髋臼缺损程度对成人髋关节应力影响的三维有限元分析  

Effect of acetabular defect on hip stress in adults: three-dimensional finite element analysis

作　　者：田丰德 赵德伟[1,2] 李东怡 郭林[2] 安宁 张耀[2] 郝瑞胡[2] 崔大平[1] Tian Feng-de;Zhao De-wei;Li Dong-yi;Guo Lin;An Ning;Zhang Yao;Hao Rui-hu;Cui Da-ping(Ministry of Electronic Information and Electrical Engineering,Dalian University of Technology,Dalian 116024,Liaoning Province,China;Department of Joint Surgery,Zhongshan Hospital Affiliated to Dalian University,Dalian 116001,Liaoning Province,China)

机构地区：[1]大连理工大学电子信息与电气工程学部,辽宁省大连市116024 [2]大连大学附属中山医院关节外科,辽宁省大连市116001

出　　处：《中国组织工程研究》2018年第3期380-384,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(30670542)~~

摘　　要：背景:髋臼缺损是成人髋关节发育不良的典型特征之一。髋臼缺损导致其对股骨头包容不足,二者间接触面积减少,局部压强增大,久之势必造成髋关节磨损加快,导致关节炎甚至关节脱位的发生。但何种程度缺损才会导致髋关节生物力学改变,还没有公认的客观标准。目的:应用三维有限元方法分析不同程度髋臼缺损对髋关节周围应力分布的影响,为临床治疗髋关节发育不良提供理论指导。方法:选取正常成人髋关节CT薄层扫描数据,利用Mimics15.0和Hypermesh软件去除髋臼外缘部分骨性结构,模拟建立伴有不同程度骨缺损髋关节发育不良患者模型。以Ansys10.0加载关节负荷,分析单足着地情况下髋关节软骨下骨Von Mises应力分布情况。结果与结论:各组模型计算结果与实际情况相符合,髋臼和股骨的最大Von Mises应力值出现在髋臼顶穹部及股骨颈后内侧;当模拟单腿站立时,其应力峰值随着CE角变小而增大,由CE角30°时的2.768 MPa和3.029 MPa增加到5°时的11.075 MPa和15.322 MPa。CE角小于15°时该变化趋势更明显。提示髋臼缺损加大髋关节周围应力峰值,且缺损程度越大该影响越大,因而建议对于髋臼缺损患者尽早进行临床干预。BACKGROUND:Acetabular defect is one of the typical characteristics of adult developmental dysplasia of the hip.The acetabular defect caused an insufficient coverage to the femoral head,which means the contact area between them decreased and the pressure increased.Stress concentration could quicken hip wear and lead to arthritis or dislocation of the hip.Till now,there is no accepted objective criterion about what degree defect could lead to biomechanics changes in the hip.OBJECTIVE:To analyze the influence of different degrees of acetabular defect on the stress distribution of hip joint by using three-dimensional finite element method,and provide theoretical guidance for clinical treatment of hip dysplasia.METHODS:CT thin layer scanning data of normal adult hip were selected.Hip dysplasia models with varying degrees of bone defect were built by using Mimics15.0 and Hypermesh software.Von Mises stress distribution on the subchondral bone of the hip was analyzed by using Ansys10.0 software in the case of single foot touchdown.RESULTS AND CONCLUSION:Each model result was consistent with the actual situation.The maximum Von Mises stress value appeared at the top of the acetabulum dome and medial posterior femoral neck.When simulating one leg standing,the smaller the CE angle,the greater the maximum Von Mises stress on femoral head was;and acetabulum increased from 2.768 MPa and 3.029 MPa with 30°CE angle to 11.075 MPa and 15.322 MPa with 5°CE angle.This change was more obvious when CE angle was less than 15°.These findings confirmed that acetabular defect increases the peak stress of the hip joint,and the greater the defect,the greater the stress was.It is suggested that clinical intervention should be done as early as possible in patients with acetabular defect.

关 键 词：髋关节 计算机模拟 骨软骨发育不良 组织工程 

分 类 号：R318[医药卫生—生物医学工程]