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【medical-news】内侧半月板后角撕裂的生物力学结
J Bone Joint Surg Am. 2008;90:1922-1931.
Robert Allaire, Muturi Muriuki, Lars Gilbertson, and Christopher D. Harner
http://www.ejbjs.org/cgi/content/abstract/90/9/1922
Background: Tears of the posterior root of the medial meniscus are becoming increasingly recognized. They can cause rapidly progressive arthritis, yet their biomechanical effects are not understood. The goal of this study was to determine the effects of posterior root tears of the medial meniscus and their repairs on tibiofemoral joint contact pressure and kinematics.
Methods: Nine fresh-frozen cadaver knees were used. An axial load of 1000 N was applied with a custom testing jig at each of four knee-flexion angles: 0°, 30°, 60°, and 90°. The knees were otherwise unconstrained. Four conditions were tested: (1) intact, (2) a posterior root tear of the medial meniscus, (3) a repaired posterior root tear, and (4) a total medial meniscectomy. Fuji pressure-sensitive film was used to record the contact pressure and area for each testing condition. Kinematic data were obtained by using a robotic arm to record the position of the knees for each loading condition. Three-dimensional knee kinematics were analyzed with custom programs with use of previously described transformations. The measured variables were axial rotation, varus angulation, lateral translation, and anterior translation.
Results: In the medial compartment, a posterior root tear of the medial meniscus caused a 25% increase in peak contact pressure compared with that found in the intact condition (p < 0.001). Repair restored the peak contact pressure to normal. No difference was detected between the peak contact pressure after the total medial meniscectomy and that associated with the root tear. The peak contact pressure in the lateral compartment after the total medial meniscectomy was up to 13% greater than that for all other conditions (p = 0.026). Significant increases in external rotation and lateral tibial translation, compared with the values in the intact knee, were observed in association with the posterior root tear (2.98° and 0.84 mm, respectively) and the meniscectomy (4.45° and 0.80 mm, respectively), and these increases were corrected by the repair.
Conclusions: This study demonstrated significant changes in contact pressure and knee joint kinematics due to a posterior root tear of the medial meniscus. Root repair was successful in restoring joint biomechanics to within normal conditions.
Clinical Relevance: This study provides a biomechanical rationale for surgical repair of posterior root tears of the medial meniscus. Clinical studies are required to define the appropriate patient population for, and to determine the clinical efficacy of, surgical treatment of this injury.
本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Biomechanical Consequences of a Tear of the Posterior Root of the Medial Meniscus——Similar to Total Meniscectomy
内侧半月板后角撕裂的生物力学结果——与半月板全切相似
Background: Tears of the posterior root of the medial meniscus are becoming increasingly recognized. They can cause rapidly progressive arthritis, yet their biomechanical effects are not understood. The goal of this study was to determine the effects of posterior root tears of the medial meniscus and their repairs on tibiofemoral joint contact pressure and kinematics.
背景：内侧半月板后角撕裂能很快导致退行性关节炎，正日益受到关注，但其生物力学特性尚不清楚。本研究旨在确定内侧半月板后角撕裂的生物力学特性，以及修复后对胫股关节接触压力和动力学的影响。
Methods: Nine fresh-frozen cadaver knees were used. An axial load of 1000 N was applied with a custom testing jig at each of four knee-flexion angles: 0°, 30°, 60°, and 90°. The knees were otherwise unconstrained. Four conditions were tested: (1) intact, (2) a posterior root tear of the medial meniscus, (3) a repaired posterior root tear, and (4) a total medial meniscectomy. Fuji pressure-sensitive film was used to record the contact pressure and area for each testing condition. Kinematic data were obtained by using a robotic arm to record the position of the knees for each loading condition. Three-dimensional knee kinematics were analyzed with custom programs with use of previously described transformations. The measured variables were axial rotation, varus angulation, lateral translation, and anterior translation.
方法：使用9具新鲜冷冻尸体膝关节进行实验。在定制试验台上对每个膝关节在屈膝0°, 30°, 60°和90°分别施加1000牛轴向应力。不限制膝关节运动。检测4种不同情况的组别：(1)完整组；(2)内侧半月板后角撕裂组；(3)修补后角撕裂组；(4)半月板全切组。使用富士压力感应胶片记录接触应力和每个检测条件区域。通过一个机器臂获取动力学数据，记录每种应力条件下膝关节的位置。使用定制程序分析膝关节三维动力学。测量变量为轴向旋转、内翻角、外向平移和前向平移。
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作者:admin@医学,生命科学 2011-06-27 05:17
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