张鹏飞,齐岩松,包呼日查,王永祥,魏宝刚,马秉贤,李筱贺,徐永胜.外侧半月板后根部损伤不同缝合位置对膝关节生物力学的影响[J].医用生物力学,2019,34(5):507-513
外侧半月板后根部损伤不同缝合位置对膝关节生物力学的影响
Influences of Lateral Meniscus Posterior Root Tear with Different Suture Methods on Knee Biomechanics
投稿时间:2018-07-02  修订日期:2018-09-14
DOI:
中文关键词:  膝关节  外侧半月板  根部损伤  缝合位置  生物力学
英文关键词:knee  lateral meniscus  root injury  suture position  biomechanics
基金项目:国家自然科学基金项目(81560374,81460330),内蒙古自治区科技计划项目(20140149),内蒙古自治区自然科学基金项目(2014MS08131,2014BS0811)
作者单位
张鹏飞 内蒙古自治区人民医院 骨关节科(运动医学中心) 
齐岩松 内蒙古自治区人民医院 骨关节科(运动医学中心) 
包呼日查 内蒙古自治区人民医院 骨关节科(运动医学中心) 
王永祥 内蒙古自治区人民医院 骨关节科(运动医学中心) 
魏宝刚 内蒙古自治区人民医院 骨关节科(运动医学中心) 
马秉贤 内蒙古自治区人民医院 骨关节科(运动医学中心) 
李筱贺 内蒙古医科大学 基础医学院人体解剖教研室 
徐永胜 内蒙古自治区人民医院 骨关节科(运动医学中心) 
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中文摘要:
      目的 对损伤的外侧半月板后根部进行不同位置的修复固定,比较不同缝合方式时膝胫股关节的生物力学结果 ,探讨外侧半月板后根部损伤最佳缝合术式。方法 使用8例人体尸体膝关节,胫腓骨固定装置维持膝关节在0°位,在1 kN压缩载荷下,采用Tek-scan压力感测片收集膝关节外侧半月板后根部完整、外侧半月板后根部断裂、将外侧半月板后根部分别缝合至中心点、中心点偏后5 mm、中心点偏前5 mm、中心点偏外5 mm位置下的平均接触压力、峰值压力以及接触面积。结果 在外侧间室,与完整状态相比半月板后根部损伤断裂后会导致平均接触压力和峰值压力明显增加(P<0.01),接触面积减少(P<0.05)。4种缝合固定方法 均可减少平均压力和峰值接触压力,接触面积较根部断裂时均有增加。在半月板后根部中心点偏外5 mm缝合时,生物力学结果 更接近完整膝关节(P<0.05)。比较缝合位点在根部中心点和中心点偏后5 mm时,平均接触压力影响差别微小,峰值接触压力、接触面积均无统计学差异(P>0.05)。在内侧间室,生物力学指标各组间均无统计学差异(P>0.05)。结论 外侧半月板后根部发生撕裂后会导致膝关节外侧间室的平均接触压力、峰值压力以及接触面积相比正常膝关节发生显著改变;半月板缝合位置在原根部中心点偏外5 mm时,其生物力学功能更接近完整膝关节。
英文摘要:
      Objective To evaluate the biomechanical effects of lateral meniscus posterior root (LMPR) tears fixed at different suture positions, so as to investigate the optimal suture method for repairing LMPR tears. Methods Eight fresh cadaveric knees were used. Each knee was tested under 6 conditions: intact knee, ruptur of LMPR, suture of LMPR to the center point of root insertion, suture of LMPR posterior, interior and later 5 mm to the center point of root insertion, respectively. The peak contact pressure, the average contact pressure and contact area were evaluated using a Tek-scan sensor positioned between the meniscus and tibial plateau, under 1 kN compressive loading, at 0 degree knee extension. Results In the lateral compartment, the average contact pressure and peak pressure significantly increased under rupture of LMPR compared with the intact state (P<0.01), and the contact area decreased significantly (P<0.05). For LMPR tears fixed by four different suture methods, both the average pressure and peak contact pressure reduced, and the contact area increased. The average contact pressure, peak pressure and contact area were closer to the knee joint in the intact state when the suture positions of LMPR tears was posterior 5 mm to the center point of root insertion (P<0.05). In the medial compartment, there were no significant differences in contact pressure, peak contact pressure and contact area with the knee joint at 0 degree (P>0.05). Conclusions The average contact pressure, the peak contact pressure and the contact area between the lateral meniscus and the tibial plateau changed obviously due to the LMPR tears. When the suture position was 5 mm lateral to the center point of root insertion, similar biomechanical function with the intact knee could be obtained.
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