全髋关节置换假体不同角度的生物力学特点

发布时间：2018-05-28 19:42

本文选题：关节成形术 + 置换　；参考：《中国组织工程研究》2017年11期

【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。
[Abstract]:Background: total hip replacement (THR) is a commonly used method in clinical treatment. However, it is difficult to accurately determine the exact position of pelvis after treatment, and it is easy to cause pelvic position change after treatment, and it is easy to produce obvious angle deviation after implantation of prosthesis. It is difficult to determine the exact position and direction of the prosthesis. Objective: to study the angle and biomechanical characteristics of total hip replacement prosthesis. Methods CT scan was performed on a male volunteer and pelvic finite element model was established. Total hip arthroplasty was performed with three different combined anterior tilt techniques, the femoral shaft anteversion angle was 0 掳, 20 掳and 25 掳, and the acetabular cup was tilted 35 掳, 15 掳and 10 掳, respectively. Under 240N mechanical loading, the peak Von Mises stress of 6 cadavers was measured. The position of the prosthesis was the same as that of the volunteers. The strain of anterior and posterior wall around the femoral stalk and acetabular was measured by the resistance strain gauge technique. Results and conclusion the peak Von Mises stress of acetabular tip increased by 25.7 when the anteversion angle of femoral petiole was 25 掳acetabular cup anteversion 10 掳, the peak Von Mises stress of acetabular cup was 135.21 MPA when the femoral petiole inclination angle was 0 掳acetabular cup anteversion 35 掳, and the femoral stalk anteversion angle was 20 掳hip. The peak Von Mises stress of acetabular was 68.3 MPA at 15 掳anterior dip of acetabular cup, 134.2 MPa at 25 掳acetabular cup anteversion 10 掳, 6.8MPa at 0 掳acetabular cup anteversion 35 掳. The peak Von Mises stress is 3.9 MPA at 20 掳acetabular cup anteversion 15 掳, Von Mises stress 6.7 MPA at 25 掳acetabular cup anteversion 10 掳, and 0 掳acetabular cup forward tilt 35 掳femoral stalk. The peak Von Mises stress was 127.1 MPA, the peak Von Mises stress of femoral stalk was 100.2 MPA at 20 掳acetabular cup anteversion 15 掳, and the peak Von Mises stress was 128.2 MPA ~ 35 掳-35 掳and 25 掳-10 掳Von Mises stress at 10 掳anterior tilt of acetabular cup. Anterior and posterior wall strain of bone cortex and acetabular, It was significantly greater than 20 掳-15 掳. The results suggest that 20 掳anterior tilt of femoral petiole combined with 15 掳anterior dip of acetabular cup is effective and helpful to the recovery of joint function.
【作者单位】：南阳医学高等专科学校;
【基金】：河南省教育科学“十二五”规划2013年度课题([2013]-JKGHB-0098)~~
【分类号】：R687.4

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