全膝关节在不同运动状态下的有限元仿真研究
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摘要
膝关节是人全身最大、最复杂的关节,位居髋关节和踝关节之间,是下肢活动的枢纽。它的任何一个主要组成部分的损坏都会引起膝关节的反常运动,久之软骨和半月板由于磨损、变性而形成骨性关节病,从而严重影响得病者的正常活动。包括膝关节骨关节病、髋关节骨关节病在内的各类骨关节病其发病率随年龄的增长而不断增高。据统计,50岁以上的人群中,50%患有骨关节病,65岁以上的人群中,90%的女性和80%的男性患有此病。骨关节疾病严重地影响了老年人的生活质量,甚至对他们的生命构成了威胁;老年患者不仅饱尝病痛的折磨,同时也给家庭和社会带来许多负担。目前,随着经济的发展,生活水平的日渐提高,骨性关节病也开始趋向低龄化,将来越来越多的人会受到骨性关节病的困扰。
鉴于膝关节的重要性及相关疾病的危害性,人们对其解剖结构与相应的生物力学特性的研究也越来越深入和广泛。通过对正常和病变膝关节的对比研究和分析,不但可以更好地阐明膝关节疾病的发生机制,而且还可以指导相关疾病的治疗及康复。但由于膝关节自身解剖结构的复杂性、组成材料性质的多样性、运动形式以及各组成部分载荷分配情况的复杂性,因而人们目前还不能对膝关节的各种生物力学性质及行为做出准确的描述。
经过将近四十年的发展,有限元方法已经成为目前国际上进行肌肉—骨骼系统计算力学分析的主要手段,但由于膝关节处所涉及的关节面、韧带、肌肉众多,建立完全的有限元模型由于过于复杂而不易研究。目前的研究主要集中在组成膝关节的骨骼和主要韧带,但包括膝部各骨骼和主要韧带的三维有限元模型研究还较少。
鉴于此,本文的主要工作是进行了下蹲和步行运动过程的拍摄,通过实验得到了下蹲过程中人体的足底受力情况,确定了在下蹲过程中股四头肌的力矩;建立包括膝部各骨骼和主要韧带的三维有限元模型,通过有限元仿真方法,研究膝关节在不同运动的情况下(包括下蹲、步行等运动),膝关节各关节及韧带的应力分布。
具体内容包括以下几个方面:
(1)建立简化的股骨、胫骨及半月板的生物力学模型,初步估算了股骨、胫骨软骨关节面接触时,接触面上的接触压力和股骨、半月板接触时的接触压力。并着重对软组织的生物力学特性进行分析,给出了韧带的材料特性、初始应变等数据。进行了下蹲和步行运动过程的拍摄,得到了运动过程中各关节角度的变化曲线;同时实验测量了下蹲过程中人体的足底受力情况,确定了在下蹲过程中股四头肌的力矩;
(2)从生物力学角度,基于一名志愿者的膝部CT扫描图像,建立了包括完整股骨、胫骨、腓骨、髌骨,及膝部各主要软骨、韧带的三维有限元模型,通过与其它理论模型、实验、有限元模型的结果进行比较分析,证实了该模型的合理性、有效性;
(3)利用已建成膝部的三维有限元模型,计算并分析了双腿站立、下蹲和步行运动作用下膝关节各部位和韧带的应力分布,探讨了载荷和运动耦合的情况对接触压力分布的影响。可以看出在0°～90°的屈膝运动中,随着屈膝角度的增大,各软骨和半月板上的接触压力峰值也随之增大,相对于内侧半月板,外侧半月板峰值变化不大,且内侧半月板的压力值大于外侧半月板的。在步行运动中,ACL比其他韧带的张力值大;
(4)双腿站立时各软骨和半月板上的接触压力峰值最小,深度屈膝90时,各接触压力峰值最大,单腿支撑时压力峰值略大于脚跟着地状态;
综上所述,本文建立了膝关节周围所有完整骨骼、主要韧带的三维有限元模型,引入髋、踝关节的运动形态学数据,从股骨顶端加载来研究膝部各关节面接触力及韧带的应力分布。通过与其他学者的研究数据比较,证实了该模型的合理性和有效性。本文的研究结果为个体化人膝关节的三维建模和在体生物力学研究提供了可操作的平台;也为进一步深入了解膝部各部件在力载荷作用下的生物力学行为和功能效应提供参考依据;对于了解日常活动对膝关节的影响具有重要的意义;以及对今后发展膝关节置换术及其临床应用具有重要的学术意义和应用价值。
The knee joint is the most biggest and complicated joint in the whole human body, lied between hip joint and ankle joint. And it is the junction for activities of human lower extremity. Anyone damage of the main components will result in abnormal movement of knee joint. As time passes, osteoarthritis of cartilage and meniscus will emerge because of wearing and degeneration, thereby normal activities of sufferers will be severely affected. Disease rate of all kinds of osteoarthritis,raises up unceasingly with age growing, including hip and knee joints’osteoarthritis. According to statistics, in crowd whose age above 50 year’s old, 50 percent people suffered the osteoarthritis; in crowd whose age above 65 year’s old, 90 percent female and 80 percent male suffered this disease. The osteoarthritis severely affects the old people’s quality of life, even threatens their life; old patient not only suffer the pains, but bring many burden to family and society. At present, with economy development and improvement of living standard day by day, the low age people begin to suffer the osteoarthritis, and more and more people will be cursed by the osteoarthritis in the future.
In view of the significance of knee joint and hazardless of related disease, researches on anatomical structure and corresponding biomechanical characteristics become more and more deep and extensive. Through the comparative study and analysis of normal and diseased knee joint, the disease occurred mechanism of knee joint can not only be better demonstrated, but can be guided to cure and rehabilitate related disease. But because of the complexity of anatomical structure in knee joint, the diversity of material properties composed of the knee joint, and the complexity of moving form and load distribution in every component in knee joint, therefore accurate description can’t be made at present for biomechanical properties and behavior of knee joint.
By near 40 year’s development, finite element method already becomes the international main means in computational mechanics analysis for musculoskeletal system; but because of many articular surfaces, ligaments and muscles involved in knee joint, it is too difficult and too complex to built a complete finite element model for researching. Current research mainly concentrates on bones and important ligaments made up of knee joint, but studies on three-dimensional finite element model are fewer including complete bones and main ligaments of knee joint.
In the light of these conditions, the main work in this paper is that : the motions of squat and gait are photographed,force distribution at the bottom of foot is obtained by experimental measurement, and the moments of the quadriceps are determined during the squat.; a three-dimensional finite element model above-mentioned is constructed to determine the stress distribution in articulation and ligaments of knee joint under different motions ( including squat, gait, and so on ) in this paper by finite element simulation method.
Specific contents include the following several aspects:
(1) A biomechanical model including simplified femur, tibia and menisci is built, and the contact pressure on articular cartilage of femur and tibia and contact pressure between femur and menisci are estimated preliminarily; and explicit analysis are done on mechanical properties of soft tissue, material properties, initial strain of ligaments and other data are given;the motions of squat and gait are photographed, the angle changed curves of some joints are obtained; at the same time, force distribution at the bottom of foot is obtained by experimental measurement, and the moments of the quadriceps are determined during the squat.
(2) from the point of biomechanical view, based on CT scanning pictures of a volunteer’s knee joint, a three-dimensional finite element model is constructed including complete femur, tibia, fibular, patellar, the cartilages and the main ligaments of knee joint. It is proved to be reasonable and valid by comparison with results of other theoretical models, experiments, and finite element models.
(3) by using the above constructed finite element model, the stress distribution of articulation and ligaments of knee joint are calculated and analyzed under the conditions of double leg standing, squat and gait; and effects of loads coupled with motions on contact stress distribution are investigated. The results of the 0°～90°squat are that the peak value of contact pressure of cartilages and menisci would grow larger with the flexion angle increasing; the change of peak value of lateral meniscus is not significant relative to medial meniscus, and the peak values are smaller than that of medial.
(4) The peak value of contact pressure of cartilages and menisci is the smallest in double legs standing, the largest value in the deep flexion 90°, and the peak value in single limb stance is larger than heel strike. And the tension force of ACL is larger than other ligaments in gait.
Above all, a three-dimensional finite element model of the knee joint is constructed in this paper for the first time, including complete femur, tibia, fibular, patellar,main cartilage,menisci,and ligaments around the knee joint. The contact force for every articular surface and the stress distribution for ligaments of knee joint are researched by loading at the top femurios, based on morphological data of hip and ankle joints. It is proved to be reseanale and valid by comparing with research data of other scholars. Results of this paper give a operational platform for three-dimensional modeling of personal human knee joint and in vivo biomechanical studies; it also gives reference for insight to further to understand the mechanical behavior and function in every component of the knee joint under mechanical loads; it has significant meaning to understand the effects of daily activities on knee joint; and it has significant academic meaning and applicable value to develop replacement method of knee joint and to guide for clinical application.
鉴于膝关节的重要性及相关疾病的危害性,人们对其解剖结构与相应的生物力学特性的研究也越来越深入和广泛。通过对正常和病变膝关节的对比研究和分析,不但可以更好地阐明膝关节疾病的发生机制,而且还可以指导相关疾病的治疗及康复。但由于膝关节自身解剖结构的复杂性、组成材料性质的多样性、运动形式以及各组成部分载荷分配情况的复杂性,因而人们目前还不能对膝关节的各种生物力学性质及行为做出准确的描述。
经过将近四十年的发展,有限元方法已经成为目前国际上进行肌肉—骨骼系统计算力学分析的主要手段,但由于膝关节处所涉及的关节面、韧带、肌肉众多,建立完全的有限元模型由于过于复杂而不易研究。目前的研究主要集中在组成膝关节的骨骼和主要韧带,但包括膝部各骨骼和主要韧带的三维有限元模型研究还较少。
鉴于此,本文的主要工作是进行了下蹲和步行运动过程的拍摄,通过实验得到了下蹲过程中人体的足底受力情况,确定了在下蹲过程中股四头肌的力矩;建立包括膝部各骨骼和主要韧带的三维有限元模型,通过有限元仿真方法,研究膝关节在不同运动的情况下(包括下蹲、步行等运动),膝关节各关节及韧带的应力分布。
具体内容包括以下几个方面:
(1)建立简化的股骨、胫骨及半月板的生物力学模型,初步估算了股骨、胫骨软骨关节面接触时,接触面上的接触压力和股骨、半月板接触时的接触压力。并着重对软组织的生物力学特性进行分析,给出了韧带的材料特性、初始应变等数据。进行了下蹲和步行运动过程的拍摄,得到了运动过程中各关节角度的变化曲线;同时实验测量了下蹲过程中人体的足底受力情况,确定了在下蹲过程中股四头肌的力矩;
(2)从生物力学角度,基于一名志愿者的膝部CT扫描图像,建立了包括完整股骨、胫骨、腓骨、髌骨,及膝部各主要软骨、韧带的三维有限元模型,通过与其它理论模型、实验、有限元模型的结果进行比较分析,证实了该模型的合理性、有效性;
(3)利用已建成膝部的三维有限元模型,计算并分析了双腿站立、下蹲和步行运动作用下膝关节各部位和韧带的应力分布,探讨了载荷和运动耦合的情况对接触压力分布的影响。可以看出在0°～90°的屈膝运动中,随着屈膝角度的增大,各软骨和半月板上的接触压力峰值也随之增大,相对于内侧半月板,外侧半月板峰值变化不大,且内侧半月板的压力值大于外侧半月板的。在步行运动中,ACL比其他韧带的张力值大;
(4)双腿站立时各软骨和半月板上的接触压力峰值最小,深度屈膝90时,各接触压力峰值最大,单腿支撑时压力峰值略大于脚跟着地状态;
综上所述,本文建立了膝关节周围所有完整骨骼、主要韧带的三维有限元模型,引入髋、踝关节的运动形态学数据,从股骨顶端加载来研究膝部各关节面接触力及韧带的应力分布。通过与其他学者的研究数据比较,证实了该模型的合理性和有效性。本文的研究结果为个体化人膝关节的三维建模和在体生物力学研究提供了可操作的平台;也为进一步深入了解膝部各部件在力载荷作用下的生物力学行为和功能效应提供参考依据;对于了解日常活动对膝关节的影响具有重要的意义;以及对今后发展膝关节置换术及其临床应用具有重要的学术意义和应用价值。
The knee joint is the most biggest and complicated joint in the whole human body, lied between hip joint and ankle joint. And it is the junction for activities of human lower extremity. Anyone damage of the main components will result in abnormal movement of knee joint. As time passes, osteoarthritis of cartilage and meniscus will emerge because of wearing and degeneration, thereby normal activities of sufferers will be severely affected. Disease rate of all kinds of osteoarthritis,raises up unceasingly with age growing, including hip and knee joints’osteoarthritis. According to statistics, in crowd whose age above 50 year’s old, 50 percent people suffered the osteoarthritis; in crowd whose age above 65 year’s old, 90 percent female and 80 percent male suffered this disease. The osteoarthritis severely affects the old people’s quality of life, even threatens their life; old patient not only suffer the pains, but bring many burden to family and society. At present, with economy development and improvement of living standard day by day, the low age people begin to suffer the osteoarthritis, and more and more people will be cursed by the osteoarthritis in the future.
In view of the significance of knee joint and hazardless of related disease, researches on anatomical structure and corresponding biomechanical characteristics become more and more deep and extensive. Through the comparative study and analysis of normal and diseased knee joint, the disease occurred mechanism of knee joint can not only be better demonstrated, but can be guided to cure and rehabilitate related disease. But because of the complexity of anatomical structure in knee joint, the diversity of material properties composed of the knee joint, and the complexity of moving form and load distribution in every component in knee joint, therefore accurate description can’t be made at present for biomechanical properties and behavior of knee joint.
By near 40 year’s development, finite element method already becomes the international main means in computational mechanics analysis for musculoskeletal system; but because of many articular surfaces, ligaments and muscles involved in knee joint, it is too difficult and too complex to built a complete finite element model for researching. Current research mainly concentrates on bones and important ligaments made up of knee joint, but studies on three-dimensional finite element model are fewer including complete bones and main ligaments of knee joint.
In the light of these conditions, the main work in this paper is that : the motions of squat and gait are photographed,force distribution at the bottom of foot is obtained by experimental measurement, and the moments of the quadriceps are determined during the squat.; a three-dimensional finite element model above-mentioned is constructed to determine the stress distribution in articulation and ligaments of knee joint under different motions ( including squat, gait, and so on ) in this paper by finite element simulation method.
Specific contents include the following several aspects:
(1) A biomechanical model including simplified femur, tibia and menisci is built, and the contact pressure on articular cartilage of femur and tibia and contact pressure between femur and menisci are estimated preliminarily; and explicit analysis are done on mechanical properties of soft tissue, material properties, initial strain of ligaments and other data are given;the motions of squat and gait are photographed, the angle changed curves of some joints are obtained; at the same time, force distribution at the bottom of foot is obtained by experimental measurement, and the moments of the quadriceps are determined during the squat.
(2) from the point of biomechanical view, based on CT scanning pictures of a volunteer’s knee joint, a three-dimensional finite element model is constructed including complete femur, tibia, fibular, patellar, the cartilages and the main ligaments of knee joint. It is proved to be reasonable and valid by comparison with results of other theoretical models, experiments, and finite element models.
(3) by using the above constructed finite element model, the stress distribution of articulation and ligaments of knee joint are calculated and analyzed under the conditions of double leg standing, squat and gait; and effects of loads coupled with motions on contact stress distribution are investigated. The results of the 0°～90°squat are that the peak value of contact pressure of cartilages and menisci would grow larger with the flexion angle increasing; the change of peak value of lateral meniscus is not significant relative to medial meniscus, and the peak values are smaller than that of medial.
(4) The peak value of contact pressure of cartilages and menisci is the smallest in double legs standing, the largest value in the deep flexion 90°, and the peak value in single limb stance is larger than heel strike. And the tension force of ACL is larger than other ligaments in gait.
Above all, a three-dimensional finite element model of the knee joint is constructed in this paper for the first time, including complete femur, tibia, fibular, patellar,main cartilage,menisci,and ligaments around the knee joint. The contact force for every articular surface and the stress distribution for ligaments of knee joint are researched by loading at the top femurios, based on morphological data of hip and ankle joints. It is proved to be reseanale and valid by comparing with research data of other scholars. Results of this paper give a operational platform for three-dimensional modeling of personal human knee joint and in vivo biomechanical studies; it also gives reference for insight to further to understand the mechanical behavior and function in every component of the knee joint under mechanical loads; it has significant meaning to understand the effects of daily activities on knee joint; and it has significant academic meaning and applicable value to develop replacement method of knee joint and to guide for clinical application.
引文
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