Sutured tendon repair; a multi-scale finite element model.
Sutured tendon repair; a multi-scale finite element model.
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DOI：
10.1007/s10237-014-0593-5
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发表时间：
2015-01
影响因子：
3.5
通讯作者：
Cartmell, Sarah H.
中科院分区：
文献类型：
--
作者：
Rawson, Shelley D.;Margetts, Lee;Wong, Jason K. F.;Cartmell, Sarah H.
断裂后，缝合肌腱以重新接近切断的末端并允许愈合。临床上采用了多种修复技术，最近的重点是高强度缝合线，允许早期主动活动，从而改善由此产生的关节活动度。然而，缝合修复的布置局部改变了肌腱所经历的负载环境。增强的应力分布的程度及其对组织的影响尚不清楚。使用传统的拉伸测试、缝线修复的体内或离体研究无法确定应力分布。我们开发了凯斯勒缝合修复的 3D 有限元模型，采用多尺度建模来表示肌腱微观结构，并将其高度正交各向异性行为纳入组织描述中。这是通过猪指深屈肌腱的离体拉伸试验得出的。近端和远端肌腱样本的肌腱横向模量分别为0.2551 0.0818 MPa和0.1035 0.0454 MPa，原纤维间组织模量范围为0.1021至0.0416 MPa。我们观察到缝合锚周围有一个椭圆形的高应力区域，与已知的无细胞区域一致，该区域在术后 72 小时内形成并持续至少一年。我们还观察到靠近切断的肌腱末端的应力屏蔽区域，由于缺乏拉伸应力，这可能会在修复重塑阶段损害胶原纤维的重新排列。
Following rupture, tendons are sutured to reapproximate the severed ends and permit healing. Several repair techniques are employed clinically, with recent focus towards high-strength sutures, permitting early active mobilisation thus improving resultant joint mobility. However, the arrangement of suture repairs locally alters the loading environment experienced by the tendon. The extent of the augmented stress distribution and its effect on the tissue is unknown. Stress distribution cannot be established using traditional tensile testing, in vivo, or ex vivo study of suture repairs. We have developed a 3D finite element model of a Kessler suture repair employing multiscale modelling to represent tendon microstructure and incorporate its highly orthotropic behaviour into the tissue description. This was informed by ex vivo tensile testing of porcine flexor digitorum profundus tendon. The transverse modulus of the tendon was 0.2551 0.0818 MPa and 0.1035 0.0454 MPa in proximal and distal tendon samples, respectively, and the interfibrillar tissue modulus ranged from 0.1021 to 0.0416 MPa. We observed an elliptically shaped region of high stress around the suture anchor, consistent with a known region of acellularity which develop 72 h post-operatively and remain for at least a year. We also observed a stress shielded region close to the severed tendon ends, which may impair collagen fibre realignment during the remodelling stage of repair due to the lack of tensile stress.
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影响因子：
14.8
作者：
Starborg T;Kalson NS;Lu Y;Mironov A;Cootes TF;Holmes DF;Kadler KE
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