不同屈曲状态下固定轴和移动轴膝关节胫-股关节的生物力学变化  

Biomechanical Changes of the Tibial-femoral Joint of the Knee Joint with Fixed and Moving Axes Under Different Flexion States

作　　者：高辉 王晨艳 李志 王文治 王长江 陈静 陈维毅 GAO Hui;WANG Chenyan;LI Zhi;WANG Wenzhi;WANG Changjiang;CHEN Jing;CHEN Weiyi(College of Mechanical and Vehicle Engineering,Taiyuan University of Technology,Taiyuan 030024,China;College of Biomedical Engineering,Taiyuan University of Technology,Taiyuan 030024,China)

机构地区：[1]太原理工大学机械与运载工程学院,太原030024 [2]太原理工大学生物医学工程学院,太原030024

出　　处：《太原理工大学学报》2021年第1期144-150,共7页Journal of Taiyuan University of Technology

基　　金：国家自然科学基金资助项目(11772214,11702184)。

摘　　要：全膝关节置换术是治疗膝关节疾病有效方法,但对于固定轴和移动轴膝关节假体的优劣还未有统一的观点。以往对两种假体也有对比验证,但绝大多数都是静态模拟。首先构建健康自然膝关节有限元模型,然后分别建立含有上述两种假体的膝关节,通过动态模拟膝关节屈膝运动,计算出胫-股关节的接触应力和接触面积变化。结果发现:固定轴和移动轴人工膝关节在0°~90°屈膝角度下随着角度增大,接触区域由胫骨衬垫的前方转移到其的后方,胫-股关节接触应力不断变大,在90°时达到最大。移动轴间的胫-股关节接触压力始终小于固定轴,接触面积始终大于固定轴。随着屈膝角度加深,两种假体聚乙烯垫上的接触应力逐渐变大,接触面积随着逐渐变小。且两种假体接触应力无显著性差异,而假体接触面积有显著性差异。结果显示:在接触应力相同的情况下,接触面积越大,越不容易产生应力集中,越不易发生磨损,有助于延长膝关节使用寿命,因此移动轴膝关节假体优于固定轴膝关节假体。此研究可为临床假体移植类型的选择提供一定参考。Total knee arthroplasty is an effective method for treating knee diseases,but there is no unified view on the advantages and disadvantages of fixed-axis and mobile-axis knee prostheses.In the past,there have been comparative verifications of the two prostheses,but most of which are static simulations.In this paper,a finite element model of a healthy knee joint was built;then a knee joint containing the above two prostheses was established;finally,by dynamically simulating the knee flexion motion,the contact stress and contact area of the tibia-femoral joint were calculated.The results show that for the fixed and mobile axis artificial knee joints,in the range of 0°to 90°knee flexion angle,the contact area shifts from the front of the tibial liner to the rear,and the contact stress of the tibiofemoral joint continues to increase,reaching maximum at 90°.With respect to the fixed shafts,the contact pressure of the tibiofemoral joint between the moving shafts is smaller,and the contact area is larger.As the knee bending angle deepens,the contact stress on the polyethylene pads of the two prostheses gradually increases,and the contact area gradually decreases.No significant difference exists between the two prostheses in the contact stress,but there is a significant difference in the contact area of the two prostheses.The results suggest that under the same contact stress,the larger the contact area is,the less stress concentration is likely to happen,that is,the prosthesis is not prone to wear.This can extend the service life of the knee joint.Therefore,the mobile axis knee prosthesis is better than the fixed axis knee joint prosthesis.This study may provide a valuable reference for the selection of prosthesis transplantation types in clinic.

关 键 词：膝关节 固定轴假体 移动轴假体 动态屈膝 生物力学 有限元分析 

分 类 号：R318[医药卫生—生物医学工程]