金属3D打印个性化股骨假体和4种类型标准化假体的生物力学对比  

Biomechanical comparison of personalized titanium femoral prosthesis fabricated by three-dimensional printing to four types of cementless prosthesis

作　　者：刘宏伟 蒋俊锋 张云坤 徐南伟 王彩梅 张文[4] Liu Hongwei;Jiang Junfeng;Zhang Yunkun;Xu Nanwei;Wang Caimei;Zhang Wen(Department of Orthopedics,Changzhou Second People’s Hospital,Nanjing Medical University,Changzhou 213003,Jiangsu Province,China;College of Internet of Things Engineering,Hehai University,Changzhou 213022,Jiangsu Province,China;Beijing AI-Kang Yicheng Limited Company,Beijing 102200,China;Orthopedic Institute,Soochow University,Suzhou 215006,Jiangsu Province,China)

机构地区：[1]南京医科大学附属常州第二人民医院骨科,江苏省常州市213003 [2]河海大学物联网工程学院,江苏省常州市213022 [3]北京爱康宜诚股份有限公司,北京市102200 [4]苏州大学骨科研究所,江苏省苏州市215006

出　　处：《中国组织工程研究》2019年第32期5151-5157,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学面上基金资助项目(61772172),项目参与人:刘宏伟;常州市卫计委重大项目资助课题(ZD201617),项目负责人:刘宏伟~~

摘　　要：背景:蓬勃发展的金属3D打印增材制造技术为骨科个性化假体的研制带来了全新的机遇,但其生物力学性能是否能满足临床需求尚待深入研究。目的:探讨高能电子束熔融金属3D打印个性化股骨假体相对于SR组配柄、矩形柄、柱形柄、锥形柄的生物力学优缺点。方法:分别将3D打印个性化股骨假体、SR组配柄、柱形柄、矩形柄、锥形柄的三维扫描stl格式数据导入UG 8.0建模,修补坏点及空洞。按临床手术要求进行虚拟截骨,置入数字化股骨假体。采用Ansys 10.0软件对5种股骨假体进行有限元网格及节点划分,对假体材料分别赋值。分别模拟双足静止站立、缓慢行走2种状态,对比5种股骨假体在界面应力、初始微动以及应力遮挡率3个方面的差异。结果与结论:(1)最大应力对比:(1)双足静止站立:3D打印个性化股骨假体正应力略高于锥形柄(10.83%),较SR组配柄、矩形柄、锥形柄正应力分别低45.65%,15.20%,41.18%;个性化股骨假体剪切应力较SR组配柄、矩形柄、柱形柄、锥形柄分别低58.53%,38.91%,15.64%,37.55%;(2)缓慢行走:3D打印个性化股骨假体正应力较SR组配柄低,较3种标准柄高;剪切应力较SR组配柄、矩形柄低(25.78%、62.50%),较柱形柄、锥形柄高(35.74%,15.82%);(2)应力遮挡率:(1)双足静止站立:3D打印个性化股骨假体对股骨近端有着最小的应力遮挡率,比SR组配柄、矩形柄、柱形柄、锥形柄分别低约56.21%,41.88%,23.92%和17.98%;(2)缓慢行走:个性化股骨假体应力遮挡率比SR组配柄、矩形柄、柱形柄、锥形柄分别低56.84%,31.10%,20.45%,16.69%;(3)假体微动:(1)双足静止站立:3D打印个性化股骨假体水平微动较其他股骨柄大,最大值26.4μm,在骨长入的微动范围内,垂直微动均较其余4种柄低;(2)缓慢行走:3D打印个性化假体的水平微动较其他柄大,最大值172μm;垂直微动较柱形柄略低(1.45%),较SR组配柄、矩形柄、锥形柄略高BACKGROUND:The vigorous development of metal three-dimensional(3D)printing additional manufacturing technology has brought new opportunities for the development of personalized prosthesis in orthopedics,but whether its biomechanical properties meet the clinical needs remains to be further studied.OBJECTIVE:To explore the biomechanical characteristics of titanium femoral prosthesis fabricated by electron beam melting 3D metal printing to four types of cementless prosthesis as SR modular prosthesis,rectangular prosthesis,cylindrical prosthesis and tapered prosthesis.METHODS:The STL files of personalized femoral prosthesis,SR modular prosthesis,cylindrical prosthesis,rectangle prosthesis and tapered femoral prosthesis were exported to UG 8.0 software.Three-dimensional model was reconstructed and bad point and cavity were repaired to get the satisfied 3D STL format files.The digitized femoral prosthesis was implanted into femoral medullary cavity in accordance with the standard operative requirements.The five femoral prostheses with finite element mesh and node were divided by using Ansys 10.0 software and the prosthetic materials were assigned.The biomechanical characteristics of the five kinds of femoral prosthesis including stress distribution,interface stress,initial micromovement and stress shielding in simulating two states as bipedal standing still and walking slowly were compared.RESULTS AND CONCLUSION:(1)Stress distribution:When standing still with double feet,positive stress of 3D printing personalized femoral prosthesis was only slightly higher than the tapered prosthesis(10.83%).Compared with SR modular prosthesis,the positive stresses of rectangle prosthesis and tapered femoral prosthesis were lower 45.65%,15.20%and 41.18%,respectively.Compared with the SR modular prosthesis,personalized femoral prosthesis shear stresses of rectangle prosthesis,cylindrical prosthesis and tapered femoral prosthesis were lower 58.53%,38.91%,15.64%and 37.55%.When in low-speed walking condition,the positive stress of persona

关 键 词：股骨假体 金属3D打印 有限元分析 生物力学 应力遮挡 国家自然科学基金 

分 类 号：R445.3[医药卫生—影像医学与核医学] R318.01[医药卫生—诊断学]