在前十字带重建后,部分是多么安全? 一个有限元素分析分析
V Kotiuk1, O Kostrub2, R Blonskyi2
1Carolina Medical Center, 78 Pory Street, Warsaw 02-757, Poland.
The Knee
|July 17, 2023
概括
部分坐会增加膝盖的压力,特别是在较高的后椎斜率 (PTS) 和患者体重的情况下,这会给前十字带 (ACL) 移植物带来后术风险. 康复必须是个性化的,考虑到移植的厚度和PTS角度.
科学领域:
- 生物力学 生物力学
- 整形外科手术 整形外科手术
- 运动医学 运动医学
背景情况:
- 部分是康复中常见的,但它们的安全性和最佳深度仍在争论中.
- 之前的研究往往忽略了后椎斜率 (PTS) 和前侧带 (ALL) 在部分 squats 期间对膝盖压力的影响.
研究的目的:
- 分析不同后斜率 (PTS) 和承重负荷在部分 squats 期间对膝关节应力的影响.
- 评估与前十字带 (ACL) 移植的部分部相关的生物机械风险,考虑不同的移植类型和患者体重.
主要方法:
- 开发了包括肌肉炼在内的全面膝盖计算机模型,用于75-150公斤的承重.
- 包括前侧带 (ALL),两种PTS变体 (5°和13.9°),以及两种前交叉带 (ACL) 类型 (本地和单束移植).
- 利用有限元分析来评估14个解剖学元素在55°膝盖曲和10°前阴倾斜时的应力.
主要成果:
- 增加的PTS (5°至13.9°) 显著增加了本地ACL (1.2-1.3x) 和ALL (1.3-1.4x) 的压力.
- 对于单束ACL重建,更高的PTS同样增加了移植 (1.2-1.3x) 和ALL (1.3-1.4x) 的压力.
- 较高的患者体重相对增加了ACL,ALL和其他关节元件的压力;125kg+对较薄的移植造成破裂风险.
结论:
- 在早期的术后阶段,部分可以冒着ACL移植失败的风险,受患者体重和PTS角度的影响.
- 康复后ACL重建需要个性化策略,考虑移植厚度,固定,患者体重,ALL状态,PTS和长期目标.
- 由于个体生物力学因素,标准化的物理治疗启动和运动选择是不建议的.
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