摘要
目的明确人膝关节半月板切除和移植对胫股关节面受力面积和平均压强的影响,为相关基础和临床研究提供参考。方法选取符合条件的成年男性右膝关节尸体标本7具,仔细解剖后保留所需结构,根据所测胫骨平台大小剪裁压敏纸备用。实验分为4组:A组为正常膝关节组,B组为膝关节半月板损伤组,C组为膝关节半月板切除组,D组为膝关节半月板移植组。按分组顺序完成4组模型的压敏实验:切开膝关节关节囊,从内外侧关节间隙置入压敏纸,稳定固定胫骨上端和股骨下端,分别于膝关节伸直位0°及屈曲30、60、90、120°状态下给予纵向700 N的压力,持续120 s,使压敏纸充分发生显色反应;取出压敏纸,分离显色底片并标记内外侧,扫描后用彩色图像分析系统计算分析受力面积、平均压强。结果随膝关节屈曲角度增大,各组膝关节受力面积均逐渐减小,平均压强均逐渐增加,各组内不同屈曲角度间比较差异均有统计学意义(P<0.05)。A、B、D组不同屈曲角度的膝关节受力面积均显著高于C组,平均压强均显著低于C组,差异均有统计学意义(P<0.05);A、B、D组间各指标比较差异均无统计学意义(P>0.05)。结论人膝关节半月板损伤或切除后,胫股关节面应力显著增加,平均压强显著增高。胫股关节面应力在同种异体半月板移植修复后恢复至接近正常状态,因此膝关节半月板损伤后应尽量保留或修复。
Objective To investigate the effects of meniscectomy and transplantation repair of the knee on the stress area and average pressure of the tibiofemoral articular surface so as to provide a reference for the relevant basic and clinical researches. Methods Seven qualified right knee joints from adult men cadavers were selected. Required structure was retained after careful dissection. The pressure-sensitive paper was clipped to the proper size in accordance with the measured size of the tibial platform to reserve. The experiment was divided into 4 groups： normal knee group （group A）, knee meniscus injury group （group B）, knee meniscectomy group （group C）, and knee meniscus transplantation group （group D）. A horizontal incision above the meniscus was made in the position of knee joint capsule, and the pressure-sensitive paper was placed into the medial and lateral space of the knee joint, then the proximal tibia and distal femur were fixed stably and finally a universal mechanical machine was used for testing in appropriate environmental conditions （the knee joints were given longitudinal 700 N pressure at 0° extension and 30, 60, 90, and 120° flexion for continuous 120 seconds） until the full color reaction. The knee models were prepared, and then the universal mechanical machine was used to perform a test according to the method stated above respectively. The pressure-sensitive paper was removed, and the color negative films were separated and marked. Colorful image analysis system was used to calculate and analyze the stress area and average pressure after the scanner being used to collect image information. Results The stress area was gradually reduced and the average pressure was gradually increased with increasing flexion angle of the knee. There was significant difference in the stress area and the average pressure between various flexion angles in 4 groups （P 〈 0.05）. Group C had significantly lower stress area and significantly higher average pressure than the other 3 groups （P 〈 0.05）, but no significant difference was found among groups A, B, and D （P 〉 0.05）. Conclusion The stress of the tibiofemoral articular surface significantly increases after knee meniscus injury or resection, and the average pressure significantly increases. The stress of the tibiofemoral articular surface can be restored to almost normal after meniscus transplantation. Therefore, the injured meniscus should also be retained or repaired in the static state.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2014年第1期21-25,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
首都临床特色应用研究资助项目(Z131107002213014)
首都医学发展基金资助项目(20073044)~~
关键词
半月板移植
胫股关节面
受力面积
平均压强
Meniscus transplantation Tibiofemoral articular surface Stress area Average pressure
作者简介
通讯作者：章亚东，教授，硕士生导师，研究方向：关节外科与运动医学，E—mail：drzyd@126．com
