摘要
目的测量胫骨高位截骨手术前后膝内侧胫股关节接触应力的改变，探讨胫骨高位截骨手术对膝关节生物力学的影响。方法从4具尸体（男尸2具，女尸2具）获得4个膝关节，年龄53。80岁。所有标本实验前均为膝内翻，切除内侧半月板，行胫骨高位外翻截骨，术后胫骨股骨角170度。压敏片技术测量截骨前后的膝内侧胫股关节接触应力。结果根据测量结果计算截骨前后胫股关节的平均接触应力和最大接触应力，实验数据以配对t检验进行统计学分析。平均接触应力截骨前（4．047±0．217）MPa，截骨后（3．163±0．438）MPa。最大接触应力截骨前（5．455±0．4537）MPa，截骨后（3．8325±0．6335）MPa。结论胫骨高位截骨可以减轻膝内侧胫股关节的接触应力，这可能是治疗膝内翻内侧间室骨关节炎的机制之一。
Objective To investigate the effect of osteotomy on biomechanical parameters such as cartilage pressure and joint kinematics, and to explore the effects of high tihial osteotomy in a human cadaver model. Methods Using pressure sensitive film and low limbs from older human （age range,53 - 80 yr） cadavers with articular cartilage degeneration, the femur was sectioned transversely 25 cm from the knee joint hne. Medial tibiofemoral contact pressttres were measured in the extended knee in two conditions： （1） natural knee position （varus-simulating single limb stance of gait） ; （2） after a proximal tibial closing wedge valgus osteotomy （femorotibial angle 170°）. Medial meniscectomy was performed before first measure in every case. Results Average medial tibiofemoral contact pressures were （4.047 ± 0.217） MPa preoperatively and （3. 163 ± 0.438） MPa postoperatively. Maximum medial tibiofemoral contact pressures were （5.455 ± 0.4537） MPa preoperatively and （3. 8325 ± 0.6335） MPa postoperatively. Average and maximum medial tibiofemoral contact pressures were less postoperatively than that preoperatively. Conclusion The valgus osteotomy resulted in contact pressures are less than those in varus. Valgus high tihial osteotomy is an effective treatment for medial gonarthrosis, which may be one of its mechanisms.
出处
《河北医药》
CAS
2006年第2期83-85,共3页
Hebei Medical Journal
