女性全身关节过度活动患者跳深着陆时膝关节应力分析
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湖北省教育厅科学研究计划项目(B2021193)


Analysis of Knee Joint Stress During Drop Jump Landing in Females with Generalised Joint Hypermobility
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    摘要:

    目的 分析全身关节过度活动(generalized joint hypermobility, GJH)女性患者与健康女性在跳深着陆中膝关节软骨、半月板 von Mises 应力分布差异。 方法 采集女性 GJH 患者与女性健康受试者在跳深着陆缓冲阶段垂直地面反作用力(vertical ground reaction force,VGRF)峰值时刻的膝关节运动学与地面反作用力特征,通过逆动力学计算膝关节反作用力,并将膝关节沿股骨长轴方向的合力作为载荷;基于 1 名女性膝关节三维有限元模型,分别对2 组受试者跳深着陆过程进行数值仿真,计算膝关节软骨与半月板 von Mises 应力及应力分布。 结果 在跳深着陆VGRF 峰值时刻,GJH 组和对照组膝关节屈曲、外翻角度具有统计学意义(P<0. 05)。 相比于对照组,GJH 组膝关节屈曲角度降低、外翻角度增加;在跳深着陆中,GJH 组膝关节内部承受应力更大且胫股关节内、外侧室负重区应力分布不均衡,其股骨软骨外侧髁外侧、外侧胫骨软骨前部/ 中部外侧以及外侧半月板前角、体部外侧缘为应力集中部位。 结论 女性 GJH 患者因膝关节活动范围增大、关节囊松弛,导致在跳跃类项目中膝关节稳定性降低、关节力线发生改变,从而使膝关节外侧软骨与半月板损伤风险增加;在跳跃运动中,GJH 女性患者尤其要防止膝关节额状面力线改变造成膝关节的损伤。

    Abstract:

    Objective To analyze the differences of von Mises stress distribution in knee cartilage and meniscus in female with generalised joint hypermobility (GJH) and healthy female during drop jump landing. Methods The kinematic and ground reaction force (GRF) characteristics of knee joint in female with GJH and healthy female at the moment of peak vertical GRF (VGRF) during loading phase of drop jump landing were collected. The knee joint reaction force was calculated via inverse dynamics, and the combined force of knee joint along long axis of the femur was applied as the load. Based on three-dimensional (3D) finite element model of a female knee joint, numerical simulations were performed separately during drop jump landing of subjects in two groups, and von Mises stresses and stress distribution of knee cartilage and meniscus were calculated. Results At the moment of peak VGRF during drop jump landing, knee flexion and valgus angles in GJH group and control group showed a statistical significance (P<0. 05). Compared with control group, knee flexion angle decreased and valgus angle increased in GJH group. During drop jump landing, GJH group bore larger stress inside the knee joint, and stress distribution in weight-bearing areas of the medial and lateral tibiofemoral compartments was uneven, while the lateral femoral cartilage lateral condyle, the anterior and middle lateral of lateral tibial cartilage, the anterior angle and body lateral margin of lateral meniscus were stress concentration sites. Conclusions For females with GJH, the stability of knee joint decreases and force lines change in jumping events, due to the increased range of motion of knee joint and relaxation of joint capsule, which increases the risk of cartilage and meniscal injury in lateral knee joint. During jumping sports, females with GJH should especially prevent knee joint injury caused by altered force lines in frontal plane of knee joint.

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向福荣,唐圣鑫,刘鑫鑫,陈奕凝,林熙凯,陈 建.女性全身关节过度活动患者跳深着陆时膝关节应力分析[J].医用生物力学,2023,38(2):317-323

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  • 收稿日期:2022-03-25
  • 最后修改日期:2022-04-08
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  • 在线发布日期: 2023-04-25
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