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.

项目摘要 具有令人衰弱的损伤的后外膜根部眼泪的最佳外科手术治疗是有争议的。尽管 许多人同意，将半月板减少到本地“解剖”位置需要恢复功能， 这在技术上可以挑战实施。结果，半月板根维修通常会减少各种 胫骨上的非解剖位置，其功能后果知之甚少。我们有 以前表明，在模拟行走中，有些膝盖是“半月板装载机”，而另一些则绕过 半月板并将较高的焦点放在软骨对牙齿接触的区域上。我们问一个问题：有些 膝盖对半月板根修理位置比其他人更敏感吗？我们的总体目标是评估 位置对动态载荷下后半半月板根维修的生物力学影响 状况。我们的中心假设是，有一个膝盖依赖的“安全区” 后期半月板撕裂，这将最大程度地减少级别行走期间关节力学的变化。测试 我们的中心假设，我们开发了两个利用尸体和尸体优势的目标 计算建模方法。特定目标1：调查整个级别的关节接触应力 在内侧非解剖根维修后行走。我们将使用尸体模型来量化接触的变化 解剖学和非解剖学修复后的力学和运动学，用于后半月板根泪液期间 模拟的楼梯攀爬和水平步行。我们将测试以下假设：（1）解剖根维修将恢复 在级别行走期间，联合接触力学比非解剖介质根源维修（2）两个维修都完好无损 将恢复接触力学比未经处理的根撕裂更好。特定目标2：量化 在级别步行期间，在关节力学上的半月板根修理位置。 SA1中生成的数据将是 用于创建经过验证的有限元模型，其中更精确地控制附件的变化 位置是可能的。我们将测试以下假设： 后半月板根维修，这可以恢复接触应力的分布到完整 级别步行期间的状况。通过结合SA1和SA2产生的数据，我们旨在开发新的 半月板根修理的理想位置以恢复关节功能的临床指南。