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

项目摘要 后内侧半月板根部撕裂是一种使人衰弱的损伤，其最佳手术治疗方案存在争议。而当 许多人同意需要将半月板还原到天然的解剖位置以恢复功能， 这在技术上很难实现。因此，半月板根部修复术通常会因各种原因而减少。 胫骨上的非解剖位置，其功能后果尚不清楚。我们有 先前的研究表明，在模拟步行过程中，一些膝盖是“半月板负荷器”，而另一些则绕过了 半月板，并在软骨与软骨接触的区域施加更高的焦点力量。我们问这样一个问题：有些人 膝盖对半月板根部修复位置比其他部位更敏感吗？我们的总体目标是评估 动态载荷下体位对后内侧半月板根部修复的生物力学影响 条件。我们的中心假设是，膝关节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，这将减少水平行走时关节力学的变化。为了测试 我们的中心假设是，我们制定了两个目标，利用身体和 计算建模方法。具体目标1：调查整个级别的关节接触应力 内侧非解剖牙根修复后行走。我们将使用身体模型来量化接触中的变化 后内侧半月板根部撕裂解剖与非解剖修复后的力学和运动学 模拟爬楼梯和水平行走。我们将检验以下假设：(1)解剖牙根修复将恢复 水平行走时关节接触力学恢复完好优于非解剖内侧根修复(2) 会使接触力学恢复完好，比未经处理的牙根撕裂要好。具体目标2：量化 水平行走时半月板根部修复位置对关节力学的影响。在SA1中生成的数据将是 用于创建经过验证的有限元模型，更精确地控制附着体的变化 位置是可能的。我们将检验这样的假设，即存在依赖于膝盖的安全区域的位置 后内侧半月板根部修复，可恢复半月板接触应力的完整分布 水平行走时的状态。通过结合SA1和SA2产生的数据，我们的目标是开发新的 临床指南为半月板根部修复的理想位置，恢复关节功能。

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.