The sensitivity of tibiofemoral contact pressure to the size and shape of the lateral and medial menisci
The sensitivity of tibiofemoral contact pressure to the size and shape of the lateral and medial menisci
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DOI：
10.1016/j.orthres.2003.12.010
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发表时间：
2004-07-01
影响因子：
2.8
通讯作者：
Jacobs, CR
中科院分区：
文献类型：
--
作者：
Donahue, TLH;Hull, ML;Jacobs, CR
为了防止半月板切除术后关节软骨的退变，人们研究了同种异体半月板移植和人工关节置换。一些生物力学标准对于半月板置换术恢复膝关节正常的胫股接触压力并因此在临床上取得成功是很重要的。其中一个标准是几何相似性。本研究的目的是：确定胫骨平台的接触变量对外侧和内侧半月板的横向深度和宽度的敏感性；确定胫骨平台的接触变量对外侧和内侧半月板的横截面宽度和高度的敏感性；以及确定两个半月板的四个参数中每一个参数的公差。为了满足这些目标，使用先前开发的胫股关节有限元模型来计算胫骨平台上的接触压力分布。通过对有限元模型的摄动，研究了上述几何参数对接触行为的影响。结果表明，接触变量对半月板的横截面参数和横截面参数都同样敏感。此外，内侧半月板参数比外侧半月板参数对接触变量的影响更大。最后，在接触变量与原始几何形状的相对差异超过10%之前，内侧半月板高度变化小于0.5 mm，外侧半月板高度变化大于1 mm是可以容忍的。因此，在半月板替代物的设计或选择中，当确定替代组织的大小时，应测量四个参数中的每一个。此外，与外侧半月板参数相比，内侧半月板参数应该有更严格的公差。(C)2004年骨科研究会。爱思唯尔有限公司出版。保留所有权利。
In an effort to prevent degeneration of articular cartilage associated with meniscectomies, both meniscal allografts and synthetic replacements have been studied. A number of biomechanical criteria may be important for a meniscal replacement to restore normal tibiofemoral contact pressure in the knee joint and hence be clinically successful. One of these criteria is geometric similarity. The objectives of the current study were to: determine the sensitivity of the contact variables of the tibia] plateau to the transverse depth and width of both the lateral and medial menisci; determine the sensitivity of the contact variables of the tibial plateau to the cross-sectional width and height of the lateral and medial menisci; and determine the tolerances on each of the four parameters for both menisci. To satisfy these objectives, a previously developed finite element model of the tibiofemoral joint was used to compute the contact pressure distribution on the tibial plateau. The effect of the above-mentioned geometric parameters on the contact behavior was studied by perturbing the finite element model. Results showed that the contact variables are similarly sensitive to both the transverse and cross-sectional parameters of the menisci. Additionally the medial meniscal parameters have a greater effect on the contact variables than do the lateral meniscal parameters. Finally, less than a 0.5 mm change in the medial meniscal height and greater than a I mm change in the lateral meniscal height could be tolerated before the relative difference in the contact variables from those for the original geometry exceeded 10%. Thus in the design or selection of meniscal replacements, each of the four parameters should be measured when sizing a replacement tissue. Also tighter tolerances should be placed on the medial meniscal parameters compared to the lateral meniscal parameters. (C) 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.