THE EFFECT OF THE ACL SINGLE-BUNDLE/DOUBLE-BUNDLE RECONSTRUCTION ON THE BIOMECHANICS OF TIBIO-FEMORAL JOINT AT DIFFERENT FLEXION ANGLES 1）

进行膝关节的轴移仿真,在证实了单例个体膝关节的重建模型能反映不同重建术后膝关节力学特性有效性的基础上,应用SONATA MAESTRO 1.5T扫描得到的屈曲角位姿为0°/25°/60°/80°的膝关节MRI图像数据,建立了对应屈曲角的正常/ACL（anterior cruciate ligament）单束/双束重建胫股关节3D模型,通过对该系列关节模型施加轴向压力与压扭载荷,来分析多屈曲角度位姿的ACL单束/双束重建法对胫股关节软骨、半月板和韧带应力分布影响及韧带张力特性影响.结果表明：（1）ACL单束/双束重建关节的软骨与半月板上的应力分布改变跟屈曲角度相关,某些角度位姿下软骨应力分布改变显著;（2）单束重建关节的软骨和半月板上的最大等效应力有较明显的增大,最大增幅达40%左右;双束重建关节在各屈曲角位姿下软骨和半月板上的最大等效应力值更接近于正常关节;（3）ACL单束重建虽降低了PCL（posterior cruciate ligament）的最大等效应力值,却使高屈曲角位姿的内侧/外侧副韧带等效应力明显增大;双束重建后MCL（medial collateralligament）上的最大等效应力随屈曲角的变化明显,但LCL（lateral collateral ligament）和PCL的最大等效应力随屈曲角度的变化趋势与正常关节相一致性;（4）单束/双束重建后MCL上平均张力要高于另外两条韧带,而双束重建的韧带张力特性比单束重建更接近于正常关节.总之,综合ACL重建后软骨、半月板和3条韧带随屈曲角度的等效应力分布、张力变化等多种特性表明：ACL双束重建的胫股关节力学特性比单束重建更接近于正常关节,且无论ACL单束还是双束重建,都引起术后关节软骨与韧带上应力分布变化与等效应力峰值增大,这将是诱发术后关节慢性退变与膝关节并发症的根源.     

EFFECTS OF 2-TUNNEL AND 3-TUNNEL FIXATION ON BIOMECHANICS OF TIBIOFEMORAL JOINT

基于正常膝关节4个屈曲角度(0°, 25°, 60°, 80°)下的磁共振(MR)图像数据, 建立正常/两隧道固定/三隧道固定内侧半月板移植术后的胫股关节模型. 对各屈曲角度下的4种模型分别施加单一轴向压载和压扭组合载荷进行有限元仿真, 得到各模型在2种载荷作用下的应力及位移分布. 提取关节软骨、半月板表面的等效应力以及半月板的最大位移进行对比分析, 得到内侧半月板移植术后两/三隧道固定对胫股关节中软骨及半月板的影响. 总体上讲内侧半月板移植中的三隧道固定要优于双隧道固定, 更利于胫股关节恢复正常的应力特性.     

前交叉韧带损伤的继发性生物力学影响

前交叉韧带(anterior cruciate ligament, ACL)损伤往往会导致半月板及周边韧带的继发性损伤. 由于离体实验和临床研究的局限性,损伤的机理仍未得到清晰的认识. 基于核磁共振断层扫面图像重建了一个比较完整和精确的膝关节三维有限元模型. 采用文献报道的解剖测量数据对关节的解剖尺寸进行了检验,证明模型在几何上比较准确. 并且对文献报道的膝关节实验作了模拟,得出的计算结果与实验比较吻合,证明模型能够在一定程度上再现膝关节真实的运动情况. 然后利用该模型对ACL损伤前后的膝关节进行模拟,分别在屈膝0$^\circ$和30$^\circ$的姿态下对胫骨施加前后方向和竖直方向的载荷. 结果表明, ACL的损伤改变了关节组织上的应力分布:内侧半月板后段的应力显著增加;外侧半月板、后交叉韧带以及侧副韧带上的应力改变程度则取决于载荷的类型和屈膝的角度. 该研究有助于认识ACL损伤之后周边组织的继发性损伤现象,并对容易诱发损伤的高危动作进行分析和预防,对研究ACL的损伤和治疗具有重要的意义.      

人工膝关节置换中的生物力学研究进展

膝关节是人全身最大最复杂的关节, 它的任何一个主要组成部分的损坏都会引起膝关节的反常运动, 久之软骨和半月板发生磨损、变性而形成骨性关节病, 从而影响人的日常生活. 通常采用的方法是进行膝关节矫形或置换, 对严重病变的膝关节, 则采用全膝置换手术.随着人工膝关节置换成为非常普遍的外科手术, 与膝关节假体相关的研究也越来越多的被人所关注. 从生物力学角度对人工膝关节假体的类型和材料、假体生物力学性能的理论和实验研究、骨重建的理论模型、骨整合的理论和实验、与理论和实验相关的有限元分析模型等几个主要方面进行了详尽的综述. 同时, 指出了人工膝关节置换和目前研究中存在的问题,并对其未来的发展方向进行了一定的预测.      

正常和早期膝骨关节炎的软骨生物力学研究

膝骨关节炎是导致膝关节疼痛和慢性残疾的一种常见的关节疾病. 膝关节的软骨生物力学是评价膝骨关节炎程度的重要指标. 然而, 早期膝骨关节炎的软骨生物力学依然有待研究, 正常、内侧和内外侧早期膝骨关节炎的软骨生物力学差异尚不清楚. 本文基于固?液双相纤维增强的软骨有限元建模方法, 分别建立了正常膝关节模型、内侧早期膝骨关节炎模型和内外侧早期膝骨关节炎模型, 在步态周期中最大载荷时刻和最大屈曲角度时刻下分别对比分析了正常、内侧和内外侧早期膝骨关节炎3种情况下的软骨生物力学差异. 结果表明, 与正常膝关节相比, 内侧早期膝骨关节炎模型的内侧软骨的流体压力减少, 固相等效应力减少以及应变增大; 外侧软骨的结果基本没有差异. 然而, 内外侧早期膝骨关节炎模型的内外侧软骨的流体压力都减少, 固相等效应力都减少以及应变都增大. 早期膝骨关节炎中退变软骨的属性变化会导致软骨的承载能力下降以及变形增大, 从而增加软骨进一步退变的风险. 本文提出的基于双相纤维增强软骨模型的膝关节有限元模型有效预测了正常和关节炎情况下的软骨生物力学差异, 该模型也可以推广应用于髋、踝和脊柱等其他关节生物力学的研究.      

人体膝关节有限元模型建立及其有效性验证

建立了人体膝关节三维数字化模型,为膝关节损伤的数字化研究奠定基础;并基于有限元理论探讨、研究了膝关节损伤发生的力学机制。利用膝关节的核磁共振图像,采用专业的医学建模软件,基于3D插补法,重建膝关节三维数字化模型。建立的完整的人体膝关节三维有限元模型包括骨骼、韧带、软骨等14个主要力学承载部件,结构完整、形态逼真。本文所建的模型高度模拟了膝关节的结构与材料特性,具有空间结构测量准确性高、单元划分精细等特点。通过应力和应变测试验证了模型的有效性,模型可以重复使用,可以用此模型来研究膝关节损伤的力学机制。     

二维平纹编织复合材料压缩力学行为研究

通过对二维平纹编织复合材料压缩力学性能进行三维有限元计算,对复合材料在沿垂直于编织平面方向和纤维束方向压缩后的微观应力场进行了分析。对于沿垂直于编织平面方向的压缩(即横向压缩),发现在经纬向纤维束相互交替处基体材料的横向压应力最大,是其薄弱部位。分析表明,与0°/90°层合板相比,编织复合材料受到横向压缩载荷时,自由边界处层间剪应力较大,容易发生层间裂纹,与实验观察相吻合。通过改变纤维束截面尺寸和纤维束之间间隙大小研究了破坏面角度的变化。     

A new nonlinear multibody/finite element formulation for knee joint ligaments

The focus of this investigation is to study the mechanics of the human knee using a new method that integrates multibody system and large deformation finite element algorithms. The major bones in the knee joint consisting of the femur, tibia, and fibula are modeled as rigid bodies. The ligaments structures are modeled using the large displacement finite element absolute nodal coordinate formulation (ANCF) with an implementation of a Neo-Hookean constitutive model that allows for large change in the configuration as experienced in knee flexion, extension, and rotation. The Neo-Hookean strain energy function used in this study takes into consideration the near incompressibility of the ligaments. The ANCF is used in the formulation of the algebraic equations that define the ligament/bone rigid connection. A unique feature of the ANCF model developed in this investigation is that it captures the deformation of the ligament cross section using structural finite elements such as beams. At the ligament/bone insertion site, the ANCF is used to define a fully constrained joint. This model will reflect the fact that the geometry, placement and attachment of the two collateral ligaments (the LCL and MCL), are significantly different from what has been used in most knee models developed in previous investigations. The approach described in this paper will provide a more realistic model of the knee and thus more applicable to future research studies on ligaments, muscles and soft tissues (LMST). Current finite element models are limited due to simplified assumptions for the spatial and time dependent material properties inherent in the anisotropic and anatomic constraints associated with joint stability, and the static conditions inherent in the analysis. The ANCF analysis is not limited to static conditions and results in a fully dynamic model that accounts for the distributed inertia and elasticity of the ligaments. The results obtained in this investigation show that the ANCF finite elements can be an effective tool for modeling very flexible structures like ligaments subjected to large flexion and extension. In the future, the more realistic ANCF models could assist in examining the mechanics of the knee to study knee injuries and possible prevention means, as well as an improved understanding of the role of each individual ligament in the diagnosis and assessment of disease states, aging and potential therapies.     

Development of a planar multibody model of the human knee joint

The aim of this work is to develop a dynamic model for the biological human knee joint. The model is formulated in the framework of multibody systems methodologies, as a system of two bodies, the femur and the tibia. For the purpose of describing the formulation, the relative motion of the tibia with respect to the femur is considered. Due to their higher stiffness compared to that of the articular cartilages, the femur and tibia are considered as rigid bodies. The femur and tibia cartilages are considered to be deformable structures with specific material characteristics. The rotation and gliding motions of the tibia relative to the femur cannot be modeled with any conventional kinematic joint, but rather in terms of the action of the knee ligaments and potential contact between the bones. Based on medical imaging techniques, the femur and tibia profiles in the sagittal plane are extracted and used to define the interface geometric conditions for contact. When a contact is detected, a continuous nonlinear contact force law is applied which calculates the contact forces developed at the interface as a function of the relative indentation between the two bodies. The four basic cruciate and collateral ligaments present in the knee are also taken into account in the proposed knee joint model, which are modeled as nonlinear elastic springs. The forces produced in the ligaments, together with the contact forces, are introduced into the system’s equations of motion as external forces. In addition, an external force is applied on the center of mass of the tibia, in order to actuate the system mimicking a normal gait motion. Finally, numerical results obtained from computational simulations are used to address the assumptions and procedures adopted in this study.     

翼状韧带断裂对枕颈部稳定性的生物力学评价

本文应用三维运动测量分析方法，用新鲜人体标本实验模拟枕颈部翼状韧带断裂，对测量结果进行分析比较，阐明了翼状韧带断裂对枕颈部稳定性影响的生物力学特性，为确定枕颈部的稳定性提供了相应的生物力学评价和理论依据。     

Influence of screw length and diameter on tibial strain energy density distribution after anterior cruciate ligament reconstruction

Postoperative tunnel enlargement has been frequently reported after anterior cruciate ligament（ACL）reconstruction.Interference screw,as a surgical implant in ACL reconstruction,may influence natural loading transmission and contribute to tunnel enlargement.The aims of this study are（1）to quantify the alteration of strain energy density（SED）distribution after the anatomic single-bundle ACL reconstruction;and（2）to characterize the influence of screw length and diameter on the degree of the SED alteration.A validated finite element model of human knee joint was used.The screw length ranging from 20 to 30 mm with screw diameter ranging from 7 to 9 mm were investigated.In the post-operative knee,the SED increased steeply at the extra-articular tunnel aperture under compressive and complex loadings,whereas the SED decreased beneath the screw shaft and nearby the intra-articular tunnel aperture.Increasing the screw length could lower the SED deprivation in the proximal part of the bone tunnel;whereas increasing either screw length or diameter could aggravate the SED deprivation in the distal part of the bone tunnel.Decreasing the elastic modulus of the screw could lower the bone SED deprivation around the screw.In consideration of both graft stability and SED alteration,a biodegradable interference screw with a long length is recommended,which could provide a beneficial mechanical environment at the distal part of the tunnel,and meanwhile decrease the bone-graft motion and synovial fluid propagation at the proximal part of the tunnel.These findings together with the clinical and histological factors could help to improve surgical outcome,and serve as a preliminary knowledge for the following study of biodegradable interference screw.     

一个解剖基人体下肢的生物动力模型--第一部分: 模型描述

建立一个完整的解剖基人体下肢二维（矢状面内）生物动力模型,该模型仿真了人体下肢的生物动力运动,并可用来计算人体下肢在冲击外载荷或肌肉活性力的作用下,下肢的重要承力部位－膝关节处的结构力（包括：膝关节的咬合接触力、膝关节处四个主要韧带张力等）和人体下肢的肌肉群力;同时本模型也可用来计算人体下肢在运动期间,膝关节处的咬合位移以及膝关节和髋关节的屈伸位移等。另外,模型还为研究人工关节、人工韧带和人工肌肉     

DETERMINATION OF QUADRICEPS FORCES IN SQUAT AND ITS APPLICATION IN CONTACT PRESSURE ANALYSIS OF KNEE JOINT

While the quadriceps muscles of human body are quite important to the daily activities of knee joints,the determination of quadriceps forces poses significant challenges since it cannot be measured in ...     

THREE-DIMENSIONAL FINITE ELEMENT SIMULATION OF TOTAL KNEE JOINT IN GAIT CYCLE

Based on CT scanning pictures from a volunteer＇s knee joint, a three-dimensional finite element model of the healthy human knee joint is constructed including complete femur, tibia, fibular, patellar and the main cartilage and ligaments. This model was validated using experimental and numerical results obtained from other authors. The pressure distribution of contact surfaces of knee joint are calculated and analyzed under the load action of ‘heel strike＇, ‘single limb stance＇ and ‘toe-off＇. The results of the gait cycle are that the contact areas of medial cartilage are larger than that of lateral cartilage; the contact force and contact areas would grow larger with the load increasing; the pressure of lateral meniscus is steady, relative to the significant variation of peak pressure in medial meniscus; and the peak value of contact pressure on all components are usually found at about 4570 of the gait cycle.