马拉松运动员外侧副韧带损伤对运动状态下踝稳定性及距骨滑车软骨受力影响的有限元分析  

Finite element analysis of the influence of lateral collateral ligament injury on ankle stability and talar trochlear cartilage stress in a marathon runner

作　　者：黄杰 姚婉贞 丁丽华 黄珍媚 林上本 丁建平[1] Huang Jie;Yao Wanzhen;Ding Lihua;Huang Zhenmei;Lin Shangben;Ding Jianping(Department of Radiology,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China;Department of orthopedics,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院放射科,杭州310015 [2]杭州师范大学附属医院骨科,杭州310015

出　　处：《中华放射学杂志》2024年第4期416-421,共6页Chinese Journal of Radiology

基　　金：浙江省医药卫生科技计划项目(2022KY260);杭州市医药卫生科技项目(A20210220)。

摘　　要：目的构建马拉松运动员踝关节三维有限元模型,模拟运动过程中外侧副韧带(LCL)损伤对踝关节稳定性及距骨滑车软骨受力分布变化情况。方法采集1名马拉松运动员右侧踝关节三维MRI图像,以DICOM格式导入Mimics软件,对图像进行初步三维模型重建。利用Ansys Workbench软件对模型进行边界条件及载荷的加载,建立4种踝关节LCL损伤有限元模型,即LCL正常模型、距腓前韧带(ATFL)损伤模型、AFTL合并跟腓韧带(CFL)损伤模型、AFTL合并CFL、距腓后韧带(PTFL)损伤模型。观察4种模型下距骨滑车软骨应力峰值及分布情况,采用单因素方差分析比较距骨前移值,两两间比较采用SNK-q检验方法。结果LCL正常模型中,距骨滑车应力峰值为0.21 MPa,主要分布于前内侧部(MA)与前外侧部(LA)交界区及部分LA区域;ATFL损伤时,应力峰值较正常模型增大,最大值为0.65 MPa,主要分布在MA区域;ATFL合并CFL损伤时,应力峰值进一步增大,峰值主要分布在MA区域,且由MA区域向LA偏移;ATFL合并CFL、PTFL损伤时,距骨滑车软骨应力峰值最高为2.29 MPa,最大应力主要分布在MA、LA,两者分布范围相当。LCL正常、AFTL损伤、AFTL合并CFL损伤、ATFL合并CFL、PTFL时,距骨前移值分别为(3.2±0.4)、(3.4±0.4)、(3.7±0.5)、(6.5±0.7)mm,差异有统计学意义(F=109.08,P<0.001)。ATFL合并CFL、PTFL损伤模型的距骨前移值大于正常模型、AFTL损伤模型以及AFTL合并CFL损伤模型的距骨前移值,差异有统计学意义(P<0.05)。结论基于马拉松运动员踝关节三维MRI图像成功构建了三维有限元模型,LCL损伤时,距骨滑车软骨应力峰值和范围发生变化,且导致距骨滑车前移。ObjectiveA three-dimensional(3D)finite element model of the ankle joint of marathon runners was constructed to simulate the changes of the lateral collateral ligament(LCL)injury on the stability of the ankle joint and the force distribution of talar talus cartilage during exercise.MethodsThe 3D MRI images of the right ankle joint of one marathon runner were acquired and imported into Mimics software in DICOM format for preliminary 3D model reconstruction of the images.The boundary conditions and loads were loaded on the model using Ansys Workbench software,and the ankle joint forces were analyzed by Ansys Workbench for marathon runners in the sports condition,and four kinds of ankle LCL injury finite element models were established,i.e.,the normal model of LCL,the injury model of anterior talofibular ligament(ATFL),the injury model of AFTL merged with the calcaneofibular ligament(CFL),and the injury model of AFTL merged with the CFL and the posterior talofibular ligament(PTFL).The peak talus slide cartilage stress and its distribution were observed under the four models,and one-way ANOVA was used to compare the values of talus advancement,and the SNK-q test was used for two-by-two comparisons.ResultsIn the LCL normal model,the maximum stress peak of the talar slide was 0.21 MPa,which was mainly distributed in the junction area of the anterior medial(MA)and anterior lateral(LA)parts and part of the LA region.In ATFL injury,the peak stress of talar cartilage increased compared with the normal model,with a maximum value of 0.65 MPa,which was mainly distributed in the MA region.In ATFL combined with CFL injury,the peak stress increased,and the peak was mainly distributed in the MA region,and was shifted from the MA to the LA region.In ATFL combined with CFL and PTFL injuries,the peak cartilage stress in the talus slide was up to 2.29 MPa,and the maximum stress was mainly distributed in MA and LA,which had a comparable range of distribution.The anterior talar displacement values were(3.2±0.4),(3.4±0.4),(3.7±0.5),an

关 键 词：磁共振成像 有限元分析 马拉松 外侧副韧带损伤 距骨前移 踝关节不稳 

分 类 号：R873[医药卫生—运动医学]