摘要
背景:内侧髌股韧带重建是目前治疗髌骨外侧脱位最常用的方法,最终目的是将髌骨调整到正常的解剖位置,恢复髌骨轨迹,目前内侧髌股韧带重建的主要核心问题在于其股骨端固定点的选取上。目的:运用有限元方法分析膝关节不同屈曲角度时重建内侧髌股韧带对髌骨的限制作用,模拟不同股骨端固定点重建内侧髌股韧带对髌骨的限制作用,为内侧髌股韧带重建时股骨端固定点的选取提供帮助。方法:依据提取的膝关节CT与MRI数据建立包含骨骼及软组织的膝关节有限元模型,在模拟膝关节30°与60°屈曲角度时,选取不同的股骨端固定点构建内侧髌股韧带,比较不同点位时髌股关节间接触应力与接触面积,以及对髌骨横向约束力的大小。对不同屈曲角度时相同股骨端固定点所构建的内侧髌股韧带等长性进行验证,以研究各种内侧髌股韧带重建位置的效果。结果与结论:①建立了30°与60°屈曲角度时膝关节的三维有限元模型,构建了不同股骨端固定点的内侧髌股韧带,不同屈曲角度时相同股骨端位置构建的内侧髌股韧带具有可用的等长性;②对髌骨向外侧施加位移后,在横向方向上,不同股骨端固定点构建的内侧髌股韧带对髌骨产生了不同的横向约束力,在前端10 mm处时横向约束力最大,近端5 mm时横向约束力最小;而在纵向方向上,髌骨软骨上应力集中点位置与大小大致相同,且接触压力变化不大,但髌骨软骨与股骨软骨的接触面积相差较为明显,在前端10 mm时接触面积最大,近端5 mm时接触面积最小;③马鞍区中心点构建的内侧髌股韧带对髌骨的横向限制良好,而在纵向限制上不会对髌骨造成过度约束,可以达到对髌骨良好的限制作用。
BACKGROUND:The medial patellofemoral ligament reconstruction is the most commonly used method for the treatment of lateral dislocation of patella at present.The ultimate goal is to adjust the patella to the normal anatomical position and restore the patella track.Currently,the main core problem of medial patellofemoral ligament reconstruction is the selection of its femoral end fixation point.OBJECTIVE:Finite element method was used to analyze the limiting effect of the reconstructed medial patellofemoral ligament on the patella at different flexion angles of the knee joint,and to simulate the limiting effect of medial patellofemoral ligament reconstruction at different fixation points of the femoral end on the patellofemoral end,so as to provide help for the selection of fixation points of the femoral end during the reconstruction of the medial patellofemoral ligament.METHODS:A finite element model of knee including bone and soft tissue was established according to the extracted CT and MRI data of knee joint.When the knee flexion angle of 30°and 60°was simulated,the medial patellofemoral ligament was constructed by selecting different fixation points of femur end.The contact stress and contact area between patellofemoral joints at different points were compared,as well as the transverse binding force on patella.The equilength of the medial patellofemoral ligament constructed from the same fixation point of the femoral end at different flexion angles was verified to study the effect of various reconstruction positions of the medial patellofemoral ligament.RESULTS AND CONCLUSION:(1)A three-dimensional finite element model of the knee joint at 30°and 60°flexion angles was established to construct the medial patellofemoral ligament at different fixation points of the femur end.The medial patellofemoral ligament constructed at the same position of the femur end had usable isometric length at different flexion angles.(2)After the lateral displacement of the patella,in the transverse direction,the medial patellofem
作者
李超杰
居来提·买提肉孜
艾尔西丁·阿不来提
郑辉
涂浒第
Li Chaojie;Gulati·Maitirouzi;Aierxiding·Abulaiti;Zheng Hui;Tu Hudi(College of Mechanical Engineering,Xinjiang University,Urumqi 830017,Xinjiang Uygur Autonomous Region,China;Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830092,Xinjiang Uygur Autonomous Region,China)
出处
《中国组织工程研究》
CAS
北大核心
2024年第9期1359-1364,共6页
Chinese Journal of Tissue Engineering Research
基金
新疆维吾尔自治区自然科学基金项目(2019D01C245),项目负责人:郑辉。
关键词
内侧髌股韧带重建术
内侧髌股韧带
膝关节
有限元
股骨端固定点
马鞍区
medial patellofemoral ligament reconstruction
medial patellofemoral ligament
knee joint
finite element
fixation point of femur end
saddle area
