髋臼高位放置对股骨假体应力影响的有限元分析  

Finite element analysis of the effect of the high acetabular position on stress of the femoral prosthesis

作　　者：徐佳明[1] 李星亮[2] 王韬[3] XU Jiaming;LI Xingliang;WANG Tao(Department of Orthopaedic Surgery,Shanghai Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院骨科,200233 [2]江西省南丰县中医院骨伤科 [3]上海市第六人民医院急诊部

出　　处：《临床外科杂志》2019年第3期239-242,共4页Journal of Clinical Surgery

摘　　要：目的研究髋臼高位放置对股骨假体应力影响,为选择合适的股骨假体提供依据。方法在Mimics 17.0及Geomagic 2012中,通过病人髋部CT图像重建髋臼的骨骼模型。在CERO 4.0中,设计Reclaim股骨柄及髋臼假体三维模型,上述模型在hypermesh中参照髋臼假体的不同位置建立组配型股骨假体近端不同长度的A模型(75mm)、B模型(85mm)、C模型(95mm),D模型(105mm)四个有限元模型。在Abaqus6.14中计算股骨假体的最大Mises应力和剪切应力。结果 A模型与B模型的最大Mises应力各区之间差异无统计学意义(P>0.05)。C模型与B模型比较,Ⅴ区受到的压应力显著增加(P<0.05)。D模型与C模型比较,Ⅰ区张应力与Ⅴ区的压应力较明显增大,Ⅶ区压应力显著减小,差异有统计学意义(P<0.05)。在A模型中,Ⅶ区剪切应力显著大于Ⅰ区、Ⅲ区(P<0.05)。C模型和D模型股骨假体Ⅲ区、Ⅴ区的剪切应力最大,与A模型比较,差异有统计学意义学意义(P<0.05)。结论髋臼高位放置会导致股骨假体远端应力及剪切应力增加,在选择假体时应注意股骨柄的长度、直径、涂层等因素对假体稳定性的影响。Objective To study the effect of the high acetabular position on stress of femoral prosthesis.Methods In Mimics 17.0 and Geomagic 2012,the patient’s hip CT image was fitted to the NUBES surface.In CERO 4.0,the three-dimensional solid model of prosthesis was designed according to the revision system.The above models was imported into hypermesh and assembled according to the length of the proximal femoral components,model A(75 mm),model B(85 mm),model C(95 mm),model D(105 mm).In Abaqus6.14,the distal femur was constrained as the boundary condition,and a single foot standing load was loaded to calculate the maximum Mises stress of the femur prosthesis and the shear stress of the coronal plane(XZ plane).Results There was no statistically significant difference between the maximum Mises stress distribution of model B and model A(P>0.05).Compared with the model B,the compressive stress significantly increased at Ⅴarea in the model C(P<0.05).In model D,the tensile stress inⅠarea and the compressive stress inⅤarea were significantly larger than that in model C(P<0.05).In model A,shear stress mainly appeared in Ⅶ area,the shear stress was significantly greater thanⅠand Ⅲ areas(P<0.05).In the model C and D,The maximum shear stress change of femoral prosthesis in Ⅲ and Ⅴareas,there were significant statistically differences compared with model A(P<0.05).Conclusion High placement technique in total hip arthroplasty may not only lead to the increase of tensile stress and compressive stress at the distal femoral prosthesis,but also increased the femoral prosthesis-bone contact interface shear stress.We should pay attention to the length,diameter,coating and other factors of the femoral prosthesis that affect the stability of the prosthesis.

关 键 词：髋臼高位放置 全髋关节置换术 翻修 股骨 假体 有限元分析 

分 类 号：R687.4[医药卫生—骨科学]