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林伟健, 李俊言, 陈瑱贤, 靳忠民. 正常和早期膝骨关节炎的软骨生物力学研究. 力学学报, 2021, 53(11): 3147-3156. DOI:10.6052/0459-1879-21-390
引用本文: 林伟健, 李俊言, 陈瑱贤, 靳忠民. 正常和早期膝骨关节炎的软骨生物力学研究. 力学学报, 2021, 53(11): 3147-3156.DOI:10.6052/0459-1879-21-390
Lin Weijian, Li Junyan, Chen Zhenxian, Jin Zhongmin. Biomechanical investigation of the cartilage of normal knee and early osteoarthritis knee. Chinese Journal of Theoretical and Applied Mechanics, 2021, 53(11): 3147-3156. DOI:10.6052/0459-1879-21-390
Citation: Lin Weijian, Li Junyan, Chen Zhenxian, Jin Zhongmin. Biomechanical investigation of the cartilage of normal knee and early osteoarthritis knee.Chinese Journal of Theoretical and Applied Mechanics, 2021, 53(11): 3147-3156.DOI:10.6052/0459-1879-21-390

正常和早期膝骨关节炎的软骨生物力学研究

BIOMECHANICAL INVESTIGATION OF THE CARTILAGE OF NORMAL KNEE AND EARLY OSTEOARTHRITIS KNEE

  • 摘要: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.

    Abstract:Knee osteoarthritis (OA), a leading cause of knee pain and chronic disability, is a common type of arthritis. The biomechanics of cartilage is an important indicator of the evaluation of knee OA. However, the biomechanics of cartilage of early knee OA remains to be elucidated. The biomechanical differences among the cartilage of healthy knee, early medial knee OA and early coexisting medial and lateral knee OA were still unknown. Therefore, three knee models with these three different OA situations were established based on fibril-reinforced biphasic cartilage finite element model. The biomechanical differences among the cartilage of healthy knee, early medial knee OA and early coexisting medial and lateral knee OA were investigated in the situation of maximum load and in the situation of maximum flexion angle of a gait cycle. When compared with the results of the healthy knee model, the fluid pressure and solid effective stress decreased while the strain increased in the medial compartment cartilage of early medial knee OA model. The results of the lateral compartment cartilage of early medial knee OA model were almost the same as that of healthy knee model. However, the fluid pressure and solid effective stress decreased and the strains increased in both compartment cartilage of early coexisting medial and lateral knee OA model. In conclusion, the changes of the degenerated cartilage in early knee OA would reduce the load support capability and increase the deformation of cartilage, thereby increasing the risk of further degeneration of cartilage. The proposed knee finite element model considering fibril-reinforced biphasic cartilage could be used to study the biomechanical differences between the cartilage of healthy knee and the cartilage of knee OA. In addition, the proposed model could also be adopted in other biomechanical studies of the joints such as hip, ankle and spine.

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