A computer modeling tool for optimizing Meniscus Allograft Transplantation

用于优化同种异体半月板移植的计算机建模工具

• 批准号: 8128461
• 负责人: XUDONG ZHANG
• 金额: $ 7.27万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-15 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8128461
• 关键词: Affect; Aftercare; Allografting; Anterior; Applications Grants; Area; Basic Science; Biomechanics; Characteristics; Clinical; Clinical Research; Clinical Sciences; Computer Simulation; Computing Methodologies; Contralateral; Data; Databases; Degenerative polyarthritis; Development; Diagnostic radiologic examination; Elements; Femur; Foundations; Functional disorder; Future; Gait; Goals; Health; High Resolution Computed Tomography; Imagery; Individual; Injury; Joints; Kinetics; Knee; Knee joint; Lateral; Leg; Location; Magnetic Resonance Imaging; Measures; Mechanics; Medial; Meniscus structure of joint; Methods; Modeling; Motion; Movement; Muscle; Operative Surgical Procedures; Optics; Orthopedic Surgical Procedures; Pain; Patients; Property; Reaction; Recruitment Activity; Research; Rotation; Science; Stress; System; Techniques; Testing; Tissue Engineering; Translations; Transplantation; United States; Variant; Walking; Wireless Technology; X-Ray Computed Tomography; base; bone; clinical care; computerized; design; early onset; functional outcomes; improved; improved functioning; in vivo; instrument; joint function; joint loading; kinematics; knowledge base; muscular system; pressure; public health relevance; response; sample fixation; simulation; tibia; tool

DESCRIPTION (provided by applicant): Meniscus allograft transplantation has become a viable treatment option for selected symptomatic patients who have undergone a complete or near-complete meniscectomy. Preliminary basic and clinical studies have suggested that meniscus allograft transplantation may help alleviate pain and improve knee function. However, the efficacy of transplantation to restore normal meniscus function compromised by meniscectomy has not been rigorously evaluated. There has been a scarcity of converging evidence from both clinical and basic science studies. Critically lacking are quantitative in vivo data and mechanistic descriptions of how meniscus allograft transplantation affects the knee joint function and mechanics. Such data and knowledge bases not only provide direct, most relevant scientific evidence for optimizing the clinical care, but also are much needed for guiding the development of tissue-engineered meniscus constructs. The proposed research is the first attempt to develop such a knowledge base by studying the effects of meniscus allograft transplantation on tibiofemoral kinematics and contact congruency in vivo and in silico. Our long-term goal is to establish a biomechanical science base and a computerized clinical utility for designing individual-optimized meniscus allograft transplantation. Our specific aims are (1) to characterize the in vivo changes in tibiofemoral kinematics and contact congruency in patients before and after treatment with meniscal transplant surgery during daily activities (level walking, squatting), and (2) to develop and validate a computational in silico model that describes mechanistically the effects of meniscus transplantation of varied characteristics on joint kinematics and contact congruency. We will measure 10 patients' tibiofemoral kinematics using a dynamic biplane radiography system, muscle activations using a wireless EMG system, and whole-body kinematics- kinetics using an optical motion capture system along with an instrumented treadmill. We will obtain high- resolution computed tomography (CT) and magnetic resonance imaging (MRI) scans of the patients. With the data, we will develop patient-specific models using an approach combining forward dynamic simulation and finite element modeling. We will validate the model based on both within-patient and cross-patient predictions. Successful fulfillment of these research aims will build a new biomechanical science foundation and a validated modeling framework for our future pursuit of individual-optimized meniscus transplantation that not only restores joint congruency but also promotes long-term joint health. PUBLIC HEALTH RELEVANCE: Meniscectomy is the most common orthopaedic surgical procedure performed in the United States and has deleterious consequences such as osteoarthritis and muscle dysfunction. Although meniscus transplant surgery has become a viable treatment option to restore normal meniscus function compromised by meniscectomy, its efficacy has not been rigorously evaluated. This grant application seeks to study the effects of meniscus allograft transplantation on tibiofemoral kinematics and contact mechanics using computer models developed from in vivo data.

描述（由申请人提供）：半月板同种异体移植已成为一种可行的治疗选择，为选定的症状患者谁经历了完全或接近完全的半月板切除术。初步的基础和临床研究表明，同种异体半月板移植可能有助于减轻疼痛和改善膝关节功能。然而，移植术恢复正常半月板功能的疗效尚未得到严格的评估。一直缺乏来自临床和基础科学研究的趋同证据。严重缺乏半月板同种异体移植如何影响膝关节功能和力学的定量体内数据和机制描述。这些数据和知识库不仅为优化临床护理提供了直接的、最相关的科学证据，而且也是指导组织工程半月板构建物发展所急需的。这项研究是首次尝试通过研究半月板同种异体移植对体内和计算机模拟胫股运动学和接触一致性的影响来开发这样一个知识库。我们的长期目标是建立一个生物力学的科学基础和计算机化的临床实用设计个人优化半月板同种异体移植。我们的具体目标是（1）描述患者在日常活动（水平行走、下蹲）期间接受半月板移植手术治疗前后胫股运动学和接触一致性的体内变化，以及（2）开发和验证计算机模拟模型，该模型从机械学角度描述不同特征的半月板移植对关节运动学和接触一致性的影响。我们将使用动态双平面X线摄影系统测量10名患者的胫股运动学，使用无线EMG系统测量肌肉激活，使用光学运动捕捉系统沿着测量全身运动学-动力学。我们将获得患者的高分辨率计算机断层扫描（CT）和磁共振成像（MRI）扫描。有了这些数据，我们将使用前向动态模拟和有限元建模相结合的方法开发患者特定的模型。我们将根据患者内和患者间的预测来验证模型。这些研究目标的成功实现将为我们未来追求个体优化的半月板移植建立一个新的生物力学科学基础和一个经过验证的建模框架，不仅可以恢复关节的一致性，还可以促进长期的关节健康。 公共卫生关系：半月板切除术是美国最常见的整形外科手术，具有骨关节炎和肌肉功能障碍等有害后果。虽然半月板移植手术已成为一种可行的治疗选择，以恢复正常半月板功能受损的半月板切除术，其疗效尚未得到严格的评估。本基金申请旨在研究半月板同种异体移植对胫股运动学和接触力学的影响，使用计算机模型从体内数据开发。