Contact Mechanics of the Medial Tibial Plateau after Implantation of a Medial Meniscal Allograft
Contact Mechanics of the Medial Tibial Plateau after Implantation of a Medial Meniscal Allograft
复制标题
内侧半月板同种异体移植后内侧胫骨平台的接触力学
DOI：
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发表时间：
2000
影响因子：
4.8
通讯作者：
S. Howell
中科院分区：
文献类型：
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作者：
Mohammad M. Alhalki;M. Hull;S. Howell
本研究的目的是确定植入时内侧胫骨同种异体移植物恢复内侧胫骨平台正常接触力学的程度。我们测量了最大压力，平均压力，和接触面积的完整的人尸体膝关节，膝关节切除术后，膝关节与原来的半月板删除和重新植入作为自体移植物，膝关节与同种异体移植物。在0°、15°、30°和45°屈曲时，使用压敏膜对10个样本进行测量，这些样本在压缩载荷为1000 N的情况下进行。自体移植物和同种异体移植物通过将骨栓连接到解剖经胫骨隧道中的半月板角上并将半月板的外缘固定到原始半月板的残余物上来相同地植入。内侧半月板同种异体移植物不能持续恢复正常的接触力学，因为植入过程以及原始半月板和同种异体移植物半月板之间的匹配程度影响了移植物的即时承重性能。然而，同种异体移植物确实显著降低了接触压力，与手术切除后的膝关节相比。如果这项研究的结果可以外推到患者，那么使用同种异体移植物恢复接触力学正常可能需要改进手术技术和移植物选择。
The goal of this study was to determine how well a medial meniscal allograft restores the normal contact mechanics of the medial tibial plateau at the time of implantation. We measured maximum pressure, mean pressure, and contact area of the intact human cadaveric knee, the knee after meniscectomy, the knee with the original meniscus removed and reimplanted as an autograft, and the knee with an allograft. Measurements were made using pressure-sensitive film in 10 specimens loaded in compression to 1000 N at 0°, 15°, 30°, and 45° of flexion. The autograft and the allograft were identically implanted by cementing bone plugs attached to the meniscal horns in anatomic transtibial tunnels and suturing the outer edge of the meniscus to the remnant of the original meniscus. A medial meniscal allograft did not consistently restore normal contact mechanics because the process of implantation and the degree of match between the original and allograft meniscus affected the immediate load-bearing performance of the transplant. However, the allograft did significantly reduce the contact pressure compared with the knee after meniscectomy. If the results from this study can be extrapolated to patients, then using an allograft to restore contact mechanics to normal may require improvements in surgical technique and graft selection.