Rotational changes at the knee after ACL injury cause cartilage thinning
Rotational changes at the knee after ACL injury cause cartilage thinning
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DOI：
10.1097/01.blo.0000197079.26600.09
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发表时间：
2006-01-01
影响因子：
4.2
通讯作者：
Koo, Seungbum
中科院分区：
文献类型：
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作者：
Andriacchi, Thomas P.;Briant, Paul L.;Koo, Seungbum
我们研究了前十字韧带损伤后特定步态变化与膝关节骨关节炎进展之间的关系。该研究是使用从磁共振图像创建的受试者特定三维软骨体积衍生的有限元模型完成的。使用基于八面体剪切应力的迭代算法来预测软骨变薄。对正常排列的膝盖和与前交叉韧带缺陷相关的胫骨内旋偏移的膝盖进行了模拟。对于健康的膝盖，该模型预测的软骨变薄模式与之前的特发性骨关节炎临床报告一致。对于 ACL 缺陷的情况，模型预测整个膝盖的软骨变薄速度更快，尤其是内侧间室。结果表明，前十字韧带损伤后骨关节炎的进展与膝关节正常功能期间由于运动学变化而发生的正常承载区域的移位有关，并强调了在前十字韧带重建过程中恢复正确步态的重要性。
We examined the relationship between specific gait changes after anterior cruciate ligament injury and the progression of osteoarthritis at the knee. The study was done using a finite-element model derived from subject specific three-dimensional cartilage volumes created from magnetic resonance images. Cartilage thinning was predicted using an iterative algorithm based on the octahedral shear stress. Simulations were done for a knee with normal alignment and for a knee with an internal tibial rotation offset, as associated with anterior cruciate ligament deficiency. For the healthy knee, the model predicted patterns of cartilage thinning consistent with a previous clinical report of idiopathic osteoarthritis. For the ACL-deficient scenario the model predicted a more rapid rate of cartilage thinning throughout the knee, especially in the medial compartment. The results suggest that the progression of osteoarthritis after anterior cruciate ligament injury is associated with a shift in the normal load bearing regions of the knee joint during normal function due to kinematic changes, and highlight the importance of restoring proper gait during anterior cruciate ligament reconstruction.