三维重建和有限元分析股骨髁上截骨对矫治膝内翻有积极作用  

Positive effect of supracondylar femoral osteotomy on the correction of knee varus based on threedimensional reconstruction and finite element analysis

作　　者：李硕 苏鹏 张力 吴秋龙 胡湘宇 来钰梁 Li Shuo;Su Peng;Zhang Li;Wu Qiulong;Hu Xiangyu;Lai Yuliang(School of Electromechanical Engineering,Beijing Information Science and Technology University,Beijing 100192,China;Second Department of Orthopedics,Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation Assistive Devices,Beijing 100176,China)

机构地区：[1]北京信息科技大学机电工程学院,北京市100192 [2]国家康复辅具研究中心附属康复医院骨二科,北京市100176

出　　处：《中国组织工程研究》2022年第6期858-863,共6页Chinese Journal of Tissue Engineering Research

基　　金：北京市自然科学基金-海淀原始创新联合基金项目(19L2018),项目负责人:苏鹏;国家自然科学基金青年科学基金项目(52005045),项目负责人:苏鹏;北京市教委科研计划科技一般项目(KM202011232009),项目负责人:苏鹏。

摘　　要：背景:从生物力学方向研究股骨髁上截骨矫治膝内翻的治疗效果,对以截骨方式治疗膝内翻畸形矫治手术的理解具有积极作用。目的:基于CT数据构建股骨髁上截骨手术前后膝关节三维模型,介绍一种可供参考的组织建模方法,通过生物力学分析验证方法的可行性及股骨髁上截骨的积极作用。方法:随机选取1例股骨髁上截骨患者手术前后的CT数据,基于图像分割建立膝关节骨骼模型,基于轮廓延展建立膝关节间半月板假体和主要韧带的三维模型,经网格划分、材料定义后,以同等工况(1 000 N,下肢力线方向)施加载荷,对手术前后模型进行有限元仿真分析,与前期学者研究结果对比验证建模方法的可行性,研究手术前后膝关节胫骨近端的应力差值和应力峰值点随时间的受力变化情况。结果与结论:(1)术后胫骨内侧最大接触应力为2.334 MPa,胫骨外侧最大接触应力为2.819 MPa,与前期研究比较差异,验证了模型的有效性及建模方法的可行性;(2)测得术前胫骨可承受最大应力(7.085 MPa)远大于术后胫骨可承受最大应力(2.819 MPa),同时伴随时间的变化,术前胫骨应力集中情况明显,术后胫骨应力集中得到改善;(3)结果表明,股骨髁上截骨对矫治膝内翻具有积极作用。BACKGROUND: Studying the effect of supracondylar femoral osteotomy in treatment of varus knee from the direction of biomechanics can have a positive effect on the understanding of the surgical treatment of knee varus deformity by osteotomy. OBJECTIVE: Based on the CT data, the preoperative and postoperative three-dimensional models of the knee joint of supracondylar femoral osteotomy are constructed. A modeling method of tissue is introduced. The feasibility of the method and the positive effect of supracondylar osteotomy of femur was verified through biomechanical analysis.METHODS: The preoperative and postoperative CT data of a patient with supracondylar femoral osteotomy surgery were selected at random to establish the knee bone model based on image segmentation, and the three-dimensional model of the knee meniscus and major ligaments between knee joints was established based on contour extension. After meshing and material definition, the load was applied under the same working condition(1 000 N, in the direction of lower limb force line), and the finite element simulation was carried out on the preoperative and postoperative model. Compared with the research results, the feasibility of modeling method was tested. The stress difference at the proximal tibia and the changes of stress peak point with time of preoperative and postoperative knee joint were studied.RESULTS AND CONCLUSION:(1) The postoperative peak of medial tibia was 2.334 MPa and the lateral tibia peak value was 2.819 MPa. The differences of stress from the previous scholars were contrasted to test the effectiveness of the model and the feasibility of the modeling method.(2) The preoperative peak tibial stress was 7.085 MPa, which was higher than the postoperative peak tibial stress(2.819 MPa). Meanwhile, with the change of time, the stress concentration of tibia before operation was more obvious, and the stress concentration of tibia after operation had been improved.(3) Results indicated that supracondylar femoral osteotomy had a positive effec

关 键 词：图像分割 股骨髁上截骨术 网格划分 有限元仿真 接触应力 有效性 

分 类 号：R459.9[医药卫生—治疗学] R311[医药卫生—临床医学]