前交叉韧带重建联合内侧半月板部分切除术后不同屈膝状态下胫股关节生物力学变化的有限元分析

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Abstract Objective To construct finite element models of different knee flexion angles after anterior cruciate ligament reconstruction combined with partial medial meniscectomy, and to analyze the biomechanical characteristics of tibiofemoral joint. Methods A male patient who underwent anterior cruciate ligament reconstruction combined with partial medial meniscectomy in the Department of Sports Medicine, Guangzhou Sport University was selected to construct the finite element model of the knee joint. After load verification, the maximum stress of tibiofemoral articular cartilage and meniscus displacement were used as indicators to analyze the stress characteristics of tibiofemoral joint at different knee bending angles. Results The total number of elements in the knee joint finite element model was 582 044 and the total number of nodes was 391 670. The stress characteristics of tibiofemoral joint under different bending angles were simulated. The results showed that the stress of femoral condyle cartilage was concentrated in the middle, the stress of tibial plateau cartilage was mainly concentrated in the middle and posterior, and the stress of medial meniscus was concentrated in the residual end after resection when bending knee was 0°. At 30° and 60°, the stress of femoral condyle cartilage was concentrated in the posterior part. At 30°, the stress of tibial plateau cartilage mainly concentrated in the anterolateral part, and at 60°, the stress concentrated in the middle part. The stress of the medial meniscus is concentrated in the front at 30° and in the middle at 60°. The maximum stress of medial femoral condylar cartilage and tibial cartilage was 60°, 0°, and 30° respectively. The maximum stress of lateral femoral condylar cartilage, tibial plateau cartilage and medial meniscus was 60°, 30°, and 0° respectively. The maximum stress of the lateral meniscus was 30°, 60°, and 0° respectively. The maximum stress of medial tibial plateau and femoral condylar cartilage at different knee bending angles was greater than the lateral one, the maximum stress of medial meniscus was less than the lateral one at 0° and 30°, and greater than the lateral one at 60°. The results showed that the deformation displacement of the medial meniscus was smaller than that of the lateral meniscus at all angles. Conclusion The stress in the tibiofemural joint is the greatest when the knee is bent at 60°. The maximum stress in the cartilage of the medial tibial plateau and femoral condyle is greater than that of the lateral side at all angles of the knee bending, and the displacement of the medial meniscus is less than that of the lateral side.

Key words： Anterior cruciate ligament reconstruction Partial medial meniscectomy Tibiofemoral joint Finite element analysis

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	ZHANG Xiaohui1 WANG Jun2 LIAO Bagen1

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ZHANG Xiaohui1 WANG Jun2 LIAO Bagen1. Finite element analysis of biomechanical changes of tibiofemoral joint under different knee flexion after anterior cruciate ligament reconstruction combined with partial medial meniscectomy[J]. 中国医药导报, 2021, 18(27): 30-34.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I27/30

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