膝关节交叉韧带功能束空间曲线长度的三维动态研究
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上海市闵行区科学技术委员会自然科学研究课题基金资助项目(2013MHZ007)


3D dynamic research on spatial lengths of functional bundles in knee cruciate ligaments
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    摘要:

    目的 分析前、后交叉韧带功能束在膝关节运动过程中的变化规律,为研究交叉韧带损伤机制和移植物重建提供依据。方法 选取5具无病理改变的膝关节节段标本作为研究对象,精确解剖膝关节前、后交叉韧带的功能束在股骨与胫骨附着点,然后分别于膝关节在0°、30°、60°、90°、120°进行CT扫描,应用Mimics及ANSYS软件对数据进行三维重建,建立包含交叉韧带附着点的膝关节三维有限元模型,最后应用ANSYS及CATIA软件确立前、后交叉韧带功能束附着部及功能束各平行切面的中心点,连接各中心点的长度,拟合得到以上5个角度各功能束中心点之间的曲线距离,即韧带的真实长度。结果 前交叉韧带(anterior cruciate ligament, ACL)的前内侧束(anterior medial bundle, AMB)在0°~ 90°的范围内随着屈曲角度增加距离逐渐增大,到120°时距离稍有减小;其后外侧束(posterior lateral bundle, PLB)在0°~90°的范围内随着屈曲角度增加距离逐渐减小,到120°时距离稍有增加。后交叉韧带(posterior cruciate ligament, PCL)的前外侧束(anterior lateral bundle, ALB)和后内侧束(posterior medial bundle, PMB)在0°~120°的范围内随着屈曲角度增加距离逐渐增大。交叉韧带各功能束的长度变化在总体上有统计学差异(P<0.05)。结论 在膝关节的屈曲过程中,ACL双束之间起到交互作用,而PCL双束之间起到协同作用。通过建立膝关节交叉韧带功能束的有限元模型,更能真实反映交叉韧带的实际长度,为研究交叉韧带各功能束在运动中的真实长度变化提供了合理的方法。

    Abstract:

    Objective To analyze patterns of functional bundles in anterior and posterior cruciate ligaments during knee joint movement, so as to provide important references for studying injury mechanism of cruciate ligaments and implant reconstruction. Methods Five healthy knee cadavers were elaborately dissected to expose insertions of functional bundles in anterior and posterior ligaments on both the femur and tibia. CT scans and 3D finite element reconstruction with Mimics and ANSYS were conducted at 0°, 30°,60°, 90°, and 120° flexion angle of the knee joint. The center points of insertions and parallel sections of functional bundles defined by the software ANSYS and CATIA were connected to the centerlines, and at five different knee flexion angles, the lengths of centerlines, defined as the bundle lengths, were measured. Results The length of anterior medial bundle (AMB) of anterior cruciate ligament (ACL) increased gradually as the flexion angle grew from 0° to 90°, but slightly decreased at 120° flexion angle; whereas the length of posterior lateral bundle (PLB) of ACL decreased as flexion angle went from 0° to 90° and slightly increased at 120° flexion angle. In posterior cruciate ligament (PCL), both anterior lateral bundle (ALB) and posterior medial bundle (PMB) extended in length as the flexion angle went from 0° to 120°. The change of ACL and PCL bundle’s length was statistically significant (P<0.05). Conclusions ACL bundles functioned in a reciprocal manner and PCL bundles functioned in a complementary manner during knee flexion. Through establishing the finite element model of functional bundles in cruciate ligaments, the actual length of cruciate ligaments could be reflected, which provided a reasonable method for studying the changes of actual length of functional bundles in cruciate ligaments during knee flexion.

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容可,王海鹏,王友,殷潇凡,杨东,陈炯,夏庆泉,谷辉杰.膝关节交叉韧带功能束空间曲线长度的三维动态研究[J].医用生物力学,2014,29(4):339-345

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  • 收稿日期:2014-04-25
  • 最后修改日期:2014-06-18
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  • 在线发布日期: 2014-08-22
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