| 基于筋束骨理论铍针松解髌骨外侧支持带改善髌股关节应力集中的有限元分析 |
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Received:November 04, 2019
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陈彦飞 |
CHEN Yan-fei |
西安交通大学附属红会医院骨科, 陕西 西安 710054 |
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| 鲁超 |
LU Chao |
西安交通大学附属红会医院骨科, 陕西 西安 710054 |
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| 赵勇 |
ZHAO Yong |
中国中医科学院望京医院骨伤综合科, 北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medicine, Beijing 100102, China |
zhaoyong423@163.com |
| 成永忠 |
CHENG Yong-zhong |
中国中医科学院望京医院骨伤综合科, 北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medicine, Beijing 100102, China |
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| 乔锋 |
QIAO Feng |
西安交通大学附属红会医院骨科, 陕西 西安 710054 |
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| 侯成志 |
HOU Cheng-zhi |
中国中医科学院望京医院骨伤综合科, 北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medicine, Beijing 100102, China |
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| 辛颖 |
XIN Ying |
西安交通大学附属红会医院骨科, 陕西 西安 710054 |
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| 刘广伟 |
LIU Guang-wei |
中国中医科学院望京医院骨伤综合科, 北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medicine, Beijing 100102, China |
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| 期刊信息：《中国骨伤》2021年34卷，第2期，第126-130页 |
| DOI：10.12200/j.issn.1003-0034.2021.02.006 |
| 基金项目:陕西省科技厅自然科学基础研究项目（编号：2017JM8118）；中央级公益性科研院所基本科研业务费自主选题（编号：ZZ11－034）；北京市科委首都临床特色应用研究与成果推广项目（编号：Z151100004015158） |
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目的：在筋束骨理论指导下，基于膝关节有限元模型研究铍针松解髌骨外侧支持带改善髌股关节应力集中的机制，阐释铍针松解术改变髌骨运行轨迹及降低髌股关节压力的生物力学机制。
方法：获取1名正常男性（年龄29岁，身高171 cm，体重58 kg）膝关节CT资料，从膝关节的三维有限元模型构建入手，经几何重建、逆向工程、网格划分、材料赋值以及加载分析等步骤，建立筋、骨结构完整的膝关节有限元模型，加载条件设置为膝关节垂直加载500 N负荷，股四头肌腱承受平均值约为200 N的牵张应力，分别在有限元模型屈膝30°位和屈膝90°位状态，模拟铍针松解髌骨外侧支持带，对比研究不同屈膝状态下铍针干预对髌股关节应力集中的改善情况。
结果：铍针松解髌骨外侧支持带后髌股关节和胫股关节的应力峰值较干预前均有所下降，分别为：（1）屈膝30°位，髌骨软骨下降0.498 MPa（下降9.06%），股骨滑车下降0.886 MPa（下降16.27%）。（2）屈膝90°位，髌骨软骨下降0.558 MPa（下降8.6%），股骨滑车下降0.607 MPa（下降9.94%）。
结论：铍针松解髌骨外侧支持带可有效缓解髌股关节的应力集中并降低局部应力峰值，有利于改善髌骨的运动轨迹并使应力分布更加均匀。 |
| [关键词]:髌股关节 有限元分析 铍针 髌骨外侧支持带 |
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| Finite element analysis on stress concentration improvement in patellofemoral joint by releasing lateral patellar retinaculum with stiletto needle based on the theory of Jinshugu(筋束骨) |
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Abstract:
Objective: To study mechanism of improvement of stress concentration on patellofemoral joint by stiletto needle releasing lateral patellar retinaculum guided by the theory of Jinshugu(筋束骨) and based on the finite element model of knee joint. and to elucidate the biomechanical mechanism of stiletto needle releasing changing patellar trajectory and reducing patellofemoral joint pressure.
Methods: CT data of knee joint from a normal male(aged 29,heighted 171 cm,weighted 58 kg) was selected. Starting with construction of three-dimensional model of knee joint by using finite element software,the finite element model of knee joint with complete tendon and bone structures were established through several steps,such as geometric reconstruction,reverse engineering,meshing,material assignment and loading analysis. The loading condition was set as 500 N load on knee joint,and the average tensile stress of quadriceps femoris tendon was about 200 N. To simulate the release of lateral patellar retinaculum by stiletto needle at 30 and 90 position of knee flexion in finite element model separately,and to compare the improvement of stress concentration of patellofemoral joint by stiletto needle intervention under different knee flexion conditions.
Results: The peak stress of patellofemoral joint and tibiofemoral joint decreased after stiletto needle releasing of patellofemoral lateral retinaculum compared with before intervention,which was(1) knee flexion at 30 degrees:patellar cartilage decreased by 0.498 MPa (decreased 9.06%),femoral trochlea decreased by 0.886 MPa(decreased 16.27%);(2) knee flexion at 90 degrees:patellar cartilage decreased by 0.558 MPa(decreased 8.6%),femoral trochlea decreased by 0.607 MPa(decreased 9.94%).
Conclusion: Releasing lateral patellofemoral retinaculum with stiletto needle could effectively alleviate the stress concentration of patellofemoral joint and reduce local stress peak value,which it is helpful to improve patellar trajectory and make stress distribution more uniform. |
| KEYWORDS:Patellofemoral joint Finite element analysis Stiletto needle Lateral patellar retinaculum |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈彦飞,鲁超,赵勇,成永忠,乔锋,侯成志,辛颖,刘广伟.基于筋束骨理论铍针松解髌骨外侧支持带改善髌股关节应力集中的有限元分析[J].中国骨伤,2021,34(2):126~130 |
| 英文格式: | CHEN Yan-fei,LU Chao,ZHAO Yong,CHENG Yong-zhong,QIAO Feng,HOU Cheng-zhi,XIN Ying,LIU Guang-wei.Finite element analysis on stress concentration improvement in patellofemoral joint by releasing lateral patellar retinaculum with stiletto needle based on the theory of Jinshugu(筋束骨)[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(2):126~130 |
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