郭云飞, 黄荣瑛, 张高龙. 半月板移植的固定法对胫股关节屈曲中韧带及骨骼的力学特性影响[J]. 工程力学, 2013, 30(2): 379-387. DOI: 10.6052/j.issn.1000-4750.2011.08.0535
引用本文: 郭云飞, 黄荣瑛, 张高龙. 半月板移植的固定法对胫股关节屈曲中韧带及骨骼的力学特性影响[J]. 工程力学, 2013, 30(2): 379-387. DOI: 10.6052/j.issn.1000-4750.2011.08.0535
GUO Yun-fei, HUANG Rong-ying, ZHANG Gao-long. EFFECTS OF THE FIXATION METHODS OF MENISCUS ALLOGRAFT ON THE MECHANICAL CHARACTERISTIC OF LIGAMENTS AND BONE IN TIBIOFEMORAL JOINT[J]. Engineering Mechanics, 2013, 30(2): 379-387. DOI: 10.6052/j.issn.1000-4750.2011.08.0535
Citation: GUO Yun-fei, HUANG Rong-ying, ZHANG Gao-long. EFFECTS OF THE FIXATION METHODS OF MENISCUS ALLOGRAFT ON THE MECHANICAL CHARACTERISTIC OF LIGAMENTS AND BONE IN TIBIOFEMORAL JOINT[J]. Engineering Mechanics, 2013, 30(2): 379-387. DOI: 10.6052/j.issn.1000-4750.2011.08.0535

半月板移植的固定法对胫股关节屈曲中韧带及骨骼的力学特性影响

EFFECTS OF THE FIXATION METHODS OF MENISCUS ALLOGRAFT ON THE MECHANICAL CHARACTERISTIC OF LIGAMENTS AND BONE IN TIBIOFEMORAL JOINT

  • 摘要: 基于正常膝关节4个屈曲角度(0°/25°/60°/80°)下的MRI图像数据,构建了正常以及内侧半月板移植术中双隧道固定和三隧道固定的胫股关节有限元模型,对屈曲角系列下的4种模型分别施加10N?m的内外旋扭矩进行有限元仿真,得到各模型在两种载荷作用下的应力及位移分布,通过从仿真结果中提取各韧带表面的最大拉应力、韧带内的张力及韧带的最大变形量以及股骨、胫骨最大等效应力进行对比分析,获得了内侧半月板移植的双隧道/三隧道固定方法对胫股关节屈曲中韧带及骨骼力学特性的影响。结果表明:同类异体半月板移植的两种固定方法均在一定程度上改善了半月板切除引起的韧带力学行为的异常情况,尤其以采用三隧道固定后的改善更为明显。与双隧道固定相比,三隧道固定使各屈曲角度下韧带表面最大拉应力的变化更为小些,且对各韧带内张力的大小的改变也更微小;虽然三隧道固定使两种载荷作用下韧带的平均变形量的变化更大一些,但4个屈曲角度下的平均变化百分比不超过10%。同类异体半月板移植的两种固定方法均在一定程度上影响股骨和胫骨应力分布,但采用三隧道固定后的影响相对于双隧道固定的小。综合而言,三隧道固定比双隧道固定更利于移植膝韧带力学性能的恢复和胫骨/股骨接近正常的骨骼应力分布。该文的研究结果能为同类异体半月板移植手术的临床实施和术后分析提供参考数据。

     

    Abstract: Based on MRI images of the normal human knee at four flexion angles(0°/25°/60°/80°), the finite element models of the normal tibiofemoral joint and two medial meniscus transplantation models (2-tunnel fixation and 3-tunnel fixation) were built in this paper. The internal and external rotation torque of 10N?m were applied to models for the finite element simulation and the stress and displacement distributions were obtained. The maximum tensile stress on ligaments, the tension in ligaments, the maximum displacement of ligaments and the maximum Von Mises stress on the femur and tibia in transplantation models were respectively compared with those in the normal model to determine the effect of 2/3-tunnel fixation on ligaments. Results showed that two fixation methods both improved ligaments’ abnormal mechanical behavior caused by the removal of meniscus, especially after 3-tunnel fixation to improve even more apparently. Compared with 2-tunnel fixation, 3-tunnel fixation caused smaller changes in the maximum tensile stress on ligaments and in the tension of ligaments. Although 3-tunnel fixation made the average deformation of ligaments at four flexion angles under two kinds of loads experience greater changes, the average percent changes were only less than 10%. Both of the two fixation methods affected the stress distribution of femur and tibia. By contrast, 3-tunnel fixation affected less apparently. On the whole, 3-tunnel fixation was better for the restoration of ligaments’ mechanical characteristics and the stress distribution of femur and tibia was more closely to the normal. Results are expected to provide reference data for the clinical application of meniscus allograft transplantation and postoperative analysis.

     

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