三维有限元法分析成人髋关节发育不良重建髋臼的生物力学特征  

Biomechanical properties of acetabular reconstruction in adult developmental dysplasia of the hip by a 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[1,2] 程亮亮[2] 郝瑞胡 杨帆[1] Tian Fengde;Zhao Dewei;Li Dongyi;Guo Lin;An Ning;Zhang Yao;Cheng Liangliang;Hao Ruihu;Yang Fan(Faculty of Electronic Information and Electrical Engineering,Dalian University of Technology,Dalian 116024,Liaoning Province,China;Department of Joint Surgery,Affiliated Zhongshan Hospital of 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35期5642-5647,共6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:成人髋关节发育不良目前主要的治疗方法有髋关节周围截骨术、髋臼旋转截骨术、髋臼加盖术等,方法多样,疗效不一。由于技术条件的限制,各种方法虽然不同程度的改善了头臼关系,但距离理想状态仍有一定差距,部分患者因而效果不佳,病情继续发展。目的:应用三维有限元方法从力学角度分析成人髋关节发育不良髋臼重建的可行性及有效性,为以后的科研及临床研究提供理论依据。方法:选择单侧髋关节发育不良患者髋关节CT薄层扫描数据,利用Mimics15.0、Hypermesh软件分别建立健髋及髋关节发育不良患髋模型,利用镜像消减计算患侧髋臼缺损的部位及范围,模拟重建髋臼,建立重建髋关节模型,应用Ansys10.0加载关节负荷,分析单足着地情况下各髋关节软骨下骨VonMises应力分布情况。结果与结论:(1)各模型结果与实际情况相符合,最大Von Mises应力值出现在髋臼顶穹部及股骨颈后内侧;(2)患髋骨性缺损出现在髋臼前外侧,大小为43mm×14mm×7mm;(3)应力加载后各组VonMises应力峰值分别为:健髋股骨头(2.800±0.012)MPa,髋臼(3.855±0.035)MPa;髋关节发育不良患髋股骨头(5.066±0.026)MPa,髋臼(8.168±0.034)MPa;重建髋股骨头(2.769±0.085)MPa,髋臼(3.804±0.132)MPa,统计学分析结果显示髋关节发育不良患髋各部位VonMises应力峰值明显高于另外二者(P<0.001),差异有显著性意义;而重建髋与健髋各部位数值相近(P>0.05),证明髋臼重建后髋关节应力分布恢复正常;(4)通过有限元模型受力分析证明,髋臼重建能够恢复髋关节力学结构,该方法治疗早期成人髋关节发育不良是可行性的。BACKGROUND:Many methods are used to treat adult developmental dysplasia of the hip,such as pericapsular osteotomy and rotational acetabular osteotomy.Due to the limitation of technical conditions,the curative effect is different.Although these methods have improved the relationship between the head and the acetabulum in varying degrees,there is still a certain gap from the ideal state,and some patients have poor results with continuous disease development.OBJECTIVE:To analyze the feasibility and effectiveness of acetabular reconstruction in adult hip dysplasia by three-dimensional finite element method and provide theoretical basis for future clinical research.METHODS:Thin-slice CT data of unilateral hip dysplasia patient were collected.Mimics 15.0 and Hypermesh were used to establish the model of healthy hip and dysplasia hip,and location and scope of bony defect were calculated,then model of reconstruction of the acetabulum was established by simulating tools.The Von Mises stress distribution in the subchondral bone of each hip joint was analyzed under the condition of single foot standing using Ansys 10.0.RESULTS AND CONCLUSION:(1)The results of each model were consistent with the actual situation,and the maximum Von Mises stress value appeared in the acetabular dome and the posteromedial femoral neck.(2)The bone defect appeared in the anterolateral part of acetabulum,the size was 43 mm×14 mm×7 mm.(3)The Von Mises stress peak values of each group after stress loading in the healthy hip were femoral head(2.800±0.012)MPa,acetabulum(3.855±0.035)MPa;femoral head of affected hip(5.066±0.026)MPa;acetabulum(8.168±0.034)MPa;reconstructed hip femoral head(2.769±0.085)MPa,acetabulum(3.804±0.132)MPa.Statistical analysis showed that the peak Von Mises stress in each part of the affected hip was significantly higher than that in the other two groups(P<0.001).The values between reconstructed hip and healthy hips were similar(P>0.05),suggesting that the stress distribution of hip joint was normal after acetabular rec

关 键 词：成人 髋关节发育不良 髋臼 缺损 关节 应力 三维 有限元 骨科植入物 国家自然科学基金 髋脱位 先天性 髋臼 应力 物理 有限元分析 组织工程 

分 类 号：R445[医药卫生—影像医学与核医学]