三维有限元法分析钽棒置入治疗个体化股骨头坏死的力学效能

发布时间：2018-06-19 23:55

  本文选题：股骨头坏死 + 有限元分析　； 参考：《中国组织工程研究》2017年31期

【摘要】：背景:研究报道股骨头前外侧柱对保髋的疗效起到关键性的作用,而中日友好医院分型(CJFH分型)强调前外侧柱的重要性,目前此分型中L型钽棒置入治疗的三维有限元研究不多。目的:以钽棒置入术为例,建立正常、坏死和L型坏死区前外侧柱钽棒置入的髋关节仿真的三维有限元模型,并进行有限元分析及力学效能对比,探讨前外侧柱的完整性对保髋疗效的重要性,为CJFH分型的治疗提供生物力学依据。方法:股骨头坏死的CJFH分型中L1、L2、L3型的坏死髋关节三维模型和正常髋关节三维模型选用团队已经做好的模型。在此基础上建立钽棒置入坏死股骨头的三维有限元模型,进行有限元分析。观察正常股骨头、坏死股骨头和钽棒置入坏死股骨头皮质骨壳应力分布及最大Mises应力值,对比并进行统计分析。结果与结论:(1)L型坏死股骨头负重区皮质骨壳的最大Mises应力均较正常股骨头升高,其中L1型升高21.76%,L2型升高31.02%,L3型升高42.79%;(2)钽棒置入术后股骨头负重区皮质骨壳的最大Mises应力较术前下降,其中L1型下降13.38%,L2型下降8.81%,L3型下降11.45%;(3)表明当股骨头发生坏死时,因坏死骨承载应力下降,导致股骨头皮质骨壳应力集中,所以坏死较正常的最大应力大,而分型程度越高,皮质骨壳所要承载的应力集中就越大;钽棒置入后承载了一部分应力,分型程度越低,纠正越明显;(4)结果表明,钽棒置入术纠正了坏死股骨头皮质骨壳部分应力,钽棒在一定程度范围内可以进行塌陷预防及起到支撑软骨下骨的生物力学作用;坏死股骨头外侧柱的完整性影响保髋疗效,可能外侧柱的存留越多,保髋疗效越好,而CJFH分型程度越高,塌陷风险越高,保髋疗效也越差。
[Abstract]:Background: it is reported that the anterolateral column of femoral head plays a key role in the curative effect of hip preservation, while CJFH classification in Sino-Japanese Friendship Hospital emphasizes the importance of anterolateral column. At present, there are few three-dimensional finite element studies on L-type tantalum rod implantation in this classification. Objective: taking tantalum rod implantation as an example, a three dimensional finite element model of hip joint simulation was established for normal, necrotic and L-type necrotic areas with anterior and lateral column tantalum rods, and the finite element analysis and mechanical effectiveness comparison were carried out. To explore the importance of the integrity of anterolateral column for hip preservation, and to provide biomechanical basis for the treatment of CJFH classification. Methods: in the CJFH classification of femoral head necrosis, the three dimensional model of the necrotic hip joint of L1 and L2 and L3 type and the 3D model of the normal hip joint were used to select the model that had been made by the team. On this basis, a three-dimensional finite element model of tantalum rod implantation into the necrotic femoral head was established and analyzed by finite element method. The stress distribution and maximum Mises stress of cortical shell of necrotic femoral head and tantalum rod were observed and compared and analyzed statistically. Results and conclusion the maximum Mises stress of cortical bone shell in the load-bearing zone of the femoral head in the L-type necrosis of the femoral head was higher than that in the normal femoral head. The maximum Mises stress in the cortical shell of the loaded area of the femoral head was decreased after tantalum rod implantation, and the decrease of the L1 type was 13.38%, the decrease of the L2 type was 8.81% and the decrease of the L3 type was 11.453), which indicated that when the femoral head was necrotic, the maximum Mises stress of the femoral head was decreased by 42.79% and 42.79% respectively, and the maximum Mises stress of the cortical shell in the loaded area of the femoral head decreased by 8.81% and 11.453% after the implantation of tantalum rod. The stress concentration of the cortical shell of the femoral head is higher than the normal maximum stress because the stress of the necrotic bone decreases, and the higher the degree of classification is, the greater the stress concentration of the cortical bone shell is. The results showed that tantalum rod implantation corrected the partial stress of cortical shell of the necrotic femoral head. Tantalum bars can be used to prevent collapse and to support the subchondral bone in a certain extent. The integrity of the lateral column of necrotic femoral head affects the curative effect of hip preservation. The higher the degree of CJFH typing, the higher the risk of collapse and the worse the curative effect of hip preservation.
【作者单位】： 广西中医药大学附属桂林医院(桂林市中医医院);玉林市中西医结合骨科医院;广西中医药大学;
【基金】：广西壮族自治区卫计委(2014年)自筹经费科研课题项目(Z2014556)~~
【分类号】：R687.3
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