Vasiliadis Angelo V, Giovanoulis Vasileios, Maris Alexandros, Chytas Dimitrios, Katakalos Konstantinos, Paraskevas George, Noussios George, Vassiou Aikaterini
Department of Orthopaedic Surgery, Sports Trauma Unit, St. Luke's Hospital, 55236 Panorama-Thessaloniki, Greece - Orthopaedic Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 69004 Lyon, France - Department of Anatomy, Faculty of Medicine, University of Thessaly, 41334 Larissa, Greece - Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Orthopaedic Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 69004 Lyon, France.
SICOT J. 2024;10:45. doi: 10.1051/sicotj/2024039. Epub 2024 Oct 31.
Finite element analysis (FEA) is a fundamental tool that can be used in the orthopaedic world to simulate and analyze the behaviour of different surgical procedures. It is important to be aware that removing more than 20% of the meniscus could increase the shear stress in the cartilage and enlarge the risk of knee joint degeneration. In this fact, the maximal shear stress value in the medial cartilage increased up to 225% from 0.15 MPa to 0.5 MPa after medial meniscectomy. Also, meniscal root repair can improve meniscal biomechanics and potentially reduce the risk of osteoarthritis, even in cases of a loose repair. FEA has been used to better understand the biomechanical role of cruciate ligaments in the knee joint. ACLr with bone-patellar tendon-bone graft at 60 N of pretension and double-bundle PCLr were closer to that of a native knee in terms of biomechanics. The addition of a lateral extra-articular augmentation technique can reduce 50% of tibial translation and internal rotation, protecting the graft and minimizing the risk of re-rupture. Interestingly, anatomic and non-anatomic medial patellofemoral ligament reconstruction increased the pressure applied to the patellofemoral joint by increasing patellar contact pressure to 0.14 MPa at 30° of knee flexion using the semitendinosus as a graft. After all the advances in medical imaging technologies, future studies should take into consideration patient-specific data on both anatomy and mechanics, in order to better personalize the experimental model.
有限元分析（FEA）是一种可用于骨科领域模拟和分析不同手术操作行为的基础工具。需要注意的是，切除超过20%的半月板可能会增加软骨中的剪切应力，并加大膝关节退变的风险。事实上，内侧半月板切除术后，内侧软骨的最大剪切应力值从0.15兆帕增加到0.5兆帕，增幅高达225%。此外，半月板根部修复可以改善半月板生物力学性能，并有可能降低骨关节炎的风险，即使是在修复不牢固的情况下。有限元分析已被用于更好地理解膝关节中交叉韧带的生物力学作用。在生物力学方面，采用60牛预张力的骨-髌腱-骨移植物进行前交叉韧带重建（ACLr）和双束后交叉韧带重建（PCLr）更接近天然膝关节。增加外侧关节外增强技术可减少50%的胫骨平移和内旋，保护移植物并将再次断裂的风险降至最低。有趣的是，使用半腱肌作为移植物，在膝关节屈曲30°时，解剖学和非解剖学的内侧髌股韧带重建通过将髌股接触压力增加到0.14兆帕，增加了施加在髌股关节上的压力。在医学成像技术取得所有进展之后，未来的研究应考虑患者特定的解剖学和力学数据，以便更好地使实验模型个性化。
