膝内翻对骨盆─腰椎矢状位序列影响的有限元分析  

Finite element analysis for effect of varus knee on sagittal sequence of pelvis lumbar spine

作　　者：周恩昌[1] 唐萍[1] 殷浩[2] 朱传英[1] 刘士明[1] 

机构地区：[1]聊城市第二人民医院骨科,山东252601 [2]合肥市第一人民医院关节骨科

出　　处：《中国骨与关节损伤杂志》2017年第12期1233-1236,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的通过有限元分析的方法,研究膝内翻对骨盆-腰椎矢状位序列的影响。方法利用逆向建模技术,将包含正常成人志愿者脊柱至双足的三维CT数据,导入Mimics 10.0、Geomagic 2012软件中对相关组织进行重建,然后在Hypermesh 13.0软件中进行网格划分,赋予材料属性,在Abaqus 6.14中添加的重力载荷,并在胫骨近端添加向外的位移量,使膝关节产生内翻变形。结果无论双下肢膝关节在中立位还是在内翻位,L4、5、L5S1的应力大于其他节段,差异均有统计学意义(P<0.05)。与中立位相比,膝内翻会导致髋关节接触面积(CAH)减少。CAH减小与骶骨倾斜角(SS)之间存在明显负相关(r=-0.803),SS角增大会导致腰椎前凸角(LL)同步增加。结论本研究显示膝内翻会引起骨盆绕股骨头前倾,骨盆应力通过L5椎体分散到其他腰椎节段,造成腰椎生理前凸增加。同时,由于腰椎后侧肌群的代偿性张力增大,会进一步加重腰椎前凸。Objective To study the effect of varus knee on the sagittal sequence of pelvis lumbar spine by finite elementanalysisl Methods The reverse modeling technology was used and the bone of normal adult volunteers was scanned by CT.Mimics 10.0 and Geomagic 2012 software were used to reconstruct the 3D structure of bones. All the models were meshed inhypermesh 13.0, and given the material properties. The gravity load was added on the upper surface of L1, and the outwarddisplacement was added at the proximal tibial to simulate varus deformity of the knee joint in Abaqus 6.14. Results Thestress of L,5 and L^I was greater than that of other segments, whether the knee joint was in neutral position or genu varus（P 〈0.05）. Genu varus could lead to reduction of the contact area of the hip joint. There was a significant negative correlationbetween the decrease of CAH and the angle of SS （1＂ =-0.803）, and the increasing of SS angle leads to LL angle changesimultaneously. Conclusion The study shows that the varus knee will cause the pelvis anteverting around the femoral head,pelvic stress spreads through the lumbar 5 vertebral column to other lumbar segments, resulting in increased lordosis in thelumbar spine. At the same time, due to the compensatory tension of the lumbar posterior muscles, the lumbar lordosis will befurther increased.

关 键 词：膝内翻 骨盆 腰椎 矢状位 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程]