The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles
The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles
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DOI：
10.1186/s12891-020-03197-2
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发表时间：
2020-04-03
影响因子：
2.3
通讯作者：
Sekiya, Ichiro
中科院分区：
文献类型：
--
作者：
Kubota, Rei;Koga, Hideyuki;Sekiya, Ichiro
背景 半月板挤压导致关节表面抵抗环向应变和生物力学过载的能力丧失。已经开发出集中化技术来克服这些问题。在本研究中，我们分析了猪膝关节在不同屈曲角度下挤压和集中的外侧半月板（LM）的生物力学。方法将猪膝关节（n = 8）置于万能测试仪中，在以下状态下对每个膝关节进行测试：1）完整； 2）通过切除LM后根和后滑膜囊形成挤压-半月板挤压； 3)通过插入外侧胫骨平台的两个锚进行集中-集中。在膝关节屈曲角度为 30 度、45 度、60 度和 90 度时，以 200 N 的轴向压缩力评估半月板的偏差距离、前 LM、中 LM、后 LM 的接触压力和接触面积以及胫骨软骨的接触压力。结果 LM的偏差距离在挤压过程中明显增大，但在各角度居中后又恢复到完整状态。前、中LM在挤压时接触压力和面积均显着下降，集中后恢复接近完整状态；然而，在后部 LM 中，减少的接触压力和面积在集中后并未恢复。胫骨软骨的接触压力在挤压时显着增加，但在集中后下降到接近完整状态。结论 这种集中手术可以减少LM的挤压并恢复LM前中部的负荷分配功能。然而，当缺陷位于后 LM 时，手术本身无法恢复箍功能。
Background Meniscal extrusion results in loss of the ability to resist hoop strain and biomechanical overload on the joint articular surface. A centralization technique has been developed to overcome these problems. In this study, we analyzed the biomechanics of the extruded and centralized lateral meniscus (LM) in porcine knee joints at different flexion angles. Methods Porcine knee joints (n = 8) were set in the universal tester and each knee was tested under the following states: 1) intact; 2) extrusion-meniscal extrusion was created by resecting the posterior root of the LM and posterior synovial capsule; and 3) centralization-centralization was performed by two anchors inserted in the lateral tibial plateau. Deviation distance of the meniscus, contact pressure, and contact area in the anterior LM, middle LM, posterior LM, and the contact pressure of the tibial cartilage were evaluated with an axial compressive force of 200 N at knee flexion angles of 30 degrees, 45 degrees, 60 degrees, and 90 degrees. Results The deviation distance of LM significantly increased in extrusion but was restored to the intact status after centralization at all angles. Both the contact pressure and area significantly decreased in extrusion and were restored after centralization close to the intact status in the anterior and middle LM; in the posterior LM, however, decreased contact pressure and area were not restored after centralization. The contact pressure of the tibial cartilage increased significantly in extrusion but decreased close to the intact status after centralization. Conclusions This centralization procedure could reduce extrusion of the LM and restore the load-distributing function of the anterior-middle LM. However, the procedure itself could not restore hoop function in cases where the defect lies in the posterior LM.