针刀松解腘肌治疗膝骨关节炎力学机制的有限元分析OA

Objective To evaluate impact of needle-knife dissection of popliteus muscle on stress distribution of knee joint by establishing finite element models of knee joint before and after needle-knife intervention.Methods CT data from a patient(male,42 years old,weighted 82 kg,the course of disease ranged from 15 months,left side,K-L grade Ⅱ)with early-stage knee osteoarthritis(KOA)were used to construct a finite element model of knee joint by using Mimics 21.0,Geomagic 2021,Solid-Works 2021,and Ansys 2021R1.The distal tibia was fixed with complete constraints to simulate single-leg standing.A vertical downward force of 500 N was applied to the proximal femur,and 200 N upward force parallel to Q-angle was applied to quadri-ceps tendon.The knee joint was simulated at 30° and 90° flexion angles to compare stress distribution and magnitude changes in meniscus,femoral cartilage,and patellar cartilage before and after acupotomy intervention.Results At 30° of knee flexion,the peak surface stresses of femoral cartilage,patellar cartilage,and meniscus in intervention group decreased by 5.910 MPa(31.23％),0.441 MPa(2.05％),and 6.216 MPa(26.38％),respectively,compared with non-intervention group.At 90° of knee flexion,the corresponding decreases were 1.999 MPa(7.10％),2.736 MPa(6.49％),and 4.671 MPa(10.51％),respectively.After acupotomy release,the area of stress distribution increased,and abnormal stress concentration was alleviated.Conclu-sion Acupotomy release of popliteus muscle effectively improves stress distribution on tibiofemoral and patellofemoral joint surfaces,reduces peak stress on articular surfaces,and promotes more uniform stress distribution,thereby providing a thera-peutic approach for early-stage knee osteoarthritis.