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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >The Effects of Anterior Cruciate Ligament Deficiency on the Meniscus and Articular Cartilage
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The Effects of Anterior Cruciate Ligament Deficiency on the Meniscus and Articular Cartilage

机译：前十字韧带缺乏对半月板和关节软骨的影响

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Background: Anterior cruciate ligament (ACL) injury increases the risk of meniscus and articular cartilage damage, but the causes are not well understood. Previous in vitro studies were static, required extensive knee dissection, and likely altered meniscal and cartilage contact due to the insertion of pressure sensing devices. Hypothesis: ACL deficiency will lead to increased translation of the lateral meniscus and increased deformation of the medial meniscus as well as alter cartilage contact location, strain, and area. Study Design: Descriptive laboratory study. Methods: With minimally invasive techniques, six 1.0-mm tantalum beads were implanted into the medial and lateral menisci of 6 fresh-frozen cadaveric knees. Dynamic stereo x-rays (DSXs) were obtained during dynamic knee flexion (from 15° to 60°, simulating a standing squat) with a 46-kg load in intact and ACL-deficient states. Knee kinematics, meniscal movement and deformation, and cartilage contact were compared by novel imaging coregistration. Results: During dynamic knee flexion from 15° to 60°, the tibia translated 2.6 mm ( P = .05) more anteriorly, with 2.3° more internal rotation ( P = .04) with ACL deficiency. The medial and lateral menisci, respectively, translated posteriorly an additional 0.7 mm ( P = .05) and 1.0 mm ( P = .03). Medial and lateral compartment cartilage contact location moved posteriorly (2.0 mm [ P = .05] and 2.0 mm [ P = .04], respectively). Conclusion: The lateral meniscus showed greater translation with ACL deficiency compared with the medial meniscus, which may explain the greater incidences of acute lateral meniscus tears and chronic medial meniscus tears. Furthermore, cartilage contact location moved further posteriorly than that of the meniscus in both compartments, possibly imparting more meniscal stresses that may lead to early degeneration. This new, minimally invasive, dynamic in vitro model allows the study of meniscus function and cartilage contact and can be applied to evaluate different pathologies and surgical techniques. Clinical Relevance: This novel model illustrates that ACL injury may lead to significant meniscus and cartilage abnormalities acutely, and these parameters are dynamically measurable while maintaining native anatomy.
机译：背景：前交叉韧带（ACL）损伤增加了半月板和关节软骨损伤的风险，但其原因尚不清楚。以前的体外研究是静态的，需要进行广泛的膝关节解剖，并且由于插入压力感应装置而可能改变半月板和软骨的接触。假设：ACL缺乏会导致外侧半月板的平移增加以及内侧半月板的变形增加，以及改变软骨的接触位置，应变和面积。研究设计：描述性实验室研究。方法：采用微创技术，将6个1.0毫米钽珠植入6个新鲜冷冻的尸体膝盖的内侧和外侧半月板。在动态膝盖弯曲（从15°到60°，模拟站立下蹲）过程中获得动态立体X射线（DSXs），其载荷为46 kg，处于完整状态和ACL缺失状态。膝关节运动学，半月板运动和变形，以及软骨接触通过新颖的成像核心技术进行了比较。结果：在从15°到60°的动态膝关节屈曲过程中，胫骨向前方平移2.6毫米（P = .05），内部旋转角度增加2.3°（P = .04），伴ACL缺失。内侧和外侧半月板分别向后平移了另外的0.7毫米（P = .05）和1.0毫米（P = .03）。内侧和外侧隔室软骨接触位置向后移动（分别为2.0 mm [P = .05]和2.0 mm [P = .04]）。结论：与内侧半月板相比，外侧半月板表现出更大的ACL缺失翻译，这可能解释了急性外侧半月板撕裂和慢性内侧半月板撕裂的发生率更高。此外，在两个隔室中，软骨接触位置比弯月面向后移动得更远，可能会产生更大的半月板应力，这可能导致早期退化。这种新的，微创的动态体外模型可以研究半月板功能和软骨接触，并可用于评估不同的病理学和手术技术。临床意义：这个新颖的模型说明ACL损伤可能会导致严重的半月板和软骨异常，并且在保持天然解剖结构的同时可以动态地测量这些参数。

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