从模拟到赛场：将有限元建模转化为儿童前交叉韧带损伤与康复的临床决策
简介
该文综述了个体化有限元建模在儿童与青少年前交叉韧带（ACL）损伤及康复中的应用。作者整合现有研究，展示了如何利用验证模型评估临床松弛度测试、ACL重建变量及运动特异性韧带负荷，并指出当前模型多依赖成人组织参数、缺乏年龄特异性验证数据。文章提出一个转化框架，将模拟结果直接关联至手术规划、支具处方及重返运动决策，旨在推动儿童膝关节“数字孪生”系统的发展，以降低再…
英文摘要
Anterior cruciate ligament injuries in children and adolescents are rising, and young athletes remain at high risk for reinjury, graft failure, and early joint degeneration despite advances in reconstruction and rehabilitation. A major barrier to improving outcomes is the lack of tools that can noninvasively quantify internal knee mechanics, tissue loading, and the biomechanical consequences of surgical and rehabilitation choices in growing patients. In this narrative, we synthesized emerging work on subject-specific finite element modeling of the pediatric knee and integrated it with clinical knowledge of anterior cruciate ligament injury and management. Drawing on peer-reviewed work from multiple groups, we emphasize pediatric and adolescent applications of these modeling approaches. Rather than presenting new data, we use representative studies to illustrate how validated models have been constructed, evaluated, and applied to clinical laxity testing, ACL reconstruction variables, movement-specific ligament loading, orthotic assessment, and rehabilitation decision-making. We then highlight the striking imbalance between adult and pediatric knee modeling, emphasizing key limitations such as reliance on adult soft tissue material properties, sparse age-specific validation data, and fragmented workflows for integrating imaging, motion analysis, and simulation. Building on these insights, we propose a translational framework that links model outputs directly to clinical decision points in pediatric sports medicine, including surgical planning, brace and orthosis prescription, and return-to-sport assessment. We conclude by outlining a roadmap toward pediatric digital twin systems, in which rigorously validated, patient-specific simulations become routine tools to personalize treatment, reduce reinjury risk, and protect long-term joint health in young athletes.