髋臼腔隙性骨缺损全髋关节置换中应用钛丝网前后的生物力学变化  

Biomechanical alterations in the treatment of acetabular cavitary bone defects using titanium metal mesh

作　　者：刁乃成[1] 李强[1] 王志义[1] 黄永玲[2] 张国强[2] 

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京市100050 [2]北京百慕航材高科技股份有限公司,北京市100095

出　　处：《中国组织工程研究与临床康复》2008年第26期5047-5050,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：钛合金网架重建髋臼技术在临床上得到一定应用,但目前国内外对钛丝网应用前后的髋臼力学状况的报道很少。目的：比较在有髋臼腔隙型骨缺损的全髋关节置换中应用钛丝网前后髋臼周围的应变变化。设计、时间及地点：对照观察实验,于2005-08/2006-01在首都医科大学附属北京友谊医院骨科生物力学实验室进行。材料：取6具25-35岁男性新鲜尸体骨盆（含双侧股骨中上段）,切除附着的软组织,保留骨膜及维持骨盆完整性的韧带,保证骶髂关节未破坏。方法：在双侧髋臼负重区人工制造出占髋臼1/4的腔隙型缺损。将每具标本左右两髋关节随机分成两组,每组6个髋。随机选取一侧行单纯骨水泥＋髋臼假体固定作为无钛丝网组,另一侧行钛丝网＋骨水泥＋髋臼假体固定作为有钛丝网组,试验均在CSS-11101型生物力学试验机上进行。试验中模拟单足站立,从上方对骨盆垂直加载,持续加压,观察髋臼内壁、负重区应变分布情况。主要观察指标：髋臼内壁和臼顶负重区应变的变化。结果：髋臼负重区和髋臼底部的应变变化规律相同,即随着负荷的增加,这些区应变增加明显,主要表现为压应力。未用钛丝网的一侧的应变增长较快,其应变值远远大于应用钛丝网一侧。结论：钛丝网能有效分散髋臼承受的应力,避免应力的集中,对于髋臼负重区、髋臼中心区的效果均明显。BACKGROUND： Titanium （Ti） metal mesh for acetabulum reconstruction has been used in clinic. However, there are few reports about acetabular mechanics before and after the surgery. OBJECTIVE： To compare strain changes around the operated acetabulum with and without Ti-mesh biomechanically in the treatment of acetabular cavity bone defects. DESIGN, TIME AND SETTING： Controlled observation was performed at Biomechanical Laboratory of Department of Orthopedics, Beijing Friendship Hospital of Capital Medical University from August 2005 to January 2006. MATERIALS： Six fresh male cadaveric pelvic specimens were used including bilateral superior and middle segment of the femur. All adhesive soft tissues were detached, and ligaments and sacroiliac joint were kept intact. METHODS： A cavity defect about 1/4 area of acetabulum was made in weight loading area at bilateral acetabulum of each pelvis. The fight and left hips were randomly divided into 2 groups （6 hips）. Ti-mesh was used randomly in one side of each pelvis with cemented acetabular prosthesis as test group, and the other side of pelvis with same procedure only without Ti-mesh was treated as control group. The loading mode of single-leg stance was simulated. The pelvis and femur were attached to a loading jig that provided reproducible positioning in a Universal Material Testing Machine. Increasing vertical stress was loaded on the fixed pelvis. Measurements were made with a strain gauge to observe strain distribution. MAIN OUTCOME MEASURES： Strain changes on the medial wall and dome region of acetabulum. RESULTS： With the use of Ti-mesh, the strain distribution of the acetabulum changed. With the increase of loading, the strain on the medial wall and dome region of acetabulum was significantly increased as compressive stress, especially the side without Ti-mesh （P 〈 0.05）. CONCLUSION： Ti-mesh can disperse the stress acted on the acetabulum, therefore effectively avoid stress concentration on the medial wall and dome region of acetabul

关 键 词：生物力学 髋臼 骨缺损 全髋置换 

分 类 号：R318[医药卫生—生物医学工程]