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

ISSN号：0567-7718
期刊名称：《力学学报：英文版》
时间：0
分类：TQ320.52[化学工程—合成树脂塑料工业] TQ330.1[化学工程—橡胶工业]
作者机构：[1]Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education,School of Biological Science and Medical Engineering/National Key Lab of Virtual Reality Technology,Beihang University, [2]Interdisciplinary Division of Biomedical Engineering,Faculty of Engineering,The Hong Kong Polytechnic University, [3]Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma,Department of Orthopaedics and Traumatology,The University of Hong Kong-Shenzhen Hospital, [4]The University of Hong Kong, [5]Tongji University School of Medicine
相关基金：supported by the National Science ＆ Technology Pillar Program of China（2012BAI18B07 and 2012BAI22B02）; the National Natural Science Foundation of China（10925208 and 11120101001）; the National Key Lab of Virtual Reality TechnologyAcknowledgment The authors thank Dr. He Gong for her very kind suggestions of the study design and results analysis, Dr. Yux- ing Wang for advices on model development.

作者： Jie Yao, Guan-Ming Kuang, Duo Wai-Chi Wong, Wen-Xin Niu, Ming Zhang, Yu-Bo Fan

关键词：螺杆直径, 螺杆长度, 能量密度, 密度分布, 应变, 韧带, 可生物降解, 胫骨, Anterior crucial ligament reconstruction Strain energy density Screw length Screw diameter

中文摘要：

手术后的隧道增大经常在前面的十字形的系带(ACL ) 以后被报导了重建。干扰螺丝钉一外科在 ACL 重建植入，可以影响装载传动的天赋并且贡献隧道增大。这研究的目的是(1 ) 确定紧张精力兽穴 sity (SED ) 的改变在解剖单个捆的 ACL 重建以后的分发；并且(2 ) 在 SED 改变的度上描绘螺丝钉长度和直径的影响。人的膝关节的一个验证有限元素模型被使用。与螺丝钉直径从 7 ～ 9 公里从 20 到 30mm 的螺丝钉长度被调查。在手术后的膝， SED 在压缩、复杂的装载下面在额外关节的隧道孔陡峭地增加了，而 SED 在螺丝钉柄下面并且附近减少了 intra 关节的隧道孔。增加螺丝钉长度能在骨头隧道的近似部分降低 SED 剥夺；而增加，螺丝钉长度或直径能在骨头隧道的远侧的部分加重 SED 剥夺。减少螺丝钉的有弹性的模量能在螺丝钉附近降低骨头 SED 剥夺。在接枝稳定性和 SED 改变的考虑，有长长度的一个可被细菌破坏的干扰螺丝钉被推荐，它能在隧道的远侧的部分提供有益的机械环境，并且同时减少在隧道的近似部分的骨头接枝运动和 synovial 液体繁殖。和临床、组织学的因素的这些调查结果能帮助改进外科的结果，并且为可被细菌破坏的干扰螺丝钉的下列学习用作初步的知识。

英文摘要：

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.