游离肌腱的长度会影响跟腱的损伤风险吗？有限元研究。

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2024-11-14 DOI:10.1002/jeo2.70036

Pedro Diniz, Carlos Quental, Hélder Pereira, André Soares Ferreira, Gino M. M. J. Kerkhoffs, Frederico Castelo Ferreira, João Folgado

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引用次数: 0

摘要

目的：跟腱是常见的损伤部位，但文献中对其损伤的解剖学风险因素的研究相对较少。本研究旨在评估游离肌腱长度的变化是否会影响跟腱模拟断裂的结果：方法：以之前验证过的跟腱游离和肌腱三维有限元模型为基础，创建了游离肌腱长度减少 25% 和增加 25% 的两个额外有限元模型。以 100N 为增量，从 2500N 到 3500N 依次对有限元模型进行加载，并记录显示最大主应变超过 10% 的元素的总体积。当体积至少为 3 立方毫米的连续元素组的最大主应变超过 10%时，即认为跟腱断裂发生。我们比较了符合断裂标准的最小载荷模型，并绘制了在整个载荷范围内最大主应变超过 10% 的元素百分比图。敏感性分析评估了副腱划分变化和副腱滑动限制对结果的影响：结果：无论自由肌腱长度如何，不同模型的断裂荷载和最大主应变超过 10%的元素百分比图相似。在没有副肌滑动的情况下进行模拟时，没有任何模型符合断裂标准。副腱分裂变化模型的断裂荷载与副腱横截面积相关：结论：跟腱的模拟断裂结果对亚腱横截面积的变化敏感，但对自由肌腱长度的变化不敏感：证据等级：V 级。

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Does free tendon length influence the injury risk of the Achilles tendon? A finite element study

Purpose

The Achilles tendon is a common injury site, but anatomical risk factors for injury are relatively unexplored in the literature. This study aimed to evaluate whether changes in free tendon length would influence the results of a simulated rupture of the Achilles tendon.

Methods

Using a previously validated 3D finite element model of the free and aponeurotic Achilles tendon as a basis, two additional finite element models with 25% decreased and increased free tendon lengths were created. The finite element models were sequentially loaded from 2500 to 3500N in 100N increments, and the total volume of elements exhibiting a maximal principal strain above 10% was recorded. An Achilles tendon rupture was considered to have occurred when a continuous group of elements with a volume of at least 3 mm³ exhibited a maximum principal strain above 10%. Models were compared regarding the smallest load that met the rupture criterion and plots of the percentage of elements exhibiting maximum principal strains above 10% across the loading range. Sensitivity analyses assessed the influence of subtendon division variations and subtendon sliding restriction on the results.

Results

Rupture loads and plots of the percentage of elements with maximum principal strains above 10% were similar between models, regardless of the free tendon length. No models met the rupture criterion when simulations were run without subtendon sliding. Rupture loads in the subtendon division variation models were correlated with the subtendon cross-sectional areas.