侧面形可以提高ACL重建的旋转稳定性吗? 一个有限元素分析分析
Konstantinos Risvas1, Dimitar Stanev1,2, Konstantinos Moustakas1
1Department of Electrical and Computer Engineering, University of Patras, Patras, Greece.
侧侧额外关节紧张术 (LET) 与前交叉带重建 (ACLR) 结合,可以减少膝盖的不稳定性,但可能会过度约束旋转. 正如有限元分析所显示的那样,最佳的LET预期对于有效的结果至关重要.
科学领域:
- 生物力学 生物力学
- 整形外科手术 整形外科手术
- 计算建模 计算建模
背景情况:
- 前十字带 (ACL) 破裂严重影响膝盖的稳定性.
- 前十字带重建 (ACLR) 是标准的,而侧向外关节延展 (LET) 用于旋转不稳定性.
- LET可能会减少ACLR移植力,但引起了人们对过度约束膝盖旋转的担忧.
研究的目的:
- 使用有限元素 (FE) 建模研究ACLR和LET之间的生物力学相互作用.
- 评估LET对膝盖动力学和ACLR移植力的影响.
- 为了评估与ACLR-LET结合的过度约束的潜力.
主要方法:
- 开发了一个开源工具,用于创建膝盖的FE模型.
- 创建了健康,ACLR和ACLR-LET膝盖的经过验证的FE模型.
- 模拟了Pivot-Shift测试,以测量外旋转 (ETR),后转移 (PTT) 和移植应力.
主要成果:
- 与单独的ACLR相比,LET降低了ETR和PTT.
- 综合ACLR-LET性能接近健康关节参数,LET移植预张力较低.
- LET降低了ACLR接种力,但在更高的预压值下造成了显著的过度约束.
结论:
- LET可以有效地减少旋转不稳定性,并保护ACLR移植.
- 优化LET移植预延伸对于平衡稳定性和生理旋转至关重要.
- FE建模框架为ACLR-LET手术中的外科规划提供了有价值的工具.
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