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目的深入研究髌骨位姿异常对髌股关节的接触影响。方法通过正常膝关节MRI图像数据建立了髌股关节的正常和异常接触模型,基于正交试验对不同水平的髌股关节异常接触模型进行了有限元仿真模拟。结果 1)在膝关节屈曲过程中,髌股关节接触特性(Von Mises应力、接触压力和接触面积)对髌骨的屈曲和旋转参数最为敏感;2)髌股异常接触时软骨表面的等效应力和接触压力都明显大于正常接触时的对应值,而接触面积则明显小于正常接触的面积。3)无论髌股是正常还是异常接触,股骨软骨上的压力和等效应力都大于髌骨软骨上的对应数值,而且同一软骨上外侧的压力和等效应力均大于内侧。结论髌骨位姿异常导致髌股关节附加应力的增大与接触面积的明显减小是引发膝关节疾病的重要根源。
Objective To investigate the effect of abnormal patellar posture on the patellofemoral joint. Methods Normal and abnormal contact models of patellofemoral joint were established by MRI data of normal knee. The abnormal contact models of patellofemoral joint were simulated by finite element method based on orthogonal experiment. Results 1) The patellofemoral joint characteristics (Von Mises stress, contact pressure and contact area) were the most sensitive to patellar flexion and rotation parameters in the flexion process of knee joint. 2) The equivalent stress of the cartilage surface in abnormal patellofemoral contact Contact pressure is significantly greater than the normal contact when the corresponding value, while the contact area was significantly less than the normal contact area. 3) Whether patellofemoral normal or abnormal contact, the pressure on the cartilage and the equivalent stress is greater than the corresponding value on the patellar cartilage, and the same cartilage on the outside of the pressure and the equivalent stress are greater than the medial. Conclusion Abnormal posture of the patella leads to the increase of the additional stress in the patellofemoral joint and the significant reduction of the contact area, which are the important causes of knee joint diseases.