腓骨中上段截骨对膝关节骨性关节炎患者的膝关节应力改变的研究

Study on the Changes of Knee Joint Stress in Patients with Osteoarthritis of Knee Joint by Middle and Upper Fibula Osteotomy

目的研究腓骨中上段截骨术对膝关节骨性关节炎患者的膝关节的应力影响。方法对1例因内侧间隙狭窄的膝关节骨性关节炎的患者行腓骨中上段截骨术,分别在术前、术后1天、术后半年行患肢膝关节CT扫描和双下肢全长负重位X线检查,获得CT数据,建立膝关节三维有限元模型,计算并分析患肢膝关节应力的变化。结果从术前到术后半年,患者膝关节内侧半月板应力出现减小趋势,降低约20%,外侧半月板应力出现明显增加趋势,增幅约55%,术后半年胫骨平台内侧受力有一定程度的减小。结论利用三维有限元计算分析,从理论角度证实腓骨中上段截骨术在治疗内侧间室狭窄的膝关节骨性关节炎中,可减轻膝关节内侧应力。

Objective To study the effect of fibular osteotomy on knee joint stress in patients with osteoarthritis of the knee.Methods Fibula upper middle section of osteotomy to the inside of the narrow gap of knee osteoarthritis patients.Respectively,at preoperative and postoperative 1 day and six months postoperatively,CT scan and long-leg radiographs,CT data obtained,three-dimensional finite element model of knee is set up,calculation and analysis of the change of the knee joint stress.Results From preoperative to half a year,the medial meniscus of knee joint stress decreasing trend,reducing by about 20%.The stress of the lateral meniscus of increased by about 55%.The pressure of the medial tibial platform is relieved half a year after surgery.Conclusion The three-dimensional finite element analysis proves that the osteotomy of middle and upper fibula can reduce the stress of medial knee joint in the treatment of knee osteoarthritis with medial interventricular stenosis.