| 人工股骨头置换术中置入不同直径假体球头的有限元分析 |
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Received:March 18, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王学斌 |
WANG Xue-bin |
宁波大学医学院, 浙江 宁波 315211 |
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| 庞清江 |
PANF Qing-jiang |
中国科学院大学宁波华美医院, 浙江 宁波 315010 |
Huamei Hospital, University of Chinese Academy of Science, Ningbo 315010, Zhejiang, China |
pqjey@sina.com |
| 余霄 |
YU Xiao |
中国科学院大学宁波华美医院, 浙江 宁波 315010 |
Huamei Hospital, University of Chinese Academy of Science, Ningbo 315010, Zhejiang, China |
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| 期刊信息：《中国骨伤》2020年33卷，第6期，第558-563页 |
| DOI：10.12200/j.issn.1003-0034.2020.06.014 |
| 基金项目:浙江省医药卫生科技资助项目（编号：2018KY156）；宁波市自然科学基金（编号：2019A610242）；中国科学院大学宁波华美医院“华美研究基金”（编号：2020HMKY18） |
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目的：针对老年股骨颈骨折行人工股骨头置换术中，借助三维有限元分析的方法，探讨置入不同直径的假体球头后的髋关节生物力学变化，观察对髋关节应力分布变化，以便选择出合适的假体球头尺寸。
方法：利用薄层CT资料及人工股骨头假体相关参数建立装配有不同假体球头直径的人工股骨头置换术后髋关节有限元模型（M0：术前模型；M1：球头直径=原股骨头直径；M2：球头直径=原股骨头直径＋1 mm；M3：球头直径=原股骨头直径-1 mm；M4：球头直径=原股骨头直径-2 mm），并加载关节合力及相关肌肉的负荷，模拟人缓慢行走时单足站立状态，分析不同直径假体植入后髋臼周围骨质及软骨的应力分布及变化。
结果：（1）M1～M4中骨盆均出现了不同程度的应力集中，M3的骨盆Von Mises应力峰值为44.8 MPa，与术前最为接近，增量约13.4%，且M3的骨盆位移在术后4组模型中最小，为1.40 mm；其次是M1，应力峰值为47.3 MPa，增量约19.7%，骨盆位移为1.59 mm。（2）在髋臼区域，M3的Von Mises应力峰值为23.3 MPa，与术前最为接近，增量约6.3%，其次是M1，应力峰值为24.0 MPa，增量约8.1%。（3）髋臼软骨上，M1与M3的应力分布同术前相似，且M3的Von Mises应力峰值为18.5 MPa，与术前最为接近；其次是M1，应力峰值为22.5 MPa。（4）M1～M4均在人工股骨头的外上象限出现不同程度的应力集中，而在其下方表现为应力遮挡；其中M3的Von Mises应力分布较其余模型更为均匀，其峰值70.8 MPa为各组中最低，其次为M1（80.7 MPa）。
结论：在行人工股骨头置换术时，建议优先使用比原股骨头直径小1 mm的假体球头，其次是与原股骨头直径相等的假体球头，来获得与置换术前的髋关节最接近的自然力学特性，降低因尺寸差异导致的并发症风险。 |
| [关键词]:髋假体 关节成形术,置换 股骨头 有限元分析 |
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| Finite element analysis of different diameter prosthesis ball head in artificial femoral head replacement |
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Abstract:
Objective: In order to select the proper size of prosthesis ball head,the biomechanical changes of hip joint using different diameter prosthesis ball head was studied by three-dimensional finite element analysis.
Methods: The thin-layer CT data and related parameters of artificial femoral head prosthesis were used to establish the finite element model of hip joint after artificial femoral head replacement with different ball diameter of prosthesis(M0:preoperative model;M1:ball head diameter=original femoral head diameter;M2:ball head diameter=original femoral head diameter+1 mm;M3:Ball head diameter=Original femoral head diameter -1 mm;M4:ball head diameter=original femoral head diameter-2 mm). Loading the joint forces and related muscle loads were loaded,and the stress distribution and change of bone and cartilage around acetabulum were analyzed by simulating the standing state of one foot when walking slowly.
Results: (1) In M1 to M4,the stress concentration in pelvis was different. The peak value of Von Mises stress in the pelvis of M3 was 44.8 MPa,which was the closest to that before operation,with an increment of 13.4%. The displacement of the pelvis of M3 was the smallest in the four groups after operation,with an increment of 1.40 mm. The next was M1,with a peak value of 47.3 MPa,with an increment of 19.7%,and a pelvic displacement of 1.59 mm. (2) In acetabulum area,the peak value of Von Mises stress in M3 was 23.3 MPa,which was the closest to that before operation,with an increment of about 6.3%,followed by M1,with a peak value of 24.0 MPa and an increment of about 8.1%. (3) On the acetabulum cartilage,the stress distribution of M1 and M3 was similar to that before operation,and the peak value of Von Mises stress of M3 was 18.5 MPa,which was the closest to that before operation,followed by M1,which was 22.5 MPa. (4) M1 to M4 showed different degree of stress concentration in the outer upper quadrant of the artificial femoral head,but showed stress shielding under it;among them,the von Mises stress distribution of M3 was more uniform than that of other models,and its peak value(70.8 MPa) was the lowest in each group,followed by M1(80.7 MPa).
Conclusion: When femoral head replacement is performed,it is suggested that the prosthesis ball head with the diameter less than 1 mm and the prosthesis ball head with the same diameter as the original femoral head should be used first,so as to obtain the closest natural mechanical characteristics of the hip joint before the replacement and reduce the risk of complications caused by size differences. |
| KEYWORDS:Hip prosthesis Arthroplasty,replacement Femur head Finite element analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王学斌,庞清江,余霄.人工股骨头置换术中置入不同直径假体球头的有限元分析[J].中国骨伤,2020,33(6):558~563 |
| 英文格式: | WANG Xue-bin,PANF Qing-jiang,YU Xiao.Finite element analysis of different diameter prosthesis ball head in artificial femoral head replacement[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(6):558~563 |
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