猕猴膝关节损伤的生物力学研究

本文对５只猕猴膝关节进行了扭转和拉伸实验，了载荷变形关系曲线，经过转换得出载荷与损伤关系曲一，这些结果为下肢系统方案设计提供了定量数据；在临床上节损伤的处治民帮助。     

肘关节稳定性的应用解剖和生物力学研究

目的 :为临床认识和治疗急、慢性肘关节不稳定提供基础。方法 :解剖观察肘关节副韧带的形态结构特点 ,测量依序切断桡侧软组织 (包括桡侧副韧带 )时肘关节后外侧旋转度的变化、依序切断肘关节尺侧副韧带时其外翻旋转角度的变化。结果 :①尺侧副韧带前束可分为前部纤维和后部纤维 ;桡侧副韧带部分止于环状韧带 ,部分止于尺骨冠突的外下方。②屈曲 60°以前 ,尺侧副韧带前束的外侧部紧张而内侧部较松弛 ,肘关节屈曲超过 60°后 ,前束内外侧处于同等程度的紧张状态 ;后束在肘关节屈曲超过 90°后才被拉紧。③肘关节桡侧副韧带复合体对维持关节外侧的稳定作用约占 5 0 % ,伸肌及伸肌腱膜起协同作用。结论 :肘关节副韧带是维持肘关节稳定的重要结构 ,在肘关节的运动过程中 ,副韧带的不同组成部分发挥着不同的作用 ,其中桡侧尺副韧带和尺侧副韧带前束是肘关节主要的稳定结构     

膝内侧副韧带功能解剖和生物力学特性的研究进展

膝关节是人体最大、最复杂的关节之一。随着膝关节外科学的发展,对膝关节韧带的研究逐渐深入,关于膝内侧副韧带的功能解剖和生物力学特性的各种量化标准也逐渐完善,这是未来对膝内侧副韧带研究的发展趋势。膝关节内侧副韧带的功能解剖研究包括维持膝关节的稳定和限制胫骨外旋,韧带各纤维束在膝关节不同的屈曲、旋转角度和不同的步态周期下应力变化等方面;生物力学研究包括结构属性、线性硬度、粘弹性、对力学刺激的反应及与年龄、性别的关系等内容。该文对近年来膝内侧副韧带的功能解剖和生物力学特性的相关量化标准的研究进展进行了综述。     

发展外科解剖生物力学的研究

生物力学是活跃在自然科学前沿的边缘科学之一.若从1960年在美国召开的第一届仿生学讨论会算起,国际上生物力学约有近30年的发展历史。我国在这一领域的起步较晚,从979年在重庆召开的全国生物力学座谈会和武汉讲习会到现在,仅有10年的历史.生物力学是现代生物医学工程的一个重要的组成部分,也是生物医学工程领域中与人体解剖学关系最为密切的部分。临床生物力学作为一门新兴的边缘学科,是今后医学科技发展的一个重要方面。我国生物力学的创建时期,得到过冯元祯教授等一批美籍华人科学家的帮助。由于美国首批的生物力学研究人员,有相当数量来自     

猕猴肘关节囊及韧带损伤的生物力学研究

本文对５只猕猴肘关节进行了离体扭转和弯曲实验，得出了载荷与变形关系曲线，经过转换得出载荷与损伤因子关系曲线。这些结果为现代弹射座椅上肢防护系统的研制提供了定量数据；对肘关节假体结构稳定性设计具有参考价值。     

全膝人工关节:历史和生物力学

由于生物力学、假体材料和手术技术的发展,全膝人工关节置换已成为临床常用的手术。迄今,已有一百余种不同类型的人工膝问世,全膝人工关节置换已成为关节固定手术外的另一种可被接受的治疗方法。本文介绍了膝人工关节的发展历史,并综述了设计结构合理的人工膝必须了解的膝关节的生物力学,包括膝关节结构对功能的影响、通过膝关节的作用力和膝关节的运动等。     

肘关节内侧副韧带生物力学及临床研究

目的：探讨肘关节内侧副韧各组成成分在肘关节稳定中的作用及手术治疗内侧副韧带损伤的临床效果。方法：收60例4％福尔马林溶液防腐保存的正常成人尸体肘关节标本，仔细解剖出肘关节内侧副韧带的前束、后束和斜束，随机分为5组，然后通过生物力学研究，分别观察肘关节内侧副韧带各组成部分在肘关节不同屈曲角度下对肘外翻角度的影响，并在此基础上临床治疗内侧副韧带损伤伴肘关节不不稳定患者11例，随访其疗效。结果：肘关节内侧副韧带前束在肘关节屈曲过程中，在抗外翻应力方面起主要作用而单纯后束或斜束损伤对肘关节内侧稳定影响小大；11例肘关节内侧副韧带损伤患者经手术修复前束，肘关节功能恢复良好．未见遗留内侧不稳定。结论：肘关节内侧副韧带前束是肘关节内侧稳定的主要结构，临床上当肘关节内侧副韧带损伤时应重点修复或重建前束以稳定肘关节。     

骨小梁的生物力学特性

骨小梁的生物力学特性胡侦明综述戴克戎校（上海第二医科大学附属第九人民医院骨科）近年来的研究表明，椎体、股骨近端和桡骨远端骨小梁结构区是与年龄增长有关骨折的好发部位，特别是在绝经期和绝经后的妇女。根据九十年代初的统计，美国每年有近５０万人发生椎体骨折，...     

Lisfranc韧带对跖跗关节稳定性的影响：解剖学测量及生物力学 研究实验方案

BACKGROUND:Lisfranc ligament is the strongest one among three ligaments between the second metatarsal bone and the medial cuneiform, and it is critical for maintaining the stability between the second metatarsal bone and the medial cuneiform because Lisfranc ligament is three times stronger than the dorsal ligament. However, there have been no reports addressing the effects of Lisfranc ligament injury on the stability of tarsometatarsal joints. METHODS/DESIGN: An anatomical and biomechanical study was performed. Anatomical measurements were performed in the origin, terminal, path, length, width, and thickness of Lisfranc ligament utilizing cadaverous embalmed specimens. In the experiment on fresh-frozen cadaveric specimens, the displacement changes between the first and the second metatarsal base under different loading were measured with biomechanical analysis after the successively resected dorsal ligament, Lisfranc ligament, and plantar ligament were loaded, respectively, exploring the effect of Lisfranc ligament on stability of tarsometatarsal joints. DISCUSSION:This study provides the theoretical basis for the treatment of tarsometatarsal joint injury in the clinic through exploring the effects of Lisfranc ligament on stability of tarsometatarsal joints. The attention should be paid to Lisfranc ligament by the physicians when the tarsometatarsal joint injury occurs. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Statische Untersuchungen am Fu? der Primaten

Zusammenfassung Die statischen bzw. quasistatischen Beanspruchungen der Zehenglieder und der Metatarsalia von Primaten werden in verschiedenen Bewegungs- und Ruhephasen analysiert. Die veränderlichen Größen werden planmäßig variiert, um die maximalen Beanspruchungen zu ermitteln. Diese liegen der weiteren Arbeit zugrunde. Mit der theoretischen Analyse werden Gestalt und Festigkeitseigenschaften der einzelnen Skeletteile verglichen.Die Endphalangen unterliegen bei Einwirkung einer Last auf die Plantarfläche und bei maximaler (isometrischer) Anspannung der Beugesehne den maßgeblichen Beanspruchungen. Mittelphalangen sind einerseits den dorsalwärts gerichteten Gelenkkräften im distalen und im proximalen Gelenk ausgesetzt, andererseits dem plantarwärts gerichteten Zug der Tendo perforata sowie der Umlenkkraft des Tendo perforans, die durch die Partes anulares vaginarum fibrosarum übertragen wird. Grundphalangen werden ähnlich wie Mittelglieder beansprucht. Beim Menschen wirken sich die Fasern der Aponeurosis plantaris, die in die Kapseln der Grundgelenke eingewebt sind, in gleicher Weise aus wie ein Sehnenansatz an der Basis des Gliedes.Krümmungen der Längsachsen sind als Anpassungen an Biegebeanspruchungen der genannten Art zu verstehen. Auch dorsalwärts konvex biegende Beanspruchungen können auftreten, ebenso wie Kräfte in der Mediolateralen Ebene. Beide erfordern eine besondere Biegefestigkeit der Schäfte. Diese ist auch vorhanden. Metatarsalia werden beim Klettern ähnlich wie Phalangen beansprucht. Sie besitzen auch oft eine entsprechende Achsenkrümmung. Beim Laufen sind sie Beanspruchungen von wechselnder Größe, wahrscheinlich sogar von wechselndem Vorzeichen ausgesetzt. Die Plantaraponeurose, die Beugesehnen und die plantaren Muskeln sind zwar geeignet, die Biegebeanspruchungen der Metatarsalia niedrig zu halten, können sie aber nur in Ausnahmefällen völlig ausschließen. Deshalb kommt es in bestimmten Phasen des Gehens zwangsläufig zu einer Anspannung der plantaren Bänder und damit zu einer Druckbeanspruchung der basalen Gelenke. Den Beanspruchungen in der dorsoplantaren Ebene sind Beanspruchungen in der mediolateralen Ebene überlagert. Die Mm. interossei sowie abductores digiti V et hallucis wirken als Zuggurtungen und halten die Biegemomente in der zuletzt genannten Ebene niedrig. In gleicher Weise wirkt sich die Kombination von 4 oder 5 Strahlen in dieser Ebene aus.Die Querschnittsform der Metatarsalschäfte entspricht bis in Einzelheiten der kombinierten Beanspruchung durch Kräfte in der dorsoplantaren und in der mediolateralen Ebene.

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Mechanical analyses of primate feetI. Phalanges and metatarsals

Summary The stresses affecting the toes and metatarsals of various primates during phases of rest or slow motion were analysed. Arbitrary values were assigned to all variable factors until that combination of values yielding the greatest stress was found. Further analysis was based on this condition. The structural requirements indicated by the theoretical analysis were then compared with the shape and the structural resistence of the skeletal elements.The distal phalanges are subjected to the greatest stress when force is exerted upon the plantar surface and the tendons of the flexors are under maximum (isometrical) contraction.The middle phalanges are subjected to the forces acting in the distal and proximal joints in a dorsal direction as well as the plantar directed pull of the tendo perforata and the vector resulting from the change in direction of the tendo perforans. The latter force is transmitted through the partes anulares vaginarum fibrosarum.The proximal phalanges are subjected to forces similar to those acting upon the middle phalanges. In man the fibers of the aponeurosis plantaris-which insert in the joint capsuleexercise the same function as a tendon inserting on the base of the phalanx.Curvatures of the longitudinal axes are adaptations to bending stresses of the sort described. Stresses tending to bend the elements in the opposite direction (dorsally convex) or in the mediolateral plane are also possible. Both require the presence of structural resistence in the shaft. This structural resistence is present.The metatarsals of climbers are subjected to essentially the same stresses as the phalanges and often possess a similar curvature. During walking the stresses vary in magnitude, probably in direction as well. The plantar aponeurosis, the flexor tendons and the plantar muscles reduce the magnitude of the bending moments, but seldom eliminate them entirely. As a result, the plantar ligaments are under tension in certain walking phases, and the basal joints are subjected to compression. The stresses in the mediolateral plane are greatly reduced by the combination of 4 or 5 rays in this plane and by the action of mm. interossei et abductores. They are not eliminated entirely, however, and the remainder combine with those in the dorsoplantar plane. The form of the cross sections of the metatarsal shafts shows an extremely high degree of adaptation to withstand stress combinations of the type described.

Angefertigt mit Unterstützung der Deutschen Forschungsgemeinschaft.     

Perspectives: A biomechanical model of the pathogenesis of arthroses

This model views the common, initiating cause of arthroses as excessive articular cartilage microdamage. If so, understanding it would become a central problem for understanding the pathogenesis of arthroses. The model proposes the microdamge can stem from: (1) Excessive total loads on normal joints; (2) underadaptations in a joint's size or shape that leave its momentarily loaded area too small for normal loads; (3) impaired microdamage repair in subchondral bone or articular cartilage; (4) abnormal composition or structure that makes a tissue develop excessive microdamage under normal loads. (5) (2)–(4) above could stem from changed set points or “lead times” for a joint's adaptations and maintenance, which in turn could stem from (6) genetic influences, some drugs, toxins, diseases, and “X,” and (7) from combinations of the above. In the pathogenesis of arthroses this model assigns special importance to the stiffness of joint tissues (as distinguished from their strength), to the typical largest unit loads they carry as a result of a subject's usual physical activities, and to microdamage in those tissues. © 1994 Wiley-Liss, Inc.     

Articular cartilage of the rabbit knee after synovectomy: a scanning electron microscopy study

We sought to study the effect of synovectomy on the surface morphology of articular cartilages of the rabbit knee using scanning electron microscopy (SEM). Fifteen rabbits were surgically synovectomised and allowed to regenerate their synovia during time intervals ranging from 3 to 44 wk. Cartilage specimens were shaved from 5 distinct articular sectors of synovectomised, contralateral and sham-operated knees and prepared for SEM using tannic acid. Applying structural reinforcement by tannic acid was found to secure the in vivo surface morphology of the cartilages and thus production of surface irregularities during preparation was excluded. The surface morphology of cartilages both from the synovectomised and contralateral joints was found to differ from that of intact healthy rabbits. A 'chaotic' nature of the altered cartilaginous morphology persisted as late as 44 wk postsynovectomy. Cartilages from sham-operated joints did not differ detectably from normal cartilages.     

The electron microscope appearance of the subchondral bone plate in the human femoral head in osteoarthritis and osteoporosis

The subchondral bone plate supports the articular cartilage in diarthrodial joints. It has a significant mechanical function in transmitting loads from the cartilage into the underlying cancellous bone and has been implicated in the destruction of cartilage in osteoarthritis (OA) and its sparing in osteoporosis (OP), but little is known of its composition, structure or material properties. This study investigated the microscopic appearance and mineral composition of the subchondral bone plate in femoral heads from patients with OA or OP to determine how these correspond to changes in composition and stiffness found in other studies. Freeze-fractured full-depth samples of the subchondral bone plate from the femoral heads of patients with osteoarthritis, osteoporosis or a matched control group were examined using back scattered and secondary emission scanning electron microscopy. Other samples were embedded and polished and examined using back-scattered electron microscopy and electron probe microanalysis. The appearances of the samples from the normal and osteoporotic patients were very similar, with the subchondral bone plate overlayed by a layer of calcified cartilage. Osteoporotic samples presented a more uniform fracture surface and the relative thicknesses of the layers appeared to be different. In contrast, the OA bone plate appeared to be porous and have a much more textured surface. There were occasional sites of microtrabecular bone formation between the trabeculae of the underlying cancellous bone, which were not seen in the other groups, and more numerous osteoclast resorption pits. The calcified cartilage layer was almost absent and the bone plate was apparently thickened. The appearance of the osteoarthritic subchondral bone plate was, therefore, considerably different from both the normal and the osteoporotic, strongly indicative of abnormal cellular activity.     

The surface contour of articular cartilage in an intact, loaded joint

The friction coefficients measured in diarthrodial joints are small. Theories of joint lubrication attribute this efficiency to entrapment or movement of synovial fluid, yet anatomical models of the surface are based on studies of isolated fragments of cartilage, not functional joints. To investigate the functional interrelationship of joint surfaces and synovial fluid, the ultrastructure of loaded joints was examined. Twenty-four New Zealand white rabbit knee joints were loaded either statically or moved ex vivo using simulated muscle forces and then plunge-frozen under load. After fixation in the frozen/loaded state by freeze-substitution fixation, the medial joint compartments were embedded in epoxy resin while still articulated. Bone was trimmed away from the articular surfaces, permitting the cartilage to be sectioned for light and electron microscopy. These joint surfaces were then compared with controls which were not loaded, not moved or had been disarticulated prior to embedding. Articular surfaces of loaded joints were smooth at magnifications from ×35 to ×7500, whereas the tibial surfaces of nonloaded joints were irregular. Small pools of joint fluid were observed at the meniscal edge and beneath the anterior horn of the meniscus. At magnifications of ×40000, the joint surfaces were separated by a uniform 100 nm space containing fluid. An amorphous, electron dense articular surface lamina was present but, when loaded, was thicker and flatter than previously reported. No surface pits or bumps were visible in embedded, loaded joints. This is the first ultrastructural study of intact loaded joints. The findings suggest that fluid film lubrication is present in diarthrodial joints, but the fluid sequestration postulated in several models is not apparent.     

The hip joint: the fibrillar collagens associated with development and ageing in the rabbit

The fibrillar collagens associated with the articular cartilages, joint capsule and ligamentum teres of the rabbit hip joint were characterised from the 17 d fetus to the 2-y-old adult by immunohistochemical methods. Initially the putative articular cartilage contains types I, III and V collagens, but when cavitation is complete in the 25 d fetus, type II collagen appears. In the 17 d fetus, the cells of the chondrogenous layers express type I collagen mRNA, but not that of type II collagen. Types III and V collagens are present throughout life, particularly pericellularly. Type I collagen is lost. In all respects, the articular cartilage of the hip joint is similar to that of the knee. The joint capsule contains types I, III and V collagens. In the fetus the ligamentum teres contains types I and V collagens and the cells express type I collagen mRNA; type III collagen is confined mainly to its surface and insertions. After birth, the same distribution remains, but there is more type III collagen in the ligament, proper. The attachment to the cartilage of the head of the femur is marked only by fibres of type I collagen traversing the cartilage; the attachment cannot be distinguished in preparations localising types III and V collagens. The attachment to the bone at the lip of the acetabulum is via fibres of types I and V collagens and little type III is present. The ligament is covered by a sheath of types III and V collagens. Type II collagen was not located in any part of the ligamentum teres. The distribution of collagens in the ligamentum teres is similar to that in the collateral ligaments of the knee. Its insertions are unusual because no fibrocartilage was detected.     

Artificial encapsulation of joint prostheses

The great success of total joint replacement in surgery has been disturbed mainly by later loosening and wear-out of the plastic components. In an attempt to improve long term performance of joint prostheses and eliminate the adverse effects of wear debris, polymeric encapsulation as a main design feature has been proposed. The benefits of having an encapsulated and artificially lubricated joint prosthesis have been evaluated in tribological terms with particular reference to the UMIST shoulder joint. The selection of a number of biopolymers involved in this research project described. The possible interactions arising from the coexistence of these materials have been mechanically investigated. Much attention and a great deal of practical work has been focussed on the sealing of the capsule and on the relevant liquid permeability.