Biomechanical effects of medial meniscus radial tears on the knee joint during gait: A concurrent finite element musculoskeletal framework investigation.
Biomechanical effects of medial meniscus radial tears on the knee joint during gait: A concurrent finite element musculoskeletal framework investigation.
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DOI：
10.3389/fbioe.2022.957435
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发表时间：
2022
影响因子：
5.7
通讯作者：
Ogaya, Shinya
中科院分区：
文献类型：
--
作者：
Wang, Sentong;Hase, Kazunori;Kita, Shunsuke;Ogaya, Shinya
行走过程中膝关节的生物力学变化，伴随着由膝关节骨关节炎（OA）引起的内侧髁桡侧撕裂尚未进行探讨。本研究引入了一个有限元肌肉骨骼模型，在一个单一的框架中使用并发的下肢肌肉骨骼动力学和膝关节有限元分析，并扩展了模型，包括膝关节内侧桡骨撕裂和全内侧桡骨切除术。径向撕裂涉及三个位置：前角、中段和后角，等级分别为半月板宽度的33%、50%和83%。使用模型在步态周期的站立阶段评估撕裂半月板和胫骨软骨接触载荷、伴随的撕裂和后半月板切除术的剪切应力和环向应力。在83%宽度的中段撕裂组中，撕裂末端的剪切应力显著大于完整半月板和其他撕裂组，最大剪切应力比完整半月板增加了310%。内侧半月板径向撕裂对胫骨软骨载荷的影响要小得多（即使在83%宽度撕裂中，软骨/总载荷比仅增加9%）。然而，与健康完整半月板相比，全后半月板切除术后胫骨软骨上的接触力增加了178.93%，并且在最大重量接受和推出时，全后半月板切除术后的峰值接触压力分别从11.94 - 12.45 MPa增加到17.64和13.76 MPa。我们的研究表明，内侧半月板宽度较大的径向撕裂在撕裂末端容易产生高应力集中，导致半月板完全破裂的潜在风险。此外，虽然撕裂没有改变软骨负荷分布，但它们破坏了半月板的周向应力传递功能，从而大大增加了膝关节OA发作的可能性。胫骨软骨负荷的显著增加与全切除术后表明骨关节炎突发的潜在风险。本研究有助于更好地了解人类活动过程中关节撕裂引起的OA生物力学变化，并为关节切除术的手术指导和OA的预防和治疗提供了一些潜在的方向。
The biomechanical variation in the knee during walking that accompanies medial meniscal radial tears stemming from knee osteoarthritis (OA) has not been explored. This study introduced a finite element musculoskeletal model using concurrent lower limb musculoskeletal dynamics and knee joint finite element analysis in a single framework and expanded the models to include knees with medial meniscal radial tears and total medial meniscectomy. The radial tears involved three locations: anterior horn, midbody, and posterior horn with grades of 33%, 50%, and 83% of the meniscus width. The shear and hoop stresses of the tear meniscus and tibial cartilage contact load, accompanying tears, and postmeniscectomy were evaluated during the stance phase of the gait cycle using the models. In the 83% width midbody tear group, shear stress at the end of the tear was significantly greater than in the intact meniscus and other tear groups, and the maximum shear stress was increased by 310% compared to the intact meniscus. A medial meniscus radial tear has a much smaller effect on the tibial cartilage load (even though in the 83% width tear, the cartilage/total load ratio increased by only 9%). However, the contact force on the tibial cartilage with total postmeniscectomy was increased by 178.93% compared with a healthy intact meniscus, and the peak contact pressure after meniscectomy increased from 11.94 to 12.45 MPa to 17.64 and 13.76 MPa, at the maximum weight acceptance and push-off, respectively. Our study shows that radial tears with larger medial meniscus widths are prone to high stress concentrations at the end of the tears, leading to the potential risk of complete meniscal rupture. Furthermore, although the tears did not change the cartilage load distribution, they disrupted the circumferential stress-transmitting function of the meniscus, thus greatly increasing the likelihood of the onset of knee OA. The significant increase in the tibial cartilage load with total postmeniscectomy indicates a potential risk of OA flare-ups. This study contributes to a better understanding of meniscal tear-induced OA biomechanical changes during human activities and offers some potential directions for surgical guidance of meniscectomies and the prophylaxis and treatment of OA.
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影响因子：
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作者：
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DOI：
10.1016/j.jmbbm.2008.10.005
发表时间：
2009-08-01
影响因子：
3.9
作者：
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