UKA 关节线安装误差对膝关节接触力学和运动学影响
DOI:
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

基金项目:

国家自然科学基金项目(11902048,12102065,52035012),陕西省自然科学基金项目(2022JQ-529),长安大学中央高校基本科研业务费专项资金(300102252106)


The influence of UKA Installation Error of Joint Line on Contact Mechanics and Kinematics of Knee Joint
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的 针对单髁膝关节置换(unicompartmental knee arthroplasty, UKA)内侧假体松动和外侧关节软骨退化问题,通过骨肌多体动力学方法研究不同生理活动中 UKA 关节线安装误差对膝关节接触力学和运动学的影响。方法 以内侧自然关节线为 0 mm 误差,分别考虑±2 mm、±4 mm、±6 mm 共 6 种关节线安装误差情况,建立 7 个内侧 UKA 置换的骨肌多体动力学模型,对比研究步行和下蹲运动中膝关节接触力学和运动学的变化。 结果 在步行步态周期 70% 时,相比于 0 mm 误差 UKA 假体关节线升高 2 mm 时内侧假体接触力增大 127. 3% ,外侧软骨接触力减少 12. 0% ;在 UKA 假体关节线降低 4 mm 时内侧假体接触力接近 0 N,外侧软骨接触力增大 10. 1% ;胫股关节总接触力在关节线升高和降低 2 mm 时分别增大 19. 7% 和减小 14. 2% 。 在下蹲屈膝 100°时,相比于 0 mm 误差关节内侧假体接触力和胫股骨关节总接触力在 UKA 假体关节线升高 2 mm 时分别增大 31. 6% 和 11. 1% ,在 UK假体关节线降低 2 mm 时分别减小 24. 5% 和 8. 5% ,而膝关节外侧软骨接触力变化不大。 同时,在步行步态周期70% 时,随 UKA 假体关节线升高,膝关节外翻运动增大、内旋运动增大、关节前移;随关节线的降低,而呈现相反趋势。 下蹲运动中膝关节内外翻运动和前后平移运动与步行步态趋势一致,但内外旋运动则刚好相反。 结论 为了降低内侧假体失效风险和外侧软骨退化风险,建议医生控制 UKA 假体关节线误差在-2 ~ 2 mm 范围内。 研究结果 为 UKA 假体关节线变化引起的临床失效问题提供理论依据。

    Abstract:

    Objective Aiming at the medial prosthetic loosening failure and lateral cartilage degeneration after unicompartmental knee arthroplasty ( UKA), the effects of prosthetic installation errors of joint line in UKA on knee contact mechanics and kinematics during different physiologic activities were studied using musculoskeletal multi-body dynamic method. Methods Taking the medial natural joint line as 0 mm error, six installation errors ofjoint line including ±2 mm, ±4 mm and ±6 mm were considered respectively, and seven musculoskeletal multibody dynamic models of medial UKA were established, to comparatively study the variations in knee contact mechanics and kinematics during walking and squatting. Results At 70% of walking gait cycle, compared with 0 mm error, the medial prosthetic contact force was increased by 127. 3% and the contact force of the lateral cartilage was decreased by 12. 0% under 2 mm elevation in joint line, the medial prosthetic contact force was close to 0 N, but the lateral cartilage contact forces were increased by 10. 1% under 4 mm reduction in joint line. The tibiofemoral total contact forces were increased by 19. 7% and decreased by 14. 2% under 2 mm elevation and 2 mm reduction in joint line, respectively. At the 100°knee flexion during squatting, compared with 0 mm error, the medial prosthetic contact force and the tibiofemoral total contact force increased by 31. 6% and 11. 1% under 2 mm elevation in joint line, and decreased by 24. 5% and 8. 5% under 2 mm reduction in joint line, respectively. The change in the lateral cartilage contact force was not marked. Moreover, at 70% of walking gait cycle, the varus angle decreased, the internal rotation and the anterior translation increased along with the elevation of joint line in UKA, while it was just the opposite along with the reduction of joint line in UKA. The trends of the varusvalgus movement and anterior-posterior translation during squatting were consistent with those during swing phase of walking, but the trend of the internal-external rotation was opposite. Conclusions In order to reduce the risk of medial prosthetic loosening failure and lateral cartilage degeneration, it is recommended that the installation error of joint line in UKA should be controlled in the range of -2 mm to +2 mm. This study provides theoretical basis for UKA clinical failure caused by changes in joint line

    参考文献
    相似文献
    引证文献
引用本文

任佳轩,陈瑱贤,张 静,张 烜,马张稳,靳忠民. UKA 关节线安装误差对膝关节接触力学和运动学影响[J].医用生物力学,2023,38(2):290-296

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2022-04-20
  • 最后修改日期:2022-05-16
  • 录用日期:
  • 在线发布日期: 2023-04-25
  • 出版日期:
关闭