Ma Xin, Feng Luming, Lyu Yongtao, Hua Xijin, Sugita Naohiko, Shu Liming
Department of Mechanical Engineering, Dalian University of Technology, Dalian, 116024, China.
Department of Mechanical Engineering, TUM School of Engineering and Design, Technical University of Munich, Arcisstrasse 21, 80333, Munich, Germany.
Ann Biomed Eng. 2025 Jul 19. doi: 10.1007/s10439-025-03803-1.
To investigate the influences of radial tears of the medial meniscus and subsequent surgical treatment (repair or meniscectomy) on the knee joint mechanics during normal walking.
An original multiscale finite element musculoskeletal model was developed to model and study an intact knee model (no RT), four meniscal RT knee models (30% RT, 45% RT, 60% RT, and 90% RT) and 3 treatment option models for 60% RT.
The magnitude and location of peak contact pressure on tibial cartilage were minimally affected (within 0.5 MPa) by the radial tear involving up to 45% of the meniscal rim width throughout the whole gait cycle. The contact area between the femoral cartilage and the medial meniscus continued to decrease as the radial tear degree increased, with peak contact areas of approximately 450 mm, 435 mm, 430 mm, and 405 mm for 30%, 45%, 60%, and 90% RT. Regarding the surgical treatment, meniscectomy led to the most significant increase in the contact pressure and alterations in the kinematics, while suture repair restored the contact stress to the level of the intact knee joint and a better recovery in the contact area. An optimized partial meniscectomy could reduce loading on the meniscus and joint cartilage, but no significant improvement in contact area compared with 60% RT.
Meniscal tear and its resultant partial meniscectomy have a positive impact on the maintenance of high levels of contact stresses, whereas meniscectomy causes the highest risk for the development of knee osteoarthritis. Meniscal repair procedures significantly restore native meniscal function.
研究内侧半月板放射状撕裂及其后续手术治疗（修复或半月板切除术）对正常行走时膝关节力学的影响。
建立了一个原始的多尺度有限元肌肉骨骼模型，以模拟和研究完整膝关节模型（无放射状撕裂）、四个半月板放射状撕裂膝关节模型（30%放射状撕裂、45%放射状撕裂、60%放射状撕裂和90%放射状撕裂）以及60%放射状撕裂的三种治疗方案模型。
在整个步态周期中，累及半月板边缘宽度达45%的放射状撕裂对胫骨软骨上的峰值接触压力的大小和位置影响极小（在0.5兆帕以内）。随着放射状撕裂程度的增加，股骨软骨与内侧半月板之间的接触面积持续减小，30%、45%、60%和90%放射状撕裂时的峰值接触面积分别约为450平方毫米、435平方毫米、430平方毫米和405平方毫米。关于手术治疗，半月板切除术导致接触压力显著增加和运动学改变，而缝合修复将接触应力恢复到完整膝关节的水平，并使接触面积得到更好的恢复。优化的部分半月板切除术可减少半月板和关节软骨上的负荷，但与60%放射状撕裂相比，接触面积无显著改善。
半月板撕裂及其导致的部分半月板切除术对维持高水平接触应力有积极影响，而半月板切除术导致膝关节骨关节炎发展的风险最高。半月板修复手术能显著恢复半月板的天然功能。
