摘要
[目的]探讨内外侧半月板后根部损伤对膝关节生物力学的影响。[方法]膝关节正常志愿者4例作为研究对象,采用MRI对左膝关节进行扫描,建立膝关节各部位有限元模型,在股骨部分垂直加1 150 N垂直力模拟人体正常周期中的伸直状态,测量应力分布。在完整膝关节有限元模型中同时删除内、外侧半月板根部相应单元和节点,模拟内外测半月板根部同时损伤模型;将完整膝关节模型设为对照组;分别加载1 000 N轴向压缩载荷和134 N向前剪切力,测量不同部位的最大压应力和最大剪切应力。[结果]人体正常走平路膝伸直状态时,承受应力的大小依次为:外侧半月板前部>内侧胫骨平台>股骨外侧髁>内侧半月板后部>股骨内侧髁>外侧胫骨平台>双股骨髁后部。损伤组股骨内髁、股骨外髁、内侧胫骨平台、外侧胫骨平台软骨、外侧半月板最大压应力显著高于完整组(P<0.05)。损伤组股骨内髁、股骨外髁、内侧胫骨平台、外侧胫骨平台软骨、外侧半月板最大剪切力显著高于完整组(P<0.05)。[结论]内、外侧半月板后根部同时损伤导致膝关节各部位承载应力显著增加。
[Objective] To investigate the biomechanical alterations in concomitant root injuries of the medial and lateral menisci by finite element analysis. [Methods] A total of 4 health volunteer were enrolled as the study subjects. The left knee joint was scanned by MR to establish the finite element models of the knee including various structures. Under 1 150 N axial load applied at extension state of gait cycle, the stress distribution on the knee were measured. In addition, the injured model was created by deleting the nodes on the roots of the medial and lateral menisci in the knee finite model, while the intact finite element knee model was used as control. Under 1 000 N axial compression load and 134 N forward shear load respectively, the maximal compression stress and maximal shear stress distributed on various structures on the knee were assessed. [Results] The intact knee joints tolerated stress ranked upperdown as follows: anterior part of the lateral meniscus > medial tibial plateau > femoral lateral condyle > posterior part of medial meniscus > femoral medial condyle > lateral tibial plateau > posterior femoral condyles. In addition, the injured group tolerated significant greater compression stress and shear stress on the medial femoral condyle, lateral condyle, medial tibial plateau, lateral tibial plateau and menisci than the intact group(P<0.05). [Conclusion] The concurrent root injuries of medial and lateral menisci do significantly increase stress on various structures of the knee.
作者
唐保明
李钊伟
杨爱荣
王卓亚
TANG Bao-ming;LI Zhao-wei;YANG Ai-rong;WANG Zhuo-ya(Department of Orthopaedic Traumatology,Affiliated Hospital,Qinghai University,Xining 810001,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第22期2075-2079,共5页
Orthopedic Journal of China
基金
青海省科技厅自然科学基金项目（编号：2014-ZJ-761）
青海省卫生和计划生育委员会医药卫生科技项目（编号：2018-wjzdx-97）
关键词
内外侧半月板后根部同时损伤
关节软骨
有限元分析
生物力学
concomitant root injuries of medial and lateral menisci
articular cartilage
finite element analysis
biomechanics
