膝关节伸直位下外侧半月板后根不同位置撕裂对胫股关节的影响  

Effect of lateral meniscus posterior root tears at different positions on tibiofemoral joint under knee extension

作　　者：赵章伟 王俊诚 董伊隆 蔡春元 ZHAO Zhangwei;WANG Juncheng;DONG Yilong;CAI Chunyuan(Department of Orthpaedics,the Third Affiliated Hospital of Wenzhou Medical University,Wenzhou 325200,China)

机构地区：[1]温州医科大学附属第三医院关节外科,浙江温州325200

出　　处：《温州医科大学学报》2023年第9期744-748,共5页Journal of Wenzhou Medical University

基　　金：温州市基础性科研项目(Y20190272)。

摘　　要：目的:测量膝关节外侧半月板后根部不同位置撕裂对胫股关节接触面的影响。方法:采用12具冰冻成人膝关节标本,在膝关节伸直位下,施加1 kN垂直关节面的压缩载荷,在内外侧半月板完整、外侧半月板后根部止点完全撕脱、离后根止点3 mm、6 mm完全放射状撕裂及外侧半月板全切5种状态下测量内外侧间室的接触面积和平均压力。结果:在外侧间室,半月板完整状态下,平均压力为(0.68±0.07)MPa,接触面积为(454.49±32.55)mm^(2)。外侧半月板止点撕脱及离止点3 mm、6 mm放射状撕裂会显著增加外侧间室的平均压力并减少接触面积(P<0.01),但撕裂的3组中状态间差异无统计学意义(P>0.05);外侧半月板全切会进一步增强上述指标改变(P<0.05)。在内侧间室,半月板完整状态下,平均压力为(0.72±0.06)MPa,接触面积为(470.99±33.64)mm^(2),撕裂对内侧间室的接触压力和接触面积没有影响,但外侧半月板全切会减少内侧间室的接触面积(P<0.01)。结论:外侧半月板后根撕裂会显著增加外侧间室的平均压力及减少接触面积,但3个不同位置的撕裂没有差异。外侧半月板全切会进一步增强外侧间室上述指标的改变,并会减少内侧间室的接触面积。Objective:To measure the effect of lateral meniscus posterior root(LMPR)tears at different positions on the both tibiofemoral compartments.Methods:Twelve cadaveric knees were tested under a 1 kN axial load at flexion angles 0°.The contact area and average contact pressure of both tibiofemoral compartments were measured under 5 lateral meniscus conditions:intact,root avulsion,serial radial tear at 3 mm,6 mm from the root attachment site,and total meniscectomy.Results:In the lateral compartment,the average contact pressure was(0.68±0.07)MPa and the contact area was(454.49±32.55)mm2 when the meniscus was intact.The lateral meniscus posterior root(LMPR)avulsion and radial tear of 3 mm,6 mm from the root attachment site resulted in significantly decreased contact area and increased average contact pressure of the lateral compartment,compared with the intact state(P<0.01).There was no difference among the three groups(P>0.05).Meniscectomy produced higher decreases than root tear in contact area and increases in average pressure(P<0.05).In the medial compartment,average contact pressure was(0.72±0.06)MPa and the contact area was(470.99±33.64)mm2 when the meniscus was intact.The lateral meniscus posterior root(LMPR)avulsion and radial tear had no effect on the average contact pressure or contact area of the medial compartment,but total lateral meniscectomy would reduce the contact area(P<0.01).Conclusion:The lateral meniscus posterior root(LMPR)avulsion and radial tear can significantly increase the average contact pressure and reduce the contact area of the lateral compartment,but there is no difference among the tears at three different positions in the experiment.Total lateral meniscectomy will further enhance the changes of the above indexes of the lateral compartment and reduce the contact area of the medial compartment.

关 键 词：膝关节 外侧半月板 根部撕裂 生物力学 

分 类 号：R684[医药卫生—骨科学]