全膝关节置换后关节线变化对髌股关节生物力学的影响.docVIP

全膝关节置换后关节线变化对髌股关节生物力学的影响 王 韬(河南中医学院第一附属医院骨伤科，河南省郑州市 450000) 引用本文：王韬. 全膝关节置换后关节线变化对髌股关节生物力学的影响[J].中国组织工程研究，2016，20(13):1845-1851. DOI: 10.3969/j.issn.2095-4344.2016.13.003 ORCID: 0000-0002-3518-604X(王韬) 文章快速阅读： 文题释义： 全膝关节置换假体对线不良：有关节线位置变化、轴向对线不良以及旋转对线不良3种，旋转对线不良可以增加扭转应力和屈膝不稳定，引起聚乙烯衬垫磨损和假体松动，轴向对线不良导致胫骨平台负荷偏心，聚乙烯衬垫加剧磨损，引起假体松动，旋转对线不良和轴向对线不良目前的研究已经比较广泛和深入。 关节线异常：髌股关节的生物力学特性受关节线的影响，关节线的异常会引起生物力学的变化，引起膝关节疼痛。正常的关节线在股骨外上髁下1 cm、腓骨小头上1 cm或者股骨内上髁下2.5 cm。 摘要 背景：全膝关节置换翻修的主要原因除感染外，聚乙烯衬垫磨损以及假体松动也是最常见的原因，关节线高度对髌股关节生物力学的影响尚无定论。 目的：观察全膝关节置换后关节线变化对髌股关节生物力学的影响。 方法：建立全膝关节置换后膝关节三维有限元模型，计算膝关节屈曲度在0°，30°，60°和90°时不同关节线高度对股四头肌拉力、骸韧带拉力和髌股关节间作用力变化的影响。 结果与结论：①膝关节屈曲0°时，关节线高度在3-4.5 mm变化对股四头肌拉力、膑腱拉力和髌股关节间作用力没有太大影响。②在膝关节屈曲30°90°时，关节线高度在3 mm以下对股四头肌拉力、膑腱拉力和髌股关节间作用力影响不大；关节线高度超过3 mm对股四头肌拉力、膑腱拉力Effects of joint line changes on biomechanics of patellofemoral joint after total knee arthroplasty Wang Tao (Department of Orthopedics and Traumatology, First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China) Abstract BACKGROUND: In addition to infection, the reasons for total knee arthroplasty revision are polyethylene liner wear and prosthesis loosening. The impact of joint line height on patellofemoral biomechanics was inconclusive. OBJECTIVE: To study the impact of joint line changes after total knee arthroplasty on patellofemoral joint biomechanics. METHODS: Three-dimensional finite element models were established after total knee arthroplasty. The impact of different joint line height on quadriceps tensile force, patella tendon tension, and patellofemoral joint forces was calculated at range of flexion of 0°, 30°, 60° and 90°. RESULTS AND CONCLUSION: (1) At knee flexion of 0°, the height of the joint line in -3 mm-4.5 mm did not have great impacts on quadriceps tensile force, patella tendon tension and patellofemoral joint forces. (2) At knee flexion of 30°-90°, the height of the joint line below 3 mm did not have great impacts on quadriceps t