ACL单束/双束重建对胫股关节应力分布影响  

EFFECTS OF THE ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTIONS ON THE STRESS DISTRIBUTION OF THE TIBIO-FEMORAL JOINT

作　　者：黄荣瑛[1] 徐强[1] 许勇刚[1] 郑红光[1] 

机构地区：[1]北京航空航天大学机械工程及自动化学院,北京100191

出　　处：《工程力学》2011年第8期240-247,共8页Engineering Mechanics

基　　金：国家自然科学基金项目(50975013)

摘　　要：该文基于正常膝关节的MRI图像数据,构建正常/单束/双束韧带重建胫股关节整体模型,通过对这3个关节整体模型分别加载单一负荷(轴向力)及组合负荷(轴向力和扭矩)进行有限元仿真,得到3个整体模型在两类负荷作用下的应力分布;通过从整体模型的应力云图中提取股骨、胫骨、关节软骨、半月板及后交叉/内侧/外侧韧带的表面应力等进行对比分析,得到ACL单束/双束重建对胫股关节各组织应力分布的影响。结果表明:1)股骨/胫骨的高应力区位于股骨/胫骨与韧带的连接部位及胫骨与腓骨的接触部位,除单束重建在组合载荷作用下股骨与内侧韧带连接处的应力明显超过正常关节外,重建后胫骨/股骨上的应力值均接近正常关节;2)单束重建能引起股骨软骨、胫骨软骨、内侧半月板的等效应力增大,而双束重建主要使股骨软骨及外侧半月板的等效应力增大;3)单束/双束重建对内侧韧带应力影响较大,尤其在组合载荷作用下内侧韧带中部、下部区域出现了高应力。总之,ACL重建引起的股骨/胫骨、软骨、半月板以及韧带的附加应力,是重建后期导致术者患慢性膝关节炎的主要原因。根据双束重建比单束重建后更接近正常胫股关节的应力特性,得出双束重建优于单束重建的结论。Based on MRI images of the normal human knee, the normal, single-bundle and double-bundle ligaments reconstruction models of tibio-femoral joint were built. In the experiment, single load （axial force） and combined loads （axial force and torque） were applied to these models for the finite element simulation to obtain the stress distribution. Then we acquired stress distributions of the femur, tibia, articular cartilage, meniscus, posterior cruciate, medial collateral and the lateral collateral ligament to make a comparison between the stress distributions before and after the ACL reconstruction. The results show that： 1） The high-stress areas of the femur/tibia are located in the connection parts of the femur/tibia and ligament and the contact area between tibia and fibular. Meanwhile, the stresses on the tibia/femur after the reconstruction are close to those on the normal joint except for that the maximum stress in the junction between the femur and the MCL after singie-bundle reconstruction under the combined loads exceeds that on the normal joint; 2） Single-bundle reconstruction can lead to the increment of the equivalent stress on femoral/tibial cartilages and the medial meniscus while double-bundle reconstruction lead to the increment on the femoral cartilage and the lateral meniscus; 3） Reconstructions have a greater impact on MCL; particularly, under the combined loads, there is a high-stress distribution in the middle and lower zone of the MCL. In summary, the increment of the additional stress after ACL reconstruction is the main reason for the chronic arthritis of the knee. As the tibia-femoral joint after double-bundle reconstruction are close to the normal joint in biological characteristics, we can make such a conclusion that double-bundle reconstruction is superior to single-bundle one.

关 键 词：有限元 股骨 胫骨 软骨 韧带 半月板 应力 

分 类 号：TB12[理学—工程力学] R318.01[理学—力学]