction or restriction of peak loads to prevent the progression of the cascade towards PTOA of the ankle joint.

摘要

目的

研究单次创伤性撞击是否以及如何改变距骨关节软骨的力学性能。

设计

将一颗弹珠置于关节表面,对山羊双侧距骨的内侧和外侧施加重物下落冲击,以产生明确的单一局部撞击。使用微压痕仪测量完整和受撞击距骨软骨的力学性能。通过振荡斜坡和动态力学分析方案确定弹性(储能)模量和粘性(损耗)模量。

结果

我们发现双侧踝关节之间以及同一踝关节内存在显著差异,内侧距骨的储能模量和损耗模量显著高于外侧距骨。完整关节软骨的储能模量和损耗模量随压痕深度增加而增加。然而,撞击后所有标本的储能模量和损耗模量均显著且持续降低,表明创伤后立即出现损伤。距骨软骨较深区域受撞击的影响小于较浅区域。

结论

单次创伤性撞击导致储能模量和损耗模量立即且显著降低。进一步研究必须聚焦于开发非侵入性或微创诊断工具,以解决撞击造成的确切微观损伤。我们推测创伤性撞击破坏了限制水结合蛋白聚糖的胶原纤维,从而降低了软骨的静水压力。作为创伤后直接治疗的一部分,可以设想减少或限制峰值负荷,以防止向踝关节创伤后骨关节炎的级联反应进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/129f/11569663/02917e99ca4d/10.1177_19476035241235633-fig1.jpg

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