内侧副韧带不同程度损伤时膝关节的应力变化  

Stress changes of knee joint with different degrees of medial collateral ligament injury

作　　者：姜亚琼 路坦[1] 徐彪 杨骏良 阴玉娇 Jiang Yaqiong;Lu Tan;Xu Biao;Yang Junliang;Yin Yujiao(Ward One,Department of Joint and Trauma Surgery,Xinxiang Key Laboratory of Degenerative Bone and Joint Diseases,Weihui 453100,Henan Province,China;First Department of Surgery,First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院关节与创伤外科一病区,新乡市骨关节退行性疾病研究重点实验室,河南省卫辉市453100 [2]新乡医学院第一附属医院手术一部,河南省卫辉市453100

出　　处：《中国组织工程研究》2024年第33期5270-5275,共6页Chinese Journal of Tissue Engineering Research

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190450),项目负责人:路坦。

摘　　要：背景:膝关节内侧副韧带损伤易导致继发性的半月板及软骨损伤,长期慢性损害会引起骨关节炎的发生。目前,关于内侧副韧带断裂所致半月板及关节软骨损伤的力学研究较少。目的:探讨膝关节内侧副韧带不同程度损伤对膝关节半月板及软骨生物力学的影响。方法:选择一名健康志愿者行膝关节CT和MRI检查,获取其影像资料,将扫描数据依次导入Mimics、Geomagic及Solidworks软件,经配准融合后建立正常膝关节三维模型,并在此基础上模拟出膝关节内侧副韧带不同程度损伤的模型,共分为4组,包括:①内侧副韧带完整;②内侧副韧带深层断裂;③内侧副韧带浅层断裂;④内侧副韧带完全断裂。最后导入Ansys软件,对膝关节施加3种模式载荷:①股骨顶端施加10 N·m外翻力矩;②股骨顶端施加4 N·m内旋力矩;③股骨顶端施加4 N·m外旋力矩。分析4组模型在不同载荷下对膝关节生物力学的影响。结果与结论:①在膝关节伸直位,对膝关节施加10N·m外翻力矩时,内侧副韧带不同程度损伤后外侧半月板总体应力均增加,关节软骨应力变化不明显,并且当内侧副韧带浅层出现断裂后外侧半月板应力峰值明显增大;②在膝关节伸直位,对膝关节施加4 N·m内旋力矩时,内侧副韧带不同程度损伤后内外侧半月板总体应力均增加,当内侧副韧带浅层出现断裂时半月板应力峰值从内侧半月板前角转移至外侧半月板前角;③在膝关节伸直位,对膝关节施加4 N·m外旋力矩,内侧副韧带不同程度损伤后外侧半月板应力峰值较内侧半月板增加更明显,关节软骨应力变化较小;④结果表明,膝关节处于伸直状态下,膝关节内侧副韧带浅层断裂继发半月板损伤的风险远大于内侧副韧带深层断裂,而外侧半月板较内侧半月板更易受到损伤;内侧副韧带浅层和深层对膝关节的旋转稳定性均有重要作用。BACKGROUND:The incidence of medial collateral ligament injuries in the knee joint is easy to lead to secondary meniscus and cartilage damage,and long-term chronic damage can lead to the occurrence of osteoarthritis.At present,there are few studies on the mechanics of meniscus and articular cartilage injury caused by medial collateral ligament rupture.OBJECTIVE:To investigate the effect of different degrees of medial collateral ligament injury on the biomechanics of meniscus and cartilage of knee joint.METHODS:The CT and MRI examinations of the knee joint of a healthy volunteer were performed to obtain the image data.The scanning data were imported into Mimics,Geomagic,and Solidworks software in turn.After registration and fusion,a 3D model of normal knee joint was established.On this basis,models of medial collateral ligament injury in different degrees of knee joint were simulated,which were divided into four groups,including:(1)medial collateral ligament was intact;(2)deep medial collateral ligament fracture;(3)superficial medial collateral ligament fracture;(4)complete rupture of medial collateral ligament.Finally,Ansys software was introduced to apply three modes of loads to the knee joint:(1)10 N·m valvaration torque was applied to the top of the femur.(2)A 4 N·m internal torque was applied to the top of the femur.(3)A 4 N·m external torque was applied to the top of the femur.The effects of four groups of models on knee biomechanics under different loads were analyzed.RESULTS AND CONCLUSION:(1)In the extension position of the knee joint,when a 10 N·m valgus torque was applied to the knee joint,the overall stress of the posterolateral meniscus increased with different degrees of medial collateral ligament injuries,while the stress of the articular cartilage did not change significantly.The peak stress of the posterolateral meniscus increased significantly with superficial medial collateral ligament rupture.(2)In the knee extension position,when a 4 N·m internal rotation torque was applied to the knee joi

关 键 词：膝关节 内侧副韧带 半月板 有限元分析 生物力学 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R684