单髁置换术后膝关节内外侧间室应力变化有限元分析

发布时间：2018-01-22 05:32

本文关键词： 单髁置换术膝关节应力有限元分析　出处：《中国运动医学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的:采用有限元分析方法研究单髁置换术后膝关节表面应力变化,为深入了解单髁置换术优势及劣势提供依据。方法:对6例单髁置换术后及6例正常人膝关节屈伸活动时关节表面应力变化进行动态有限元分析,并与项目组前期全膝关节置换术后关节表面应力分析进行对比。结果:正常组屈曲30°以后内侧间室应力大于外侧间室(P0.05);单髁置换组屈曲0°、60°、90°时内侧间室应力大于外侧间室(P0.05);全膝置换组在所有屈曲角度下内侧间室应力大于外侧间室(P0.05)。屈曲60°及90°时单髁置换组内侧间室应力大于全膝置换组(P0.05);所有屈曲角度下,单髁置换组外侧间室应力大于全膝置换组外侧间室应力(P0.05);屈曲0°、30°、60°及120°时,单髁置换组外侧间室应力都大于正常膝组(P0.05)。结论:单髁置换术可增加膝关节关节面应力及加速对侧间室关节炎发展,从而影响手术远期疗效,但在严格把握手术适应症、优化手术操作、假体适当改良、指导患者合理康复后,该术式仍具有优势。
[Abstract]:Objective: to study the surface stress changes of knee joint after single condylar replacement by finite element analysis (FEM). Methods: the dynamic finite element analysis was carried out on the surface stress of 6 cases of single condylar replacement and 6 cases of normal knee joint during flexion and extension activity in order to provide the basis for further understanding the advantages and disadvantages of single condylar replacement. Results: the stress of medial interventricular after 30 掳flexion in normal group was greater than that of lateral interventricular chamber (P0.05). In the single condylar replacement group, the stress of the medial interventricular was greater than that of the lateral interventricular compartment at the flexion of 0 掳~ 60 掳~ 90 掳; The stress of medial interventricular in total knee replacement group was greater than that in lateral interventricular chamber at all flexion angles, and the stress of medial interventricular chamber in single condylar replacement group was greater than that in whole knee replacement group at flexion of 60 掳and 90 掳. At all flexion angles, the stress of the lateral interventricular in the single condylar replacement group was higher than that in the whole knee replacement group (P 0.05). When flexion was 0 掳, 30 掳, 60 掳and 120 掳. Conclusion: single condyle replacement can increase the stress of articular surface of knee joint and accelerate the development of contralateral ventricular arthritis, thus affecting the long-term outcome of the operation. But after strictly grasping the indication of operation, optimizing the operation operation, improving the prosthesis properly and guiding the patients to recover reasonably, the operation method still has advantages.
【作者单位】：昆明医科大学第一附属医院运动医学科;
【基金】：国家自然科学基金资助项目(81560372) 云南省国际合作项目(2013IA004) 云南省创新团队项目(2014HC018) 云南省医疗卫生内设研究机构项目(2014NS161)
【分类号】：R687.4
【正文快照】： 膝关节单髁置换术(unicompartmental knee arthro-plasty,UKA)因手术创伤小、保留正常骨量多、不破坏伸膝装置及前交叉韧带从而获得更接近于正常膝的功能等优势,是许多医生治疗膝关节内侧间室骨关节炎(osteoarthritis,OA)的首选方案[1,2]。但许多学者对UKA的临床疗效致怀疑态

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