Marcelo DE Almeida Ferrer, Mariana DE Oliveira Lobo, Laís Maria Pinto Almeida, Anderson Freitas, Sílvio Leite DE Macedo Neto, Leonardo Morais Paiva, Leonardo Rigobello Battaglion
{"title":"前交叉韧带重建髌骨骨折:体外分析。","authors":"Marcelo DE Almeida Ferrer, Mariana DE Oliveira Lobo, Laís Maria Pinto Almeida, Anderson Freitas, Sílvio Leite DE Macedo Neto, Leonardo Morais Paiva, Leonardo Rigobello Battaglion","doi":"10.1590/1413-785220233102e259557","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine, by biomechanical analysis, safe patellar cut limits in anterior cruciate ligament (ACL) reconstruction that minimize fracture risks.</p><p><strong>Methods: </strong>From three-dimensional reconstruction, triangular cuts were made in the patella, with a depth of 6.5 mm and variable width and length (10 to 20 mm and 8 to 12 mm, respectively, both with an interval of 1 mm). The combinations of cuts constituted 55 models for tests, with five variations in width and 11 variations in length, tested with the finite element method (FEM).</p><p><strong>Results: </strong>The mean of the localized principal maximum (traction force) values was 4.36 Pa (SD 0.87 ± 0.76) and the localized principal minimum (compression force) was -4.33 Pa (SD 1.05 ± 1.11). Comparing width and length to the tension force of the values of the main maximum, we found statistical significance from 11 mm for width and 13 mm for length.</p><p><strong>Conclusion: </strong>In ACL reconstruction, the removal of the patellar bone fragment is safe for fragments smaller than 11 mm in width and 13 mm in length, which corresponds to 24% of the width and 28% of the length of the patella used. <b><i>Level of Evidence II, Comparative Prospective Study.</i></b></p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 2","pages":"e259557"},"PeriodicalIF":0.5000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158969/pdf/","citationCount":"0","resultStr":"{\"title\":\"PATELLAR FRACTURE IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: IN VITRO ANALYSIS.\",\"authors\":\"Marcelo DE Almeida Ferrer, Mariana DE Oliveira Lobo, Laís Maria Pinto Almeida, Anderson Freitas, Sílvio Leite DE Macedo Neto, Leonardo Morais Paiva, Leonardo Rigobello Battaglion\",\"doi\":\"10.1590/1413-785220233102e259557\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine, by biomechanical analysis, safe patellar cut limits in anterior cruciate ligament (ACL) reconstruction that minimize fracture risks.</p><p><strong>Methods: </strong>From three-dimensional reconstruction, triangular cuts were made in the patella, with a depth of 6.5 mm and variable width and length (10 to 20 mm and 8 to 12 mm, respectively, both with an interval of 1 mm). The combinations of cuts constituted 55 models for tests, with five variations in width and 11 variations in length, tested with the finite element method (FEM).</p><p><strong>Results: </strong>The mean of the localized principal maximum (traction force) values was 4.36 Pa (SD 0.87 ± 0.76) and the localized principal minimum (compression force) was -4.33 Pa (SD 1.05 ± 1.11). Comparing width and length to the tension force of the values of the main maximum, we found statistical significance from 11 mm for width and 13 mm for length.</p><p><strong>Conclusion: </strong>In ACL reconstruction, the removal of the patellar bone fragment is safe for fragments smaller than 11 mm in width and 13 mm in length, which corresponds to 24% of the width and 28% of the length of the patella used. <b><i>Level of Evidence II, Comparative Prospective Study.</i></b></p>\",\"PeriodicalId\":55563,\"journal\":{\"name\":\"Acta Ortopedica Brasileira\",\"volume\":\"31 2\",\"pages\":\"e259557\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158969/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Ortopedica Brasileira\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/1413-785220233102e259557\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Ortopedica Brasileira","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/1413-785220233102e259557","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的:通过生物力学分析，确定前交叉韧带(ACL)重建中安全的髌骨切面范围，以减少骨折风险。方法:从三维重建出发，在髌骨处做三角形切口，切口深度为6.5 mm，宽度和长度分别为10 ~ 20mm和8 ~ 12mm，间隔均为1mm。这些切割组合构成了55个用于测试的模型，其中宽度有5个变化，长度有11个变化，并采用有限元法进行了测试。结果:局部主最大值(牵引力)平均值为4.36 Pa (SD 0.87±0.76)，局部主最小值(压缩力)平均值为-4.33 Pa (SD 1.05±1.11)。比较宽度和长度对拉力的主要最大值的值，我们发现从宽度11 mm到长度13 mm有统计学意义。结论:在ACL重建中，对于宽度小于11 mm、长度小于13 mm的碎片，即所使用髌骨宽度的24%和长度的28%，髌骨碎片的移除是安全的。证据水平II，比较前瞻性研究。
PATELLAR FRACTURE IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: IN VITRO ANALYSIS.
Objective: To determine, by biomechanical analysis, safe patellar cut limits in anterior cruciate ligament (ACL) reconstruction that minimize fracture risks.
Methods: From three-dimensional reconstruction, triangular cuts were made in the patella, with a depth of 6.5 mm and variable width and length (10 to 20 mm and 8 to 12 mm, respectively, both with an interval of 1 mm). The combinations of cuts constituted 55 models for tests, with five variations in width and 11 variations in length, tested with the finite element method (FEM).
Results: The mean of the localized principal maximum (traction force) values was 4.36 Pa (SD 0.87 ± 0.76) and the localized principal minimum (compression force) was -4.33 Pa (SD 1.05 ± 1.11). Comparing width and length to the tension force of the values of the main maximum, we found statistical significance from 11 mm for width and 13 mm for length.
Conclusion: In ACL reconstruction, the removal of the patellar bone fragment is safe for fragments smaller than 11 mm in width and 13 mm in length, which corresponds to 24% of the width and 28% of the length of the patella used. Level of Evidence II, Comparative Prospective Study.
期刊介绍：
A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
