How three methods for fixing a medial meniscal autograft affect tibial contact mechanics
How three methods for fixing a medial meniscal autograft affect tibial contact mechanics
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DOI：
10.1177/03635465990270030901
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发表时间：
1999-05-01
影响因子：
4.8
通讯作者：
Hull, ML
中科院分区：
文献类型：
--
作者：
Alhalki, MM;Howell, SM;Hull, ML
我们评估了三种固定内侧半月板自体移植物的方法，以确定哪种方法可以恢复最接近正常的胫骨接触力学。当膝关节样本在 0 度、15 度、30 度和 45 度屈曲时承受 1000 N 的压缩载荷时，使用压敏薄膜测定胫骨内侧关节面的接触力学（最大压力、平均压力、接触面积和最大压力中心的位置）。使用三种不同的固定方法测量了完整膝关节、半月板切除术后膝关节以及去除原始半月板并作为自体移植物重新植入的膝关节的压力。通过骨塞固定重新插入的自体移植物的接触力学最接近正常；然而，最大压力明显大于完整膝盖的压力。添加外围缝合线既不会改善也不会恶化接触力学。仅用缝线固定并不能恢复正常的接触力学。我们得出的结论是，内侧半月板移植需要对附着在前角和后角的骨塞进行解剖固定，以恢复最接近正常的接触力学。不建议仅用缝合线固定半月板角。
We evaluated three methods for fixing a medial meniscal autograft to determine which method restored tibial contact mechanics closest to normal. The contact mechanics (maximum pressure, mean pressure, contact area, and location of the center of maximum pressure) of the medial tibial articular surface were determined using pressure-sensitive film while knee specimens were loaded in compression to 1000 N at 0 degrees, 15 degrees, 30 degrees, and 45 degrees of flexion. Pressure was measured for the intact knee, the knee after meniscectomy, and the knee with the original meniscus removed and reimplanted as an autograft using three different fixation methods. The contact mechanics of the autograft reinserted with bone plug fixation were closest to normal; however, the maximum pressure was significantly greater than in the intact knee. Adding peripheral sutures neither improved nor worsened the contact mechanics. Fixation with sutures only did not restore normal contact mechanics. We concluded that medial meniscal transplantation requires anatomic fixation of bone plugs attached to the anterior and posterior horns to restore contact mechanics closest to normal. Fixation of the meniscal horns with sutures alone cannot be recommended.