摘要
目的构建前交叉韧带重建联合内侧半月板部分切除术后不同屈膝角度的有限元模型,分析胫股关节的生物力学特征。方法选取广州体育学院运动医学室就诊的1名前交叉韧带重建联合内侧半月板部分切除术后的男性患者,完成膝关节有限元模型构建。载荷验证后以胫股关节软骨最大应力、半月板位移为研究指标,分析不同屈膝角度下胫股关节的应力特征。结果膝关节有限元模型单元总数为582044,节点总数为391670。模拟不同屈膝角度时载荷下胫股关节应力的特征,结果显示,屈膝0°时,股骨髁软骨应力集中于中部,胫骨平台软骨应力主要集中于中、后部,内侧半月板应力集中于被切除的残留端;30°、60°时股骨髁软骨应力均集中于后部;30°时胫骨平台软骨应力主要集中于前外侧,60°时集中于中部;内侧半月板30°时应力集中于在前部,60°时在中部。内侧股骨髁软骨、胫骨平台软骨的最大应力由大到小依次为屈膝60°、0°、30°,外侧股骨髁软骨及胫骨平台软骨、内侧半月板的最大应力由大到小依次为屈膝60°、30°、0°,外侧半月板最大应力由大到小依次为屈膝30°、60°、0°,内侧胫骨平台与股骨髁软骨不同屈膝角度的最大应力均大于外侧,内侧半月板最大应力在屈膝0°、30°时小于外侧,屈膝60°时大于外侧。半月板形变位移特征分析结果显示,各角度下内侧半月板形变位移均小于外侧。结论屈膝60°时胫股关节内部结构的应力最大,屈膝各角度下内侧胫骨平台与股骨髁的软骨最大应力均大于外侧,内侧半月板位移形变小于外侧。
Objective To construct finite element models of different knee flexion angles after anterior cruciate ligament reconstruction combined with partial medial meniscectomy,and to analyze the biomechanical characteristics of tibiofemoral joint.Methods A male patient who underwent anterior cruciate ligament reconstruction combined with partial medial meniscectomy in the Department of Sports Medicine,Guangzhou Sport University was selected to construct the finite element model of the knee joint.After load verification,the maximum stress of tibiofemoral articular cartilage and meniscus displacement were used as indicators to analyze the stress characteristics of tibiofemoral joint at different knee bending angles.Results The total number of elements in the knee joint finite element model was 582044 and the total number of nodes was 391670.The stress characteristics of tibiofemoral joint under different bending angles were simulated.The results showed that the stress of femoral condyle cartilage was concentrated in the middle,the stress of tibial plateau cartilage was mainly concentrated in the middle and posterior,and the stress of medial meniscus was concentrated in the residual end after resection when bending knee was 0°.At 30°and 60°,the stress of femoral condyle cartilage was concentrated in the posterior part.At 30°,the stress of tibial plateau cartilage mainly concentrated in the anterolateral part,and at 60°,the stress concentrated in the middle part.The stress of the medial meniscus is concentrated in the front at 30°and in the middle at 60°.The maximum stress of medial femoral condylar cartilage and tibial cartilage was 60°,0°,and 30°respectively.The maximum stress of lateral femoral condylar cartilage,tibial plateau cartilage and medial meniscus was 60°,30°,and 0°respectively.The maximum stress of the lateral meniscus was 30°,60°,and 0°respectively.The maximum stress of medial tibial plateau and femoral condylar cartilage at different knee bending angles was greater than the lateral one,the maximum stress of medial meniscus was less than the lateral one at 0°and 30°,and greater than the lateral one at 60°.The results showed that the deformation displacement of the medial meniscus was smaller than that of the lateral meniscus at all angles.Conclusion The stress in the tibiofemural joint is the greatest when the knee is bent at 60°.The maximum stress in the cartilage of the medial tibial plateau and femoral condyle is greater than that of the lateral side at all angles of the knee bending,and the displacement of the medial meniscus is less than that of the lateral side.
作者
张晓辉
王俊
廖八根
ZHANG Xiaohui;WANG Jun;LIAO Bagen(Department of Sports Medicine,Guangzhou Sport University,Guangdong Province,Guangzhou515500,China;Guangzhou Center,Gosun Medical Imaging,Guangdong Province,Guangzhou515500,China)
出处
《中国医药导报》
CAS
2021年第27期30-34,F0004,共6页
China Medical Herald
基金
广东省自然科学基金项目(2018A030313786)。
关键词
前交叉韧带重建
内侧半月板部分切除术
屈膝角度
有限元分析
Anterior cruciate ligament reconstruction
Partial medial meniscectomy
Tibiofemoral joint
Finite element analysis
