PDF(Pubmed)
Abstract：
BACKGROUND: Knee osteoarthritis (KOA) represents a widespread degenerative condition among adults that significantly affects quality of life. This study aims to elucidate the biomechanical implications of proximal fibular osteotomy (PFO), a proposed cost-effective and straightforward intervention for KOA, comparing its effects against traditional high tibial osteotomy (HTO) through in-silico analysis.
METHODS: Using medical imaging and finite element analysis (FEA), this research quantitatively evaluates the biomechanical outcomes of a simulated PFO procedure in patients with severe medial compartment genu-varum, who have undergone surgical correction with HTO. The study focused on evaluating changes in knee joint contact pressures, stress distribution, and anatomical positioning of the center of pressure (CoP). Three models are generated for each of the five patients investigated in this study, a preoperative original condition model, an in-silico PFO based on the same original condition data, and a reversed-engineered HTO in-silico model.
RESULTS: The novel contribution of this investigation is the quantitative analysis of the impact of PFO on the biomechanics of the knee joint. The results provide mechanical evidence that PFO can effectively redistribute and homogenize joint stresses, while also repositioning the CoP towards the center of the knee, similar to what is observed post HTO. The findings propose PFO as a potentially viable and simpler alternative to conventional surgical methods for managing severe KOA, specifically in patients with medial compartment genu-varum.
CONCLUSIONS: This research also marks the first application of FEA that may support one of the underlying biomechanical theories of PFO, providing a foundation for future clinical and in-silico studies.
METHODS: Using medical imaging and finite element analysis (FEA), this research quantitatively evaluates the biomechanical outcomes of a simulated PFO procedure in patients with severe medial compartment genu-varum, who have undergone surgical correction with HTO. The study focused on evaluating changes in knee joint contact pressures, stress distribution, and anatomical positioning of the center of pressure (CoP). Three models are generated for each of the five patients investigated in this study, a preoperative original condition model, an in-silico PFO based on the same original condition data, and a reversed-engineered HTO in-silico model.
RESULTS: The novel contribution of this investigation is the quantitative analysis of the impact of PFO on the biomechanics of the knee joint. The results provide mechanical evidence that PFO can effectively redistribute and homogenize joint stresses, while also repositioning the CoP towards the center of the knee, similar to what is observed post HTO. The findings propose PFO as a potentially viable and simpler alternative to conventional surgical methods for managing severe KOA, specifically in patients with medial compartment genu-varum.
CONCLUSIONS: This research also marks the first application of FEA that may support one of the underlying biomechanical theories of PFO, providing a foundation for future clinical and in-silico studies.
摘要：
背景：膝骨性关节炎（KOA）在成年人中表现出广泛的退行性疾病，严重影响生活质量。本研究旨在阐明腓骨近端截骨术（PFO）的生物力学意义，对KOA提出的具有成本效益和直接的干预措施，通过计算机分析比较其与传统胫骨高位截骨术（HTO）的效果。
方法：使用医学成像和有限元分析（FEA），这项研究定量评估了模拟PFO手术对严重内侧房性翻患者的生物力学结果，接受过HTO手术矫正的人。这项研究的重点是评估膝关节接触压力的变化，应力分布，和解剖定位的压力中心（CoP）。为这项研究中调查的五名患者中的每一名生成三个模型，术前原始条件模型，基于相同原始条件数据的计算机内PFO，和反向工程HTO计算机模型。
结果：这项研究的新颖贡献是对PFO对膝关节生物力学影响的定量分析。结果提供了机械证据，证明PFO可以有效地重新分配和均匀接头应力，同时还将CoP重新定位到膝盖的中心，类似于HTO后观察到的内容。研究结果表明，PFO是治疗严重KOA的传统手术方法的潜在可行且更简单的替代方法。特别是在内侧房型内翻患者中。
结论：这项研究也标志着FEA的首次应用，可能支持PFO的潜在生物力学理论之一，为未来的临床和计算机研究奠定基础。
方法：使用医学成像和有限元分析（FEA），这项研究定量评估了模拟PFO手术对严重内侧房性翻患者的生物力学结果，接受过HTO手术矫正的人。这项研究的重点是评估膝关节接触压力的变化，应力分布，和解剖定位的压力中心（CoP）。为这项研究中调查的五名患者中的每一名生成三个模型，术前原始条件模型，基于相同原始条件数据的计算机内PFO，和反向工程HTO计算机模型。
结果：这项研究的新颖贡献是对PFO对膝关节生物力学影响的定量分析。结果提供了机械证据，证明PFO可以有效地重新分配和均匀接头应力，同时还将CoP重新定位到膝盖的中心，类似于HTO后观察到的内容。研究结果表明，PFO是治疗严重KOA的传统手术方法的潜在可行且更简单的替代方法。特别是在内侧房型内翻患者中。
结论：这项研究也标志着FEA的首次应用，可能支持PFO的潜在生物力学理论之一，为未来的临床和计算机研究奠定基础。
