个性股骨假体的三维仿真及模拟力学试验  

Three-dimensional simulation and simulated mechanical test of individual femoral prosthesis

作　　者：李亢 姜燕[2] 田大为 刘向阳[2] Li Kang;Jiang Yan;Tian Da-wei;Liu Xiang-yang(Department of Orthopedics,Taihe Hospital of Shiyan,Hubei University of Medicine,Shiyan 442000,Hubei Province,China;Computer Teaching and Research Office,Hubei University of Medicine,Shiyan 442000,Hubei Province,China;Department of Orthopedics,Dongfeng Hospital,Hubei University of Medicine,Shiyan 442000,Hubei Province,China)

机构地区：[1]十堰市太和医院,湖北医药学院附属医院骨科,湖北省十堰市442000 [2]湖北医药学院计算机教研室,湖北省十堰市442000 [3]湖北医药学院附属东风医院骨科,湖北省十堰市442000

出　　处：《中国组织工程研究》2018年第11期1731-1736,共6页Chinese Journal of Tissue Engineering Research

基　　金：湖北省科技计划项目(2015CFC808),课题名称:个性股骨假体的三维仿真及移植的研究

摘　　要：背景:有研究将医用CT技术与数字化三维影响交互式控制系统Mimics软件以及计算机仿真技术等工具软件相结合重建活体股骨三维模型,并进行仿真再造,专门定制的个性化股骨假体与人体结构具有较高的匹配度,在临床研究上具有较高的应用价值。目的:探究个性股骨假体的三维仿真及移植在人工股骨假体置换中的应用价值。方法:选择2014年7月至2016年6月在十堰市太和医院拟行人工股骨假体置换的患者82例,按随机数表法分为3组,各组分别设计不同类型的股骨假体,个性化组28例,普通生物型组27例,骨水泥型组27例,分别进行股骨假体三维仿真及模拟力学试验。采用医用CT技术结合计算机辅助设计重建活体股骨三维模型,在计算机上虚拟假体模型的置入过程并记录相关信息,对股骨假体在双足及单足载荷下进行力学试验的模拟操作,为股骨假体置换提供最适宜的方案,并对可能出现的风险进行预测评估做好术前准备工作。结果与结论:(1)3组在模拟力学试验中,双足与单足载荷下,假体置换后假体和股骨上应力情况比较,个性化组明显优于生物型组与骨水泥型组,差异有显著性意义(P<0.05);(2)假体置换后的正应力与剪切应力,个性化组明显优于生物型组与骨水泥型组,差异有显著性意义(P<0.05);(3)假体置换后假体的初始微动情况,水平微动与垂直微动个性化组明显优于生物型组与骨水泥型组,差异有显著性意义(P<0.05);(4)综上,联合计算机CT三维技术与计算机辅助设计等软件可以有效为患者定制个性化股骨假体,与生物型与骨水泥型假体相比,个性化股骨假体在各种性能上尤其是在生物力学层面其应力分布、界面应力、初始微动等都具有明显优势。BACKGROUND:A study combined medical CT technology and digital three-dimensional(3D)interactive control system Mimics software and computer simulation software tools for 3D reconstruction and simulation reconstruction of the femur.Customized individualized femoral prosthesis has high matching degree with human body structure,and has high application value in clinical research.OBJECTIVE:To investigate the application value of 3D simulation of femoral prosthesis in artificial femoral prosthesis replacement.METHODS:Totally 82 cases,who received femoral prosthesis replacement from July 2014 to June 2016 in Taihe Hospital of Shiyan,were enrolled and randomly assigned to three groups:personalized group(n=28),cementless group(n=27)and cemented group(n=27).Different types of femoral prosthesis were designed in each group.3D model reconstruction in femur was designed using medical CT technology combined with computer.Prosthesis implantation was simulated in computer,and the relevant information was recorded.Simulated operation was conducted on the mechanical experiment of femoral prosthesis in the biped and single foot loads so as to provide the most suitable operation plan.The possible risk was forecasted and assessed for preoperative preparation.RESULTS AND CONCLUSION:(1)In the simulation of mechanical experiment,under double foot and single foot loads,after prosthetic replacement,stress in the femur was significantly better in the personalized group than in the cementless group and cemented group(P<0.05).(2)After replacement,normal stress and shear stress were significantly better in the personalized group than in the cementless group and cemented group(P<0.05).(3)The initial,horizontal and vertical micromovement was significantly better in the personalized group than in the cementless group and cemented group(P<0.05).(4)In summary,the use of computer technology and 3D CT software can make individualized femoral prosthesis for patients.Compared with the cementless and cemented prostheses,personalized prosthesis has obvi

关 键 词：股骨假体 三维模型 计算机辅助技术 仿真 移植 人工假体 骨科植入物 计算机辅助设计 有限元分析 假体植入 组织工程 

分 类 号：R318[医药卫生—生物医学工程]