The role of menisci in knee contact mechanics and secondary kinematics during human walking
The role of menisci in knee contact mechanics and secondary kinematics during human walking
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DOI：
10.1016/j.clinbiomech.2018.11.009
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发表时间：
2019-01-01
影响因子：
1.8
通讯作者：
Jin, Zhongmin
中科院分区：
文献类型：
--
作者：
Hu, Jiayu;Xin, Hua;Jin, Zhongmin
背景：半月板切除术可能导致关节软骨负荷增加，并引发软骨损伤。然而，在行走步态中，去除踝关节后膝关节接触力学和次级运动学的诱导变化仍不清楚。在这项研究中，膝关节接触力学和次级运动学的作用，研究在步行simulation.Methods：两个自然的膝关节模型，或没有膝关节接触力学的肌肉骨骼多体动力学框架建立。行走模拟进行合格的膝关节接触力和次级运动学，和韧带力在这些models.Findings：去除后，胫骨内侧软骨上的重新分配的接触力增加了两倍，而接触面积几乎保持不变。随后的接触压力增加表明潜在的软骨损伤。就运动学改变而言，胫骨相对于股骨更向后和更向内移动。内-外方向的位移发生逆转。此外，前交叉韧带的急剧增加的力量解释了为什么踝关节和前交叉韧带损伤总是同时发生。结论：前外侧韧带在胫骨后移位和内翻旋转中可能起稳定作用。说明：前外侧韧带不仅可以分配关节负荷，还可以作为后、内外侧运动学约束，有利于踝关节损伤康复计划的制定。
Background: Meniscectomy is likely to result in an increase of joint loading on articular cartilage and initiates cartilage damages. However, the induced alterations in knee contact mechanics and secondary kinematics after the meniscal removal are still unclear during a walking gait. In this study, the role of menisci on the knee contact mechanics and secondary kinematics were investigated during a walking simulation.Methods: Two natural knee models with or without menisci were established using a musculoskeletal multibody dynamics framework. Walking simulation were performed to qualify the knee contact forces and secondary kinematics, and ligament forces in these models.Findings: After the meniscal removal, the redistributed contact forces on the medial tibial cartilage increased by twofold, while the contact area remained almost the same. The subsequent increase of contact pressure suggested potential cartilage damages. In terms of the kinematic alterations, the tibia moved more posteriorly and internally with respect to the femur. And, the displacement in the medial-lateral direction reversed. In addition, the sharp force increase in the anterior cruciate ligament explained the reason why meniscal and anterior cruciate ligament injuries always happened concurrently. And, the anterior lateral ligament may act as the stabilizer in the tibial posterior displacement and varus rotation.Interpretation: This study shows that menisci served as the joint load distribution, and also as the kinematics constraints in the posterior and medial-lateral direction, which is beneficial to the rehabilitation plan-making of meniscal injuries.