Changes in Tissue Composition and Load Response After Transtibial Amputation Indicate Biomechanical Adaptation.
Changes in Tissue Composition and Load Response After Transtibial Amputation Indicate Biomechanical Adaptation.
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DOI：
10.1007/s10439-021-02858-0
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发表时间：
2021-12
影响因子：
3.8
通讯作者：
Dickinson AS
中科院分区：
文献类型：
--
作者：
Bramley JL;Worsley PR;Bader DL;Everitt C;Darekar A;King L;Dickinson AS
尽管假肢的使用具有生物力学调节的潜力，但下肢截肢后残肢的软组织容易受到损伤。尽管认识到肌内脂肪水平表明对机械负荷的耐受性降低，但揭示这些软组织形态学变化的成像研究并未区分浅表和肌内脂肪分布。此外，目前还不清楚这些变化如何改变组织色调和硬度，而这是假肢接受腔设计的关键特征。本研究的目的是比较形态和肢体组织的生物力学反应的机械负荷的个人和没有经胫骨截肢，使用磁共振成像结合组织结构刚度。结果显示，残肢中的脂肪浸润肌肉高于完整肢体（残肢：中位数2.5%（范围0.2-8.9%）;对侧：1.7%（0.1-5.1%）;对照：0.9%（0.4-1.3%）），表明截肢后肌肉萎缩和适应。肌内脂肪含量与日常插座使用呈负相关，尽管与截肢后时间无关。在髌腱部位，残肢明显比完好肢体僵硬，髌腱在肢体-假体界面的载荷传递中起着关键作用。截肢后的组织变化与临床上对这一弱势群体的假肢接受腔设计变量和软组织损伤风险的理解相关。
Despite the potential for biomechanical conditioning with prosthetic use, the soft tissues of residual limbs following lower-limb amputation are vulnerable to damage. Imaging studies revealing morphological changes in these soft tissues have not distinguished between superficial and intramuscular adipose distribution, despite the recognition that intramuscular fat levels indicate reduced tolerance to mechanical loading. Furthermore, it is unclear how these changes may alter tissue tone and stiffness, which are key features in prosthetic socket design. This study was designed to compare the morphology and biomechanical response of limb tissues to mechanical loading in individuals with and without transtibial amputation, using magnetic resonance imaging in combination with tissue structural stiffness. The results revealed higher adipose infiltrating muscle in residual limbs than in intact limbs (residual: median 2.5% (range 0.2–8.9%); contralateral: 1.7% (0.1–5.1%); control: 0.9% (0.4–1.3%)), indicating muscle atrophy and adaptation post-amputation. The intramuscular adipose content correlated negatively with daily socket use, although there was no association with time post-amputation. Residual limbs were significantly stiffer than intact limbs at the patellar tendon site, which plays a key role in load transfer across the limb-prosthesis interface. The tissue changes following amputation have relevance in the clinical understanding of prosthetic socket design variables and soft tissue damage risk in this vulnerable group.
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DOI：
10.12659/msm.909550
发表时间：
2018-10-23
期刊：
Medical science monitor : international medical journal of experimental and clinical research
影响因子：
--
作者：
Huang J;Qin K;Tang C;Zhu Y;Klein CS;Zhang Z;Liu C
通讯作者：
Liu C
影响因子：
4
作者：
Aird, Lucy;Samuel, Dinesh;Stokes, Maria
通讯作者：
Stokes, Maria
影响因子：
4
作者：
Agyapong-Badu, Sandra;Warner, Martin;Stokes, Maria
通讯作者：
Stokes, Maria
影响因子：
2.4
作者：
Ceelen, K. K.;Stekelenburg, A.;Oomens, C. W. J.
通讯作者：
Oomens, C. W. J.
影响因子：
3.2
作者：
Gavronski, Georg;Veraksits, Alar;Maaroos, Jaak
通讯作者：
Maaroos, Jaak