与幼年猪模型相比，早期青春期猪模型的前交叉韧带重建具有更好的前稳定性，但组织功能相似

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-09-04 DOI:10.1016/j.clinbiomech.2025.106667

Kaan Gurbuz , Yukun Zhang , Logan Opperman , Jeffrey T. Spang , Matthew B. Fisher

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引用次数: 0

摘要

背景：儿童前交叉韧带损伤在过去二十年中有所增加。手术重建通常是必要的，以恢复关节稳定性和防止继发性损伤。保留身体的前交叉韧带重建通常用于青春期前患者，以尽量减少生长障碍的风险。然而，这种技术也被用于青少年。年龄对保骨重建后关节稳定性和组织功能的影响尚不清楚。本研究旨在比较幼年期和青春期早期猪关节保留重建的初始生物力学结果。方法采用机器人检测系统对12头猪后肢进行检测，每年龄组6头。在完整的胫骨上施加前后负荷、压缩负荷和内翻扭矩，切断前交叉韧带，并在屈曲40°和60°时重建前交叉韧带。采用叠加原理计算软组织受力。研究发现，与青少年关节相比，青少年早期关节保留骨关节重建在胫骨前负荷和压迫下具有更好的前路稳定性，尤其是在关节尺寸标准化时。内侧副韧带撑开和内侧半月板压迫的贡献在早期青少年组60°屈曲重建后显示较小的变化。其他关节运动学和组织力在两组之间相似。这些研究结果表明，骨骼成熟度影响保留前交叉韧带重建后的关节稳定性，支持其对年轻和早期青少年患者的可行性。这项研究为年轻患者的外科治疗提供了生物力学的见解，并强调了使用年龄特异性模型来评估儿科外科技术的重要性。

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Physeal-sparing anterior cruciate ligament reconstruction in an early adolescent porcine model provides better anterior stability but similar tissue function compared to a juvenile porcine model

Background

Pediatric anterior cruciate ligament injuries have increased over the past two decades. Surgical reconstruction is often necessary to restore joint stability and prevent secondary injuries. Physeal-sparing anterior cruciate ligament reconstruction is commonly used in prepubertal patients to minimize the risk of growth disturbances. However, this technique has also been used for adolescents. The effect of age on joint stability and tissue function following physeal-sparing reconstruction remains unclear. This study aimed to compare initial biomechanical outcomes of physeal-sparing reconstruction within juvenile and early adolescent porcine joints.

Methods

Twelve porcine hindlimbs (n = 6 per age group) were tested using a robotic testing system. Anterior-posterior loading, compression loading, and varus-valgus torque were applied to the tibia in the intact, anterior cruciate ligament transected, and anterior cruciate ligament reconstructed states at 40° and 60° of flexion. Soft tissue forces were calculated by the principle of superposition.

Findings

Physeal-sparing reconstruction in early adolescent joints resulted in superior anterior stability under anterior tibial loading and compression compared to juvenile joints, especially when normalized for joint size. Medial collateral ligament distraction and medial meniscus compression contributions showed smaller changes following reconstruction in the early adolescent group at 60° of flexion. Other joint kinematics and tissue forces were similar between groups.

Interpretation

These findings suggest that skeletal maturity influences joint stability following physeal-sparing anterior cruciate ligament reconstruction, supporting its viability for both younger and early adolescent patients. This study provides biomechanical insights into surgical treatments for young patients and underscores the importance of using age-specific models to evaluate pediatric surgical techniques.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.