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Femoral entheseal shape and attachment angle as potential risk factors for anterior cruciate ligament injury
Journal of the Mechanical Behavior of Biomedical Materials ( IF 3.9 ) Pub Date : 2018-08-30 , DOI: 10.1016/j.jmbbm.2018.08.045
Callan M. Luetkemeyer , Benjamin C. Marchi , James A. Ashton-Miller , Ellen M. Arruda

Although non-contact human ACL tears are a common knee injury, little is known about why they usually fail near the femoral enthesis. Recent histological studies have identified a range of characteristic femoral enthesis tidemark profiles and ligament attachment angles. We tested the effect of the tidemark profile and attachment angle on the distribution of strain across the enthesis, under a ligament stretch of 1.1. We employed a 2D analytical model followed by 3D finite element models using three constitutive forms and solved with ABAQUS/Standard. The results show that the maximum equivalent strain was located in the most distal region of the ACL femoral enthesis. It is noteworthy that this strain was markedly increased by a concave (with respect to bone) entheseal profile in that region as well as by a smaller attachment angle, both of which are features more commonly found in females. Although the magnitude of the maximum equivalent strain predicted was not consistent among the constitutive models used, it did not affect the relationship observed between entheseal shape and maximum equivalent strain. We conclude that a concave tidemark profile and acute attachment angle at the femoral ACL enthesis increase the risk for ACL failure, and that failure is most likely to begin in the most distal region of that enthesis.



中文翻译:

股骨包膜的形状和附着角度是前交叉韧带损伤的潜在危险因素

尽管非接触式人类ACL眼泪是常见的膝关节损伤,但对于为什么它们通常在股骨周围附近失败的原因知之甚少。最近的组织学研究已经确定了一系列特征性的股骨假体潮线轮廓和韧带附着角度。我们在1.1韧带拉伸下测试了潮痕轮廓和附着角对整个网点应变分布的影响。我们采用2D分析模型,然后采用三种本构形式的3D有限元模型,并使用ABAQUS / Standard求解。结果表明,最大等效应变位于ACL股骨假体的最远端区域。值得注意的是,该区域的凹形(相对于骨骼)的合缝轮廓以及较小的附着角均显着增加了该应变,两者都是女性中较常见的特征。尽管在所使用的本构模型之间预测的最大等效应变的大小不一致,但它不会影响封装形状与最大等效应变之间的关系。我们得出的结论是,股骨ACL假体处的凹痕标记轮廓和锐角附着会增加ACL失败的风险,并且最有可能在该假体的最远端区域开始失败。

更新日期:2018-08-30
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