前交叉韧带移植物种类及拉力影响的有限元模拟  

Three-dimensional finite element simulations of the long-term effects of hamstring tendon graft type and tensioning on anterior cruciate ligament reconstruction

作　　者：万超[1] 郝智秀[1] 温诗铸[1] 林剑浩[2] 

机构地区：[1]清华大学摩擦学国家重点实验室,北京100084 [2]北京大学人民医院关节病诊疗研究中心,北京100044

出　　处：《清华大学学报（自然科学版）》2014年第10期1282-1287,共6页Journal of Tsinghua University(Science and Technology)

基　　金：国家自然科学基金项目(51275267)

摘　　要：为了研究肌腱移植物种类及拉力对前交叉韧带重建长期效果的影响,在经过有效性验证的人体膝关节有限元模型(包含骨、半月板、软骨及主要韧带)基础上,对比了134N胫骨向前推力下两种移植物种类(双股及四股肌腱移植物)及3种重建后远期时的移植物实际拉力(0N,20N和40N)对关节稳定性及韧带受力的影响。结果表明:移植物实际拉力的增大会导致膝关节胫骨向后内侧移动并伴有外旋及外翻;移植物的受力也会变大,但应力分布并没有明显变化。由重建后远期时的膝关节稳定性及移植物受力结果可得,使用双股肌腱移植物且初始拉力为80N时,前交叉韧带重建的长期效果与完好关节最为接近。A validated finite element model of a human knee joint（including the bone,cartilage,menisci and main ligaments）is used to compare the effects of three graft tensions（i.e.,0N,20Nand40N）as well as two hamstring tendon（HT）graft types（i.e.,quadruple and double HT grafts）to study the long-term effects of graft type and tensioning on joint kinematics and ligament biomechanics of anterior cruciate ligament（ACL）reconstruction.Both the joint kinematics and ligament biomechanics are obtained for a 134 Nanterior tibial load.The tibia moves posteromedially with external and valgus rotations as the graft tension increases regardless of the graft type.The forces in the grafts increase as the tension increases while the stress distributions in the grafts do not change.Both the simulated kinematics and the forces in the grafts demonstrate that the double HT graft with an initial tension of 80 N gives the closest function to the original ACL.

关 键 词：前交叉韧带重建 肌腱移植物 初始拉力 长期效果 有限元 

分 类 号：R318.01[医药卫生—生物医学工程]