半月板部分切除后胫股关节接触面积及生物力学变化

半月板部分切除后胫股关节接触面积及生物力学变化 半月板部分切除后胫股关节接触面积及生物力学变化 张元民，王国栋，张玉革，赵晓伟，王 雷，李炳亮，孔 颖 济宁医学院附属医院关‎‎节与运动医学科，山东省济宁市 272029 Tibiofemoral joint contact area and biomechanical changes after partial meniscecto‎‎my Zhang Yuan-min, Wang Guo-dong, Zhang Yu-ge, Zhao Xiao-wei, Wang Lei, Li Bing-liang, Kong Ying Department of Joint and Sports Medicine, Affiliated Hospital of Jining Medical College, Jining 272029, Shandong Province, China 摘要 背景:生物力学实验有助于阐明为何半月板切除后会导致进行性的软骨病变。关节软骨退行性变的原因复杂，包括生物学、力学以及结构通路等。 目的:研究内侧半月板后角撕裂行半月板部分切除后胫股关节接触面积、压力及半月板应变的变化。 :取8具新鲜冷冻的混合品种的狗后肢膝关节标本，序贯进行以下半月板切除操作，采取百分比来计算每一样本半月板切除的范围:?内30%的内侧半月板后角撕裂。?内75%的内侧半月板后角撕裂。?内侧半月板后角完全切除。用双轴液压伺服生物测试实验机(MTS 858)进行生物力学测试。统计学比较采用SPSS 18.0软件进行组间比较。 结果与结论:半月板组织切除越多，内侧和外侧胫股关节接触面积下降越明显，内侧半月板后角切除75%和全切后，内侧接触面积差异无显著性意义(P > 0.05);内侧半月板后角完全切除之后，外侧接触面积显著减少。内侧半月板后角切除75%和全切之后，内侧间室的接触压力显著升高，与对照组相比差异有显著性意义(P < 0.05)，内侧半月板后角完全切除后外侧间室接触压力显著降低(P < 0.05)。因为半月板组织的切除，其相应的应变下降，但是各组间差异无显著性意义。说明半月板切除多少决定术后半月板的生物力学功能;对于半月板撕裂，尤其是“红区”损伤，应尽量选择半月板缝合术，减少半月板切除范围，以避免或者延缓膝关节的退行性变。 中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程 全文链接: 关键词 : 组织构建; 组织工程; 植入物; 关节植入物; 半月板; 生物力学; 损伤; 半月板切除术; 胫股关节; 接触面积; 接触压力; 应变; 生物力学; Abstract: BACKGROUND: Biomechanical experiments contribute to elucidate the progressive cartilage lesions following meniscectomy. The causes of articular cartilage degeneration are very complex, including biology, mechanics and structural pathway. OBJECTIVE: To observe the changes of tibiofemoral joint contact area, pressure and strain after‎‎ serial meniscectomies of the caudal pole of the medial meniscus. METHODS: Unpaired pelvic limbs were harvested from eight hybrid adult dogs. All specimens under‎‎went sequential meniscectomy, and the range of resected meniscus in each specimen was calculated as the percentage: a 30% radial width partial meniscectomy, a 75% radial width partial meniscectomy, and a segmental caudal pole hemi-meniscectomy. Biomechanical tests were performed using MTS 858. The difference between groups was compared with statistical analysis using SPSS 18.0 software. RESULTS AND CONCLUSION: More tissues removed after meniscectomy, more obviously the medial and lateral tibiofemor‎‎al joint contact area declined. After a 70% radial width meniscectomy and total meniscecto‎‎my, the medial contact area showed no significant difference (P > 0.05); after the total meniscectomy, the lateral contact area was significantly reduced. After a 70% radial width meniscectomy and total meniscectomy, the medial contact pressure was significantly increased, showing significant differences compared with control group (P < 0.05); after the total meniscectomy, the lateral conta‎‎ct pressure was significantly decreased (P < 0.058). A meniscectomy resulted in a decrease in medial meniscal strain, but there was no significant difference between groups. The range of meniscectomy determines the biomechanical function post-operation; as for the meniscus tear, we suggest meniscal suture, to reduce the range of meniscectomy, avoid or delay the degeneration of knee joint. 中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程 全文链接: Key words: menisci, tibial; biomechanics; pressure; allostasis; 中图分类号: R318 基金资助: 济宁市科技局资助项目(济科字[2011]57号) 作者简介: 张元民，男，1972年生，山东省济宁市人，汉族，2002年天津医科大学毕业，硕士，主任医师，主要从事关节置换与运动医学方面的研究。 引用本文: 张元民,王国栋,张玉革等. 半月板部分切除后胫股关节接触面积及生物力学变化[J]. 中国组织工程研究, 2014, 18(24): 3779-3784. Zhang Yuan-min,Wang Guo-dong,Zhang Yu-ge et al. Tibiofemoral joint contact area and biomechanical changes after partial meniscectomy[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(24): 3779-3784.