三维有限元分析大转子骨瓣转移治疗股骨头缺血坏死应力分布变化  

Three-dimensional finite element analysis on stress distribution after greater trochanter bone flap for treating osteonecrosis of the femoral head

作　　者：张天一[1,2] 董巍 米盼盼[1] 孔繁林[1] 朱军[1] 吴建伟[1] 乔金环[1] 樊国峰[1] 田丰德[2] Zhang Tian-yi;Dong Wei;Mi Pan-pan;Kong Fan-lin;Zhu Jun;Wu Jian-wei;Qiao Jin-huan;Fan Guo-feng;Tian Feng-de(Department of Orthopedics,China National Petroleum Corporation Central Hospital,Langfang 065000,Hebei Province,China;Affiliated Zhongshan Hospital,Dalian University,Dalian 116001,Liaoning Province,China)

机构地区：[1]中国石油中心医院骨科,河北省廊坊市065000 [2]大连大学附属中山医院,辽宁省大连市116001

出　　处：《中国组织工程研究》2018年第7期1090-1095,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(30670542)~~

摘　　要：背景:三维有限元分析已经被较多骨科学者应用,但作为股骨头坏死保髋治疗术后评价结果不一。目的:研究运用三维有限元方法检测大转子骨瓣转移治疗股骨头坏死后股骨头的生物力学变化及股骨近端生物力学改变,验证该术式力学安全性及有效性。方法:选取1例单侧股骨头坏死ARCOⅢ期患者并行带血管蒂大转子骨瓣移植术患者,根据术前及术后6个月股骨近段的计算机断层成像技术CT数据,以DICOM格式保存,用计算机辅助技术及专业医学建模软件MIMICS及HYPERMESH建立股骨近段三维几何模型分为正常组、坏死组及修复组三维有限元模型。应用有限元分析软件ANSYS模拟人体站立及运动等不同情况,将模型自由网格划分,赋予材料参数,建立正常股骨近段,股骨头坏死骨缺损和运用大转子骨瓣转移修复骨缺损的三维有限元模型。载荷加载于不同的有限元模型,观察3组模型股骨头的最大位移和股骨近段的应力分布情况。结果与结论:(1)在同一载荷下,此3组模型的最大位移值分别为:正常组0.61 mm,坏死组0.66 mm,修复组0.61 mm;坏死模型的最大Von Mises应力值远大于正常模塑。修复模型的最大Von Mises应力值逐渐降低,与正常值接近;(2)此3组模型均提示股骨颈区小转子上方出现应力集中,在转子位置的最大应力,坏死模型较正常增高,而修复后该处的最大应力值逐渐增高,但仍低于骨的破坏应力;(3)结果证实,运用大转子骨瓣转移修复股骨头坏死骨缺损后的股骨头的最大应力值及最大位移值更接近正常,大转子区作为修复股骨头骨缺损的骨瓣供区是安全可靠的。BACKGROUND:Three-dimensional finite element analysis has been used by many scholars from department of orthopedics,but the results of postoperative evaluation of hip preserving treatment for osteonecrosis of femoral head are different.OBJECTIVE:To study the biomechanical changes of the femoral head and the biomechanical changes of the proximal femur after greater trochanter bone flap for the treatment of femoral head necrosis using three-dimensional finite element method,and to verify the mechanical safety and effectiveness.METHODS:One case of unilateral femoral head necrosis in ARCOIII stage undergoing parallel vascularized greater trochanter bone flap transplantation was selected.Computed Tomography data of proximal femur were collected before and 6 months after the operation,and preserved in DICOM format.With the aid of computer technology,professional medical modeling software,MIMICS and HYPERMESH,were used to establish the three-dimensional geometric models of the proximal femur.These models were divided into normal group,necrosis group and repair group.Finite element analysis software ANSYS was utilized to simulate human body standing and movement in different situations.The model was divided by free mesh,and given material parameters to establish normal proximal femur,femoral head necrosis and bone defect.Greater trochanter bone flap was applied in repairing three-dimensional finite element model of bone defect.Loads were loaded on different finite element models.The maximum displacement of the femoral head and the stress distribution in the proximal femur of the three groups were observed under different loading models.RESULTS AND CONCLUSION:(1)Under the same load,the maximum displacement of the three sets of models was 0.61 mm in the normal group,0.66 mm in the necrosis group,and 0.61 mm in the repair group,respectively.Maximum Von Mises stress was greater in necrosis model than in the normal molding.The maximum Von Mises stress gradually decreased in the repair model,and was close to normal value.(2)Thr

关 键 词：组织工程 股骨头坏死 生物力学 

分 类 号：R318[医药卫生—生物医学工程]