Diversity Supplement: How Partial Meniscectomy Affects Contact Mechanics and Tissue Response

多样性补充：部分半月板切除术如何影响接触力学和组织反应

• 批准号: 10170899
• 负责人: Suzanne A. Maher
• 金额: $ 9.06万
• 依托单位: HOSPITAL FOR SPECIAL SURGERY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-12 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10170899
• 关键词: Adhesions; Affect; Anatomy; Anterior; Anterolateral; Applications Grants; Area; Biomechanics; Bypass; Cadaver; Cartilage; Clinical; Computer Models; Consensus; Data; Elements; Engineering; Evaluation; Exposure to; Gait; Grant; Group Meetings; Guidelines; Human; Injury; Joints; Journals; Knee; Lateral; Learning; Location; Magnetic Resonance Imaging; Measures; Mechanics; Medial; Medial meniscus structure; Meniscus structure of joint; Modeling; Operative Surgical Procedures; Outcome; Parents; Plant Roots; Positioning Attribute; Procedures; Running; Scanning; Science; Site; Specimen; Sports Medicine; Stress; Surface; Surgeon; Techniques; Testing; Tissue Viability; Tissues; Training; United States National Institutes of Health; Variant; Walking; base; experimental study; functional restoration; imaging Segmentation; joint function; joint loading; kinematics; meetings; multidisciplinary; novel strategies; parent grant; physical model; primary outcome; repaired; response; sensor; skills; tibia

Project Summary The optimal surgical treatment for posteromedial meniscal root tears, a debilitating injury, is controversial. While many agree that the reduction of the meniscus to the native ‘anatomic’ position is required to restore function, this can be technically challenging to implement. As a result, meniscal root repairs are often reduced in various nonanatomic locations on the tibia, the functional consequences of which are poorly understood. We have previously shown that during simulated walking, some knees are ‘meniscal loaders’, while others bypass the meniscus and place higher focal forces on areas of cartilage-to-cartilage contact. We ask the question: are some knees more sensitive to meniscal root repair position than others? Our overall objective is to evaluate the biomechanical effects of position on posteromedial meniscal root repairs under dynamic loading conditions. Our central hypothesis is that there is a knee-dependent ‘safe zone’ for the repair position of posterior medial meniscal root tears, which will minimize changes in joint mechanics during level walking. To test our central hypothesis, we have developed two aims that harness the strengths of both cadaveric and computational modeling approaches. Specific Aim 1: Investigate joint contact stress throughout level walking after medial nonanatomic root repairs. We will use a cadaveric model to quantify changes in contact mechanics and kinematics after anatomic and nonanatomic repairs for posteromedial meniscal root tears during simulated stair climbing and level walking. We will test the hypotheses that: (1) anatomic root repairs will restore joint contact mechanics to intact during level walking better than nonanatomic medial root repairs (2) both repairs will restore contact mechanics to intact better than untreated root tears. Specific Aim 2: Quantify the effect of meniscal root repair position on joint mechanics during level walking. The data generated in SA1 will be used to create validated finite element models, where more precise control over the variation in attachment position is possible. We will test the hypothesis that there is a knee-dependent ‘safe zone’ for the position of posteromedial meniscal root repairs, which can restore the distribution of contact stress to that of the intact condition during level walking. By combining the data generated from SA1 and SA2, we aim to develop new clinical guidelines for the ideal position of meniscal root repairs to restore joint function.

项目概要 后内侧半月板根部撕裂（一种使人衰弱的损伤）的最佳手术治疗方法存在争议。尽管 许多人同意，需要将半月板还原到原始“解剖”位置才能恢复功能， 这在技术上实施起来可能具有挑战性。因此，半月板根部修复通常会因各种原因而减少。 胫骨上的非解剖位置，其功能后果知之甚少。我们有 之前的研究表明，在模拟行走过程中，一些膝盖是“半月板装载机”，而另一些则绕过半月板 半月板并在软骨与软骨接触的区域施加更高的聚焦力。我们问一个问题：有一些 膝盖对半月板根部修复位置比其他人更敏感？我们的总体目标是评估 动态载荷下位置对后内侧半月板根部修复的生物力学影响 状况。我们的中心假设是，对于修复位置存在一个依赖于膝盖的“安全区” 后内侧半月板根部撕裂，这将最大限度地减少水平行走期间关节力学的变化。测试 我们的中心假设是，我们制定了两个目标，利用尸体和尸体的优势 计算建模方法。具体目标 1：调查整个关卡的关节接触应力 内侧非解剖性牙根修复后行走。我们将使用尸体模型来量化接触的变化 半月板后内侧根部撕裂的解剖和非解剖修复后的力学和运动学 模拟爬楼梯和水平行走。我们将测试以下假设：(1) 解剖学牙根修复将恢复 水平行走期间关节接触力学完好无损优于非解剖内侧根修复 (2) 两种修复 与未经处理的根部撕裂相比，可以更好地将接触机械恢复完整。具体目标 2：量化效果 水平行走期间关节力学的半月板根部修复位置。 SA1中生成的数据将是 用于创建经过验证的有限元模型，可以更精确地控制附件的变化 位置是可以的。我们将检验以下假设：存在一个依赖膝盖的“安全区” 后内侧半月板根部修复，可以将接触应力的分布恢复到完整状态 水平行走时的状况。通过结合 SA1 和 SA2 生成的数据，我们的目标是开发新的 半月板根部修复恢复关节功能的理想位置的临床指南。