临床小儿外科杂志2025，Vol.24Issue(5)：473-479,7.DOI:10.3760/cma.j.cn101785-202501056-014
基于三维有限元软件分析的外侧髌股韧带松解术对髌骨脱位内侧髌股韧带手术中髌股关节生物力学的影响研究
Analysis of the biomechanical impact on the patellofemoral joint of lateral patellofemoral ligament re-lease in medial patellofemoral ligament reconstruction for patellar dislocation based on three-dimen-sional finite element software
摘要
Abstract
Objective To analyze the biomechanical impact on the patellofemoral joint of lateral patel-lofemoral ligament release in medial patellofemoral ligament(MPFL)reconstruction for patellar dislocation u-sing three-dimensional finite element software.Methods A normal finite element model of the knee(Normal model)was created and validated using computed tomography(CT)and magnetic resonance imaging(MRI)images from healthy adolescents.This model was modified to simulate the surgical process for patellar disloca-tion.Four finite element models were established:the normal model,a model of lateral patellofemoral ligament release(LPFL-S),a model of medial patellofemoral ligament reconstruction(MPFL-R),and a model combi-ning MPFL-R with LPFL release.Finite element analysis was employed to assess patellofemoral joint contact stress,patellar lateral displacement,and patellar tilt angle for the three surgical approaches.Results Under knee flexion from 0° to 90°,the four models exhibited distinct biomechanical characteristics regarding patel-lofemoral joint contact stress and patellar lateral displacement.The Normal model showed a peak patellofemoral contact stress of 7.82 MPa.The MPFL-R model demonstrated a peak stress of 6.64 MPa,a reduction of 15.1％compared with the Normal model.In contrast,the LPFL-S model and the MPFL-R combined with LPFL-S model had peak stresses of 3.46 MPa and 2.94 MPa,respectively,representing reductions of 55.8％and 62.4％,compared with the Normal model.The peak patellar lateral displacement in the Normal model was 4.16 mm,while the MPFL-R model showed an increase to 4.57 mm(an increase of 9.9％compared with the Normal model);the LPFL-S model and the MPFL-R combined with LPFL-S model had peak displacements of 4.67 mm and 5.79 mm,respectively,which correspond to increases of 12.3％and 39.2％,compared with the Normal model.Regarding the patellar tilt angle,the Normal model had a peak value of 12.85°,the MPFL-R model in-creased to 13.87°(a 7.9％increase),and the LPFL-S model and the MPFL-R combined with LPFL-S model had peak angles of 16.19° and 22.98°,representing increases of 26.0％and 78.8％,compared with the Nor-mal model.Conclusions MPFL reconstruction restores the mechanical parameters of patellofemoral joint con-tact stress,patellar lateral displacement,and patellar tilt angle to levels close to those of a normal knee.Howev-er,LPFL release reduces patellofemoral joint contact stress while increasing patellar lateral displacement and tilt angle.Notably,combining MPFL reconstruction with LPFL release significantly increases patellar lateral dis-placement and tilt angle,raising the risk of patellar lateral instability.关键词
髌骨脱位/三维重建/有限元分析/膝关节/外科手术/生物力学现象/儿童Key words
Patellar Dislocation/Three-dimensional Reconstruction/Finite Element Analysis/Knee Joint/Surgical Procedures,Operative/Biomechanical Phenomena/Child引用本文复制引用
谭晓艳,唐凯,侯华成,蒋岩玲,刘飞..基于三维有限元软件分析的外侧髌股韧带松解术对髌骨脱位内侧髌股韧带手术中髌股关节生物力学的影响研究[J].临床小儿外科杂志,2025,24(5):473-479,7.基金项目
江苏省卫生健康发展研究中心开放课题(JSHD2022065) （JSHD2022065）
南京市卫生科技发展专项资金项目(YKK23168) Jiangsu Health Development Research Center Open Project(JSHD2022065) （YKK23168）
Nanjing Health Science and Technology Development Special Project(YKK23168) （YKK23168）
