全髋关节置换术中臼杯水平位移对股骨侧非骨水泥型假体-骨界面应力影响的有限元分析

doi:10.13418/j.issn.1001-165x.2018.05.015

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (5): 557-564.doi: 10.13418/j.issn.1001-165x.2018.05.015

全髋关节置换术中臼杯水平位移对股骨侧非骨水泥型假体-骨界面应力影响的有限元分析

邱卫华¹,　李鉴轶²,　林荔军³

1.南方医科大学第二临床医学院, 广州 510282; 2.南方医科大学基础医学院人体解剖学教研室, 广州 510515；
3.南方医科大学珠江医院骨科，广州 510282

收稿日期:2018-06-20 出版日期:2018-09-25 发布日期:2018-10-26
通讯作者: 林荔军，主任医师，教授，博士生导师，E-mail: linlijun1@126.com
作者简介:邱卫华（1979-），副主任医师，主要从事创伤骨科及关节外科，Tel：13826021302, E-mail:7251563@qq.com

Finite element analysis of the effect of acetabular cup horizontal displacement on the stress distribution in cementless femoral prosthesis-bone interface in total hip arthroplasty

QIU Wei-hua¹，LI Jian-yi²，LIN Li-jun³

1.Second Clinical Medicine School of Southern Medical University, Guangzhou 510282, China; 2.Department of Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China; 3.Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China

Received:2018-06-20 Online:2018-09-25 Published:2018-10-26

摘要/Abstract

摘要：

目的　利用三维有限元力学分析方法, 研究全髋关节置换术中臼杯水平位移对股骨侧非骨水泥型假体-骨界面应力分布的影响。方法　选取正常人体的骨盆及股骨为实验对象, 螺旋CT 扫描,利用计算机仿真技术对CT图像进行三维重建，建立髋关节及股骨模型，进行全髋关节置换的模拟手术, 臼杯位置从髋关节旋转中心外侧10mm处起，水平内移，每隔2 mm为一个实验组，至内移至旋转中心内侧10 mm，共分11个实验组。加载关节负荷，观察股骨侧假体-骨界面间的Von Mises应力分布情况, 对结果进行统计分析。结果　臼杯的水平位移没有改变股骨总体的应力云分布；各组假体-骨界面应力均值（4.728±2.152）-（5.431±2.465）MPa，均值有差异，差异有统计学意义；应力均值、极差、标准差均随内移而降低，呈高度的负相关。近端假体-骨界面的应力变化，与整个股骨的应力变化相似。结论　假体的水平内移可以降低股骨侧假体-骨界面间的Von Mises应力，内移可以使界面的应力分布更均匀。

关键词: 全髋关节置换术, 　臼杯, 　范式等效应力, 　应力分布, 　有限元分析

Abstract:

Objective　Using the three dimensional finite element analysis, the effect of acetabular cup horizontal displacement on the stress distribution in cementless femoral prosthesis-bone interface in total hip arthroplasty was studied.　Methods　Pelvis and femur of a normal human were scanned by sprial CT. Using the computer simulation technology, the three-dimensional model of the pelvis and femur was reconstructed, after which the total hip arthroplasty in the model was simulated. The horizontal position of the acetabular cup varied from -10 mm to +10 mm，compared to hip joint center, which was divided into 11 consecutive experimental groups averagely, each group was 2 mm in width. When a simulated load was applied, the Von Mises stress distribution in cementless femoral prosthesis-bone interface was observed and analyzed.　Results　The distribution pattern of the Von Mises stress in femur did not change with the horizontal displacement of acetabular cup. The stress mean of each group varied from (4.728±2.152)MPa to (5.431±2.465)MPa. The difference of mean was statistically significant. The mean, range and standard deviation of stress decreased with cup medialization, which showed that they were highly negatively correlated. The changes of stress in proximal prosthesis stem-bone interface were similar to those in the whole femoral prosthesis-bone interface.　Conclusion　The horizontal ingression of prosthesis decreases the stress in cementless femoral prosthesis-bone interface, and makes the stress more well-distributed as well.

Key words: Total hip arthroplasty, 　Acetabular cup, 　Von Mises stress, 　Stress distribution, 　Finite element analysis

邱卫华,李鉴轶,林荔军 . 全髋关节置换术中臼杯水平位移对股骨侧非骨水泥型假体-骨界面应力影响的有限元分析[J]. 中国临床解剖学杂志, 2018, 36(5): 557-564.

QIU Wei-hua，LI Jian-yi，LIN Li-jun. Finite element analysis of the effect of acetabular cup horizontal displacement on the stress distribution in cementless femoral prosthesis-bone interface in total hip arthroplasty[J]. Chinese Journal Of Clinical Anatomy, 2018, 36(5): 557-564.

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全髋关节置换术中臼杯水平位移对股骨侧非骨水泥型假体-骨界面应力影响的有限元分析

Finite element analysis of the effect of acetabular cup horizontal displacement on the stress distribution in cementless femoral prosthesis-bone interface in total hip arthroplasty

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