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Effect of degenerative and radial tears of the meniscus and resultant meniscectomy on the knee joint: a finite element analysis

机译:半月板的退化性和放射状撕裂以及半月板切除术对膝关节的影响:有限元分析

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ObjectiveThe objective of this study is to investigate the biomechanics on the knee components caused by degenerative and radial meniscal tears and resultant meniscectomy.MethodsA detailed finite element model of the knee joint with bones, cartilages, menisci and main ligaments was constructed from a combination of computed tomography and magnetic resonance images. Degenerative and radial tears of both menisci and resultant medial meniscectomy were used and two different kinds of simulations, the vertical and the anterior load, mimicking the static stance and slight flexion simulations, were applied on the model. The compressive and shear stress and meniscus extrusion were evaluated and compared.ResultsGenerally, both degenerative and radial tears lead to increased peak compressive and shear stress of both cartilages and menisci and large meniscus extrusion, and the medial meniscal tear induced larger value of stress and extrusion than the lateral meniscal tear. The peak stress and meniscus extrusion further elevated after the medial meniscus meniscectomy. Distribution of stress was shifted from the intact hemi joint to the injured hemi joint with either medial or lateral meniscal tear.ConclusionOur finite element model provides a realistic three-dimensional knee model to investigate the effects of degenerative and radial meniscal tears and resultant meniscectomy on the stress distribution of the knee. The stress was increased in meniscal tears and increased significantly when meniscectomy was performed. Increased meniscus extrusion may explain the mechanism for higher stress on the components of the knee.The translational potential of this articleMeniscal tears are the most common damage associated to the menisci, and meniscectomy is often performed to relieve the pain and instability of the knee. The results of our study indicated increased stress on cartilages and menisci, which may lead to early onset of osteoarthritis. This may guide surgeons to preserve more of the meniscus when performing meniscectomy.
机译:目的本研究的目的是研究退行性和radial骨半月板撕裂及随后的半月板切除术所引起的膝关节组件的生物力学方法。方法通过计算得出的组合来构建膝关节的详细有限元模型,包括骨骼,软骨,半月板和主要韧带。断层扫描和磁共振图像。半月板的退行性撕裂和放射状撕裂以及由此产生的内侧半月板切除术均被使用,并且在模型上应用了两种不同的模拟,即模拟静态姿势的垂直载荷和前部载荷,以及轻微的屈曲模拟。结果表明,退化和径向撕裂通常导致软骨和半月板的峰值压应力和剪切应力增加,而大的半月板挤压,内侧半月板撕裂引起更大的应力和挤压值。比外侧半月板撕裂。半月板内侧半月板切除术后的峰值应力和半月板挤压进一步升高。结论应力分布从完整的半关节转移到受伤的半月板内侧或外侧半月板撕裂。结论我们的有限元模型提供了一个现实的三维膝关节模型,以研究变性半月板和radial骨半月板撕裂以及由此导致的半月板切除对髋臼的影响。膝盖的应力分布。半月板撕裂时应力增加,半月板切除术时应力显着增加。半月板挤压的增加可能解释了对膝部组件施加更大压力的机理。本文的翻译潜力是半月板撕裂是与半月板相关的最常见损伤,经常进行半月板切除术可减轻膝盖的疼痛和不稳定性。我们的研究结果表明,软骨和半月板的应力增加,可能导致骨关节炎的早发。这可能会指导外科医生在进行半月板切除术时保留更多的半月板。

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