摘要
背景:全髋关节置换是临床上常用的治疗方法,但是治疗时难以准确的判断出骨盆的准确方位,治疗后容易造成骨盆位置变动,并且植入假体后容易产生明显的角度偏差,难以判断假体的准确位置和方向。目的:研究全髋关节置换假体位置的角度及生物力学特性。方法:(1)对1名男性志愿者进行CT扫描,建立骨盆有限元模型,采用股骨柄前倾角为0°、20°和25°联合髋臼杯前倾35°、15°及10°三种不同的联合前倾技术进行全髋关节置换,给予240 N的力学加载,测定其峰值Von Mises应力;(2)取6具尸体标本,假体位置角度与志愿者相同,在240 N载荷下,利用电阻应变片技术测量股骨柄周缘骨皮质和髋臼前后壁应变情况。结果和结论:(1)股骨柄前倾角为25°髋臼杯前倾10°下髋臼峰值Von Mises应力变化升高25.7%;股骨柄前倾角为0°髋臼杯前倾35°下髋臼杯峰值Von Mises应力为135.21 MPa;股骨柄前倾角为20°髋臼杯前倾15°下髋臼峰值Von Mises应力为68.3 MPa;股骨柄前倾角为25°髋臼杯前倾10°下髋臼杯峰值Von Mises应力为134.2 MPa;股骨柄前倾角为0°髋臼杯前倾35°下内衬峰值Von Mises应力为6.8 MPa;股骨柄前倾角为20°髋臼杯前倾15°下内衬峰值Von Mises应力为3.9 MPa;股骨柄前倾角为25°髋臼杯前倾10°下内衬峰值Von Mises应力为6.7 MPa;股骨柄前倾角为0°髋臼杯前倾35°下股骨柄峰值Von Mises应力为127.1 MPa;股骨柄前倾角为20°髋臼杯前倾15°下股骨柄峰值Von Mises应力为100.2 MPa;股骨柄前倾角为25°髋臼杯前倾10°下股骨柄峰值Von Mises应力为128.2 MPa;(2)0°-35°和25°-10°股骨柄周缘骨皮质和髋臼前后壁应变,显著大于20°-15°。提示在股骨柄前倾20°联合臼杯前倾15°效果理想,有助于关节功能恢复。
BACKGROUND： Total hip arthroplasty is a commonly used treatment, but it is difficult to accurately determine the position of the pelvis, which is easy to cause pelvic displacement postoperatively. Additionally, the implant is likely to present with angle deviation, and the precise location and direction of prosthesis is difficult to identify.OBJECTIVE： To study the position and biomechanical characteristics of prosthesis in total hip arthroplasty.METHODS： （1） One male volunteer received CT examination, and a finite element model of the pelvic was established.Three acetabular placement positions （abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°, 15°and 10°） were used to perform total hip arthroplasty, and the peak von Mises stress was detected under a load of 240 N.（2） Six cadaver specimens were collected and received the same interventions with the former experiment, and the stress changes at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall were measured using resistance strain technology.RESULTS AND CONCLUSION： （1） The peak von Mises stress in the acetabulum at abduction angle of 25° combined with anteversion angle of 10° increased by 25.7%. The peak von Mises stress in the acetabular cup at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 135.21, 68.3 and 134.2 MPa, respectively.The peak von Mises stress in the lining at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 6.8, 3.9 and 6.7 MPa, respectively. The peak von Mises stress in the femoral shaft at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 127.1, 100.2 and 128.2 MPa,respectively. （2） The stress at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall at abduction angles of 0° and 25° combined with anteversion angles of 35° and 10° was significantly higher than that at abduction angle of 20° combined with anteversion angle of 15°. To conclude, an abduction angle of 20° combined with anteversion angle of 15° is conductive for functional recovery of the joint.
出处
《中国组织工程研究》
CAS
北大核心
2017年第11期1652-1657,共6页
Chinese Journal of Tissue Engineering Research
基金
河南省教育科学"十二五"规划2013年度课题([2013]-JKGHB-0098)~~
