膝关节盘状半月板成型术后的有限元研究  

A finite analysis on discoid meniscus secondary to partial meniscectomy and rim trimming

作　　者：穆帅 葛永军 吴伟峰 陈斌[1] 张焱[1] 张美超[2] MU Shuai;GE Yongjun;WU Wei-feng;CHEN Bin;ZHANG Yan;ZHANG Mei-chao(Department of Orthopaedics,The 904 Hospital of PLA Lo-gistic Force,Wuxi 214000,China;Biomechanical Key Lab of Guangdong Province,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]中国人民解放军联勤保障部第904医院骨科,江苏无锡214000 [2]南方医科大学广东省医学生物力学重点实验室,广州510515

出　　处：《中国矫形外科杂志》2020年第22期2087-2091,共5页Orthopedic Journal of China

基　　金：原南京军区重点课题项目(编号:ZD04)。

摘　　要：[目的]分析盘状半月板部分切除术和半月板部分切除+边缘修整术前与术后生物力学变化,以比较哪一种手术方式更能延缓膝关节的退变。[方法]采集包含盘状半月板膝关节CT和MRI影像数据,导入到Mimics软件中,构建膝关节骨骼、半月板等结构的三维模型。在Hypermesh软件中对各结构进行融合,构建膝关节有限元原始模型,模拟半月板部分切除术和半月板部分切除+边缘修整术,对原始模型及两种术后模型分别行轴向载荷,观察生物力学变化。[结果]外侧盘状半月板上表面挤压应力主要集中在体部,峰值出现在体部的中央,为2.21 MPa。单纯外侧盘状半月板部分切除术后外侧半月板表面挤压应力主要集中于体部,峰值出现在体部中央,为6.46 Mpa。而外侧盘状半月板部分切除+边缘修整后,外侧半月板表面应力分布较为平均,大小为1.55 MPa。[结论]外侧半月板部分切除+边缘修整更符合正常半月板的生物力学特征,可以更好的延缓膝关节的退变。[Objective]To analyze variation of biomechanical characteristics before and after partial meniscectomy,and partial meniscectomy combined with rim trimming,and explore which one of surgical method will be benefit to delay the degen⁃eration of the knee joint.[Methods]Based on CT and MRI image data obtained from a man with discoid meniscus,three-dimen⁃sional models of knee joint bones,meniscus and other structure were created with Mimics software,and then an original finite el⁃ement model was made by fusion of the structures with Hypermesh software.After that,the target models that simulated partial meniscectomy and partial meniscectomy combine with rim trimming were conducted.Under axial loads on the original model and the two target models respectively,the biomechanical properties of these models were analyzed and compared.[Results]For the discoid meniscus uninvolved,the compression stress focused on the body part with peak stress of 2.21 MPa on the cen⁃ter of the discoid meniscus.After simple partial meniscectomy,the compression stress increased to 6.46 Mpa on middle body.However,the compression stress became of 1.55 MPa in peak value,and distributed more homogeneously in the model of partial meniscectomy combine with rim trimming.[Conclusion]The partial meniscectomy combine with rim trimming is more in line with the biomechanical characteristics of normal meniscus,which might be favorable to delay the knee degeneration.

关 键 词：膝关节 盘状半月板 半月板部分切除 边缘修整 生物力学 

分 类 号：R687.4[医药卫生—骨科学]