ZHANG Tengyu,YAO Jie,MO Zhongjun,GUO Junchao,LIAN Zizhan,FAN Yubo.Effects of Prosthetic Alignment on Internal Contact Mechanical Characteristics of Intact Knee Joints for Transfemoral Amputees[J].Journal of medical biomechanics,2020,35(4):296-303
假肢对线对大腿截肢者健侧膝关节内部接触力学特性的影响
Effects of Prosthetic Alignment on Internal Contact Mechanical Characteristics of Intact Knee Joints for Transfemoral Amputees
Received:June 21, 2019  Revised:August 07, 2019
DOI:
Chinese key words:  假肢对线  大腿截肢者  膝关节  有限元分析
English Key words:prosthetic alignment  transfemoral amputee  knee joint  finite element analysis
Fund project:国家重点研发计划(2016YFB1101100),国家自然科学基金创新研究群体项目(11421202),111计划(B13003),国家康复辅具研究中心基本科研业务费
Author NameAffiliation
ZHANG Tengyu National Research Center for Rehabilitation Technical Aids
School of Biological Science and Medical Engineering, Beihang University
Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability 
YAO Jie National Research Center for Rehabilitation Technical AidsBeijing Advanced Innovation Centre for Biomedical Engineering 
MO Zhongjun National Research Center for Rehabilitation Technical AidsKey Laboratory of Human Motion Analysis and Rehabilitation Technology, Ministry of Civil Affairs 
GUO Junchao National Research Center for Rehabilitation Technical AidsKey Laboratory of Human Motion Analysis and Rehabilitation Technology, Ministry of Civil Affairs 
LIAN Zizhan School of Biological Science and Medical Engineering, Beihang University 
FAN Yubo National Research Center for Rehabilitation Technical AidsSchool of Biological Science and Medical Engineering, Beihang University
Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability
Key Laboratory of Human Motion Analysis and Rehabilitation Technology, Ministry of Civil Affairs 
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Chinese abstract:
      目的 研究假肢对线对大腿截肢者健侧膝关节内部接触力学特性的影响。方法 通过步态实验分析健全人及大腿截肢者在不同对线条件下行走时下肢运动及地面反作用力(ground reaction force, GRF)差异,并利用三维有限元模型分析接受腔内收和外展的异常对线情况对膝关节内部股骨软骨、胫骨软骨与半月板之间接触力学特性的影响。结果 健全人在GRF第1峰值时刻膝关节接触力主要集中在内侧,在GRF第2峰值时刻接触力主要集中在外侧,而截肢者接触力在GRF的两个峰值时刻都集中在内侧。接受腔对线内收6°会导致膝关节内侧应力、接触力、接触面积均明显增大。结论 截肢者膝骨关节炎发病率高于健全人与其膝关节内侧长期过载有关,接受腔对线内收会增加大腿截肢者健侧膝关节骨关节疾病的风险,临床对线过程中应尽量避免过度内收。
English abstract:
      Objective To study the effects of prosthetic alignment on internal contact mechanical characteristics of intact knee joint for transfemoral amputees. Methods The gait experiment of transfemoral amputees was performed under different alignment conditions, and the differences of lower limb motion and ground reaction force (GRF) were analyzed and compared with those of the non-amputees. The three-dimensional (30) finite element model of knee joint was build and used to analyze the effect of alignments of socket adduction and abduction on internal contact mechanical characteristics between femur cartilage, tibia cartilage and meniscus. Results For knee joint of the non-amputees, contact force was mainly concentrated on the medial sides at the moment of the first GRF peak, while contact force was mainly concentrated on the lateral sides at the moment of the second GRF peak. However, for intact knee joint of the transfemoral amputees, contact force was mainly concentrated on the medial side at the moment of two GRF peaks. The stress of the medial meniscus, contact force and contact area between the medial meniscus and cartilage all obviously increased under the alignment of 6° socket adduction. Conclusions Compared with non-amputees, the incidence of knee osteoarthritis (OA) in amputees was higher, which was related to the long-term overload of the medial knee joint. The alignment of socket adduction may increase the risk of knee OA in the intact side of transfemoral amputees. In clinic, excessive adduction of the socket should be avoided during prosthetic alignment.
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