A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis.
A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis.
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基于计算流体动力学分析的颞下颌关节镜下灌洗与关节穿刺术的对比研究
DOI：
10.1371/journal.pone.0078953
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zhang Z
中科院分区：
文献类型：
--
作者：
Xu Y;Lin H;Zhu P;Zhou W;Han Y;Zheng Y;Zhang Z
关节镜下灌洗和关节穿刺术是目前治疗颞下颌关节盘移位（TMJ-DD）的微创技术，使用不同内径的灌洗针进行灌洗和关节穿刺，以减轻疼痛和改善功能。在目前的研究中，我们的目的是探讨生物力学的影响，并解释这两种方法与计算流体动力学的不同临床结果。方法回顾性分析2002年至2010年78例关节镜下灌洗或关节穿刺治疗颞下颌关节发育不良患者的临床资料。四种类型的有限体积模型，具有不同直径的冲洗针，构建基于计算机断层扫描图像。我们研究了不同口径针头的灌洗液的流动模式和压力分布。我们的研究结果表明，流出门的大小是决定灌注流速的关键因素，较大的流入门和较小的流出门导致较高的关节内压力。这与临床数据一致，表明增加张口度和最大对侧运动可改善关节镜灌洗后的结局。本研究结果可供临床上根据疼痛、张口受限等主诉选择灌洗器械及关节活动度检查时参考。
Arthroscopic lavage and arthrocentesis, performed with different inner-diameter lavage needles, are the current minimally invasive techniques used in temporomandibular joint disc displacement (TMJ-DD) for pain reduction and functional improvement. In the current study, we aimed to explore the biomechanical influence and explain the diverse clinical outcomes of these two approaches with computational fluid dynamics. Data was retrospectively analyzed from 78 cases that had undergone arthroscopic lavage or arthrocentesis for TMJ-DD from 2002 to 2010. Four types of finite volume models, featuring irrigation needles of different diameters, were constructed based on computed tomography images. We investigated the flow pattern and pressure distribution of lavage fluid secondary to caliber-varying needles. Our results demonstrated that the size of outflow portal was the critical factor in determining irrigated flow rate, with a larger inflow portal and a smaller outflow portal leading to higher intra-articular pressure. This was consistent with clinical data suggesting that increasing the mouth opening and maximal contra-lateral movement led to better outcomes following arthroscopic lavage. The findings of this study could be useful for choosing the lavage apparatus according to the main complaint of pain, or limited mouth opening, and examination of joint movements.
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