不同胫骨隧道角度重建后交叉韧带术后移植物应力有限元分析  

Finite element analysis of graft stress after posterior cruciate ligament reconstruction at different tibial tunnel angles

作　　者：李媛[1] 王腾骄 薛军[1] 李志强[1] 高林翼 武建康[1] LI Yuan;WANG Teng-jiao;XUE Jun;LI Zhi-qiang;GAO Lin-yi;WU Jian-kang(Department of No.3 Orthopedics,Lüliang Hospital,Shanxi Medical University,Lüliang 033000,Shanxi,China;Department of Orthopedics,Jinzhong Traditional Chinese Medicine Hospital,Jinzhong 030600,Shanxi,China)

机构地区：[1]山西医科大学附属吕梁医院骨三科,山西吕梁033000 [2]晋中市第四人民医院,山西晋中030600

出　　处：《生物医学工程与临床》2025年第1期12-23,共12页Biomedical Engineering and Clinical Medicine

摘　　要：目的通过三维有限元分析研究不同胫骨隧道角度解剖单束重建后交叉韧带(PCL)术后移植物的应力分布及胫骨隧道的变化情况,从生物力学角度寻找最优的胫骨隧道角度。方法选择1例健康成年男性志愿者膝关节伸直位的CT和MRI图像,通过Mimics、Geomagic、Solidworks软件构建膝关节三维有限元模型并模拟PCL解剖单束重建。在矢状位上分别建立40°、45°、50°、55°、60°胫骨隧道,然后导入ANSYS软件对三维重建的膝关节分别施加5种模式的应力:在股骨顶端施加750 N的纵向载荷;胫骨远端施加10 N·m内外翻扭矩、5 N·m内外旋扭矩,分析在不同胫骨隧道角度下,移植物在胫骨隧道出口处的应力的分布情况及胫骨隧道的变化。结果移植物的最大等效应力和切应力主要分布在股骨隧道入口的后侧和胫骨隧道出口的前侧(等效应力在股骨端施加轴向扭矩、膝内翻、膝外翻、膝内旋、膝外旋,TTA为40°、45°、50°、55°、60°时分别为17.94、21.64、26.89、22.23、17.51 MPa,6.14、5.66、6.64、6.67、2.76 MPa,6.87、7.30、8.82、7.48、7.72 MPa,14.45、16.91、21.64、17.02、13.91 MPa,9.66、11.19、14.46、10.75、8.90 MPa;切应力在股骨端施加轴向扭矩、膝内翻、膝外翻、膝内旋、膝外旋,TTA为40°、45°、50°、55°、60°时分别为2.87、3.47、3.01、3.36、3.22 MPa,1.21、1.44、1.25、1.39、0.49,0.58、0.66、0.67、0.71、0.65 MPa,2.09、2.33、2.10、2.28、2.04 MPa,4.06、4.47、6.39、4.21、3.67 MPa)。不同胫骨隧道角度重建PCL后移植物的最大主应力主要位于股骨隧道入口的前后侧和胫骨隧道出口的前侧(在股骨端施加轴向扭矩、膝内翻、膝外翻、膝内旋、膝外旋,TTA为40°、45°、50°、55°、60°时分别为24.22、28.33、34.11、27.14、25.48 MPa,7.81、7.26、8.32、8.15、3.36 MPa,8.78、9.01、10.90、9.05、10.28 MPa,20.06、22.97,、27.75、21.43、20.60 MPa,3.34、3.37、3.39、3.26、2.55 MPa)。胫骨隧Objective To study the stress distribution of posterior cruciate ligament(PCL)reconstruction graft and change of tibial tunnel with different tibial tunnel angles by three-dimensional finite element analysis,and seek the optimal tibial tunnel angle from biomechanics.Methods The CT and MRI images of knee joint in a healthy adult male volunteer were enrolled,the three-dimensional finite element model of knee joint was constructed by Mimics,Geomagic and Solidworks software,and anatomical single-bundle reconstruction of PCL was simulated.The tibial tunnels of 40°,45°,50°,55°and 60°were established in sagittal position,and 5 modes of stress were applied to three-dimensional reconstruction of knee joint into ANSYS software:longitudinal load of 750 N was applied at apex femur;10 N·m valgus torque and 5 N·m internal-external rotation torque were applied at distal tibia.The stress distribution and tibial tunnel changes of graft at the tibial tunnel terminal with different tibial tunnel angles were analyzed.Results The maximum equivalent stress and shear stress of graft were mainly distributed in posterior side of femoral tunnel initial and the anterior side of tibial tunnel terminal(equivalent stress axial torque,genu varus,genu valgus,genu internal rotation,genu external rotation were applied at femoral,TTA at 40°,45°,50°,55°,60°,the indexes were 17.94,21.64,26.89,22.23,17.51 MPa;6.14,5.66,6.64,6.67,2.76 MPa;6.87,7.30,8.82,7.48,7.72 MPa;14.45,16.91,21.64,17.02,13.91 MPa;9.66,11.19,14.46,10.75,8.90 MPa,respectively;shear stress axial torque,genu varus,genu valgus,genu internal rotation,genu external rotation were applied at femoral,TTA at 40°,45°,50°,55°,60°,the indexes were 2.87,3.47,3.01,3.36,3.22 MPa;1.21,1.44,1.25,1.39,0.49,0.58,0.66,0.67,0.71,0.65 MPa;2.09,2.33,2.10,2.28,2.04 MPa;4.06,4.47,6.39,4.21,3.67 MPa,respectively).The maximum principal stress of PCL reconstruction with different tibial tunnel angles was mainly located at the anterior and posterior sides of femoral tunnel initial and anterior

关 键 词：后交叉韧带重建 胫骨隧道 移植物 应力分布 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程] R687.4[医药卫生—基础医学]