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一种新型基于几何参数的前交叉韧带重建患者特定有限元模型的开发。

Development of a novel geometrically-parametric patient-specific finite element model for anterior cruciate ligament reconstruction.

机构信息

Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.

Department of Mechanical Engineering, Iran University of Science and Technology, IUST, Tehran, Iran.

出版信息

Knee. 2024 Oct;50:41-58. doi: 10.1016/j.knee.2024.07.020. Epub 2024 Aug 7.

DOI:10.1016/j.knee.2024.07.020
PMID:39116664
Abstract

PURPOSE

A personalized model of the knee joint, with adjustable effective geometric parameters for the transplanted autograft diameter in Anterior Cruciate Ligament Reconstruction (ACLR) using the bone-patella-tendon-bone (BPTB) technique, has been developed. The model will assist researchers in understanding how different graft sizes impact a patient's recovery over time.

METHODS

The study involved selecting a group of individuals without knee injuries and one patient who had undergone knee surgery. Gait analysis was conducted on the control group and the patient at various time points. A 3D model of the knee joint was created using medical images of the patient. Forces and torques obtained from the gait analysis were applied to the model to perform finite element analysis.

RESULTS

The results of the finite element (FE) analysis, along with kinetic data from both groups, indicate that models with diameters of 7.5 mm and 12 mm improved joint motion during follow-up after ACLR. Additionally, a comparison of the stress applied to the ACL model revealed that a 12 mm autograft diameter showed a more favorable trend in patient recovery during the three follow-up intervals after ACL reconstruction surgery.

CONCLUSION

The development of a personalized parametric model with adjustable geometric parameters in ACLR, such as the transplanted autograft diameter, as presented in this study, along with FE using the patient's kinetic data, allows for the examination and selection of an appropriate autograft diameter for Patella Tendon grafting. This can help reduce stress on the autograft and prevent damage to other knee joint tissues after ACLR.

摘要

目的

本研究开发了一种个性化的膝关节模型,可调整用于前交叉韧带重建(ACL 重建)的骨-髌腱-骨(BPTB)技术中移植物直径的有效几何参数。该模型将帮助研究人员了解不同移植物大小如何随时间推移影响患者的恢复情况。

方法

本研究选择了一组无膝关节损伤的个体和一名接受过膝关节手术的患者。对对照组和患者在不同时间点进行步态分析。使用患者的医学图像创建膝关节 3D 模型。将从步态分析中获得的力和扭矩施加到模型上以进行有限元分析。

结果

有限元(FE)分析的结果以及两组的动力学数据表明,在 ACLR 后随访期间,直径为 7.5mm 和 12mm 的模型改善了关节运动。此外,对 ACL 模型施加的应力进行比较后发现,12mm 自体移植物直径在 ACL 重建手术后三个随访间隔期间显示出更有利于患者恢复的趋势。

结论

本研究提出了一种个性化的 ACLR 参数模型,可调整移植物直径等几何参数,以及使用患者的动力学数据进行有限元分析,有助于检查和选择合适的髌腱自体移植物直径。这有助于降低 ACLR 后自体移植物的应力并防止对其他膝关节组织造成损伤。

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