活动型单髁衬垫脱位力学机制的实验研究  

Experimental study on mechanical mechanism of the UKAP mobile-bearing dislocation

作　　者：黄洁茹 王献抗 周雷 HUANG Jie-ru;WANG Xian-kang;ZHOU Lei(Tianjin Key Laboratory of Functional and Personalized Research on Bone Implant Interfaces,Tianjin 300190,China;Just Huajian Medical Equipment(Tianjin)Co.,Ltd.,Tianjin 300190,China)

机构地区：[1]天津市骨植入物界面功能化与个性化研究企业重点实验室,天津300190 [2]嘉思特华剑医疗器材(天津)有限公司,天津300190

出　　处：《天津理工大学学报》2019年第5期34-38,44,共6页Journal of Tianjin University of Technology

基　　金：天津市生物医学工程科技重大专项(18ZXSGSY00010)

摘　　要：研究活动单间室膝关节假体(UKAP)衬垫在力学环境下的脱位机制.通过制作髁假体固定工装与固定平台旋转圆盘工装,建立活动衬垫脱位的体外模型.在外载荷作用下,通过压力测量片测量活动衬垫在不同撑开量、不同后倾角以及不同旋转角度下的脱位力大小.随着撑开量的增加,衬垫脱位力不断降低;随着胫骨后倾角增加,接触压由胫骨近端前侧向胫骨近端后侧转移,衬垫的脱位力不断增加。后倾角降低将减少髁假体对衬垫的接触压力、并相对增加衬垫的撑开量,这将大大削弱衬垫后方的脱位力.衬垫过旋将减小脱位力,从而增加旋转脱位的风险.衬垫撑开量与手术中假体安装后屈伸间隙不平衡、内侧副韧带延迟伸长或损伤有关,衬垫后倾角度及内外旋角度均与术中截骨位置有关,衬垫脱位力在不同安放位置存在变化.研究结果可为临床上活动衬垫脱位机制提供理论依据,对活动单间室膝关节置换手术技术及治疗具有指导意义.To study the dislocation mechanism of the mobile-bearing in the mechanical environment.The dislocation experiment model was established in vitro by making the fixation frock of condyle prosthesis and the rotating disc frock for fixing a platform.Under external load,the dislocation force of the mobile-bearing was measured by pressure measuring sheet underdifferent distraction amounts,the posterior slop and the internal rotation.With the increase in the amount of distraction,the dislocation force of the mobile-bearing was continuously reduced.With the increase of the posterior slop,the contact pressure was transferred from the anterior side to the posterior side of the proximal tibia,and the dislocation force of the mobile-bearing was increasing.Lowering the posterior slop will reduce the contact pressure of the condylar prosthesis,applied in the mobile-bearing and relatively increase the distraction amountsof the mobile-bearing,which will greatly decrease the dislocation force behind the mobile-bearing.Over-rotation of the mobile-bearing will reduce the dislocation force,thereby increasing the risk of rotational dislocation.The distraction amounts is related to the imbalance of the flexion and extension gap after the installation of the prosthesis,the delayed extension of the medial collateral ligament or the injuryduring operation.The angle of the posterior slop andthe internal and external rotation are related to the intraoperative osteotomy position.There are changes in different positions.The results can provide a theoretical basis for the clinical mechanism of the dislocation mechanism of the mobile-bearing,and have guiding significance for the technique and treatment of mobileuncompartment knee arthroplasty.

关 键 词：活动衬垫 脱位力 实验研究 脱位机制 

分 类 号：R318.01[医药卫生—生物医学工程]