前交叉韧带重建术(ACL-R),治疗的关键方面之一是固定器的选择,可以在术后提供初始移植物固定。关于不同尺寸的固定器作为股骨移植物固定的生物力学稳定性的文献有限。因此,本研究旨在通过有限元分析(FEA)分析不同直径的交叉销对ACL-R术后移植物固定稳定性的影响。在方法论上,开发了三种不同直径的插销的三维(3D)模型,其中胫骨前负荷(ATL)施加到胫骨上。从调查结果来看,具有较小直径(4毫米)的交叉销提供了最佳的稳定性比大直径的交叉销,由此,它证明了在固定器(交叉销和干涉螺钉)处的可接受应力,不同百分比为28%,而相应骨骼的应力有利于骨整合的发生。此外,4mm直径交叉销的膝关节的应变在为骨愈合提供良好的生物力学环境方面也是优越的,而在固定器处记录的应变值与较大直径的交叉销相当,而在变形方面却不差。最后,直径为4mm的交叉销描绘了ACL-R移植物固定的最佳生物力学方面,因为它可以更好地辅助骨整合过程,并且可以最大程度地减少固定器断裂和迁移的可能性.这项研究不仅有助于医疗外科医生证明他们选择针径来治疗患者,也为研究人员进行未来的研究。
For anterior cruciate ligament reconstruction (ACL-R), one of the crucial aspects of treatment is the fixator selection that could provide initial graft fixation post-operatively. Literature on biomechanical stabilities of different sizes of fixators as femoral graft fixation is limited. Therefore, this study aims to analyse the influence of different diameters of cross-pins on the stability of graft fixations after ACL-R via finite element analysis (
FEA). In the methodology, three-dimensional (3D) models of three different diameters of cross-pins were developed, of which anterior tibial loads (ATL) were applied onto the tibia. From the findings, the cross-pin with a smaller diameter (4 mm) provided optimum stability than larger diameter cross-pins, whereby it demonstrated acceptable stresses at the fixators (both cross-pin and interference screw) with a different percentage of 28%, while the stresses at the corresponding bones were favourable for osseointegration to occur. Besides, the strains of the knee joint with 4 mm diameter cross-pin were also superior in providing a good biomechanical environment for bone healing, while the recorded strain values at fixators were comparable with a larger diameter of cross-pins without being inferior in terms of deformation. To conclude, the cross-pin with 4 mm diameter depicted the best biomechanical aspects in graft fixation for ACL-R since it allows better assistance for the osseointegration process and can minimise the possibility of the breakage and migration of fixators. This study is not only useful for medical surgeons to justify their choices of pin diameter to treat patients, but also for researchers to conduct future studies.