有限元分析在人工膝关节置换中的应用  

Application of finite element analysis in artificial knee arthroplasty

作　　者：李浩然 黄健 Li Haoran;Huang Jian(Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China;Second Affiliated Hospital of Inner Mongolia MedicalUniversity(Inner Mongolia Institute of Orthopedics),Hohhot 010000,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学,内蒙古自治区呼和浩特市010000 [2]内蒙古医科大学第二附属医院(内蒙古自治区骨科研究所),内蒙古自治区呼和浩特市010000

出　　处：《中国组织工程研究》2023年第31期5058-5063,共6页Chinese Journal of Tissue Engineering Research

基　　金：内蒙古自治区科技攻关计划项目(2021GG0194),项目负责人:黄健。

摘　　要：背景:人工膝关节置换作为治疗膝关节骨性关节炎、类风湿性关节炎等各类终末期关节疾患最有效的方法,广泛应用于关节外科领域。有限元分析是随着计算机技术不断进步而逐渐发展而来的一种生物力学研究方法,具有强大的建模功能和三维仿真特点。目前,有限元分析已广泛应用于骨科生物力学研究。目的:综述有限元分析技术在各类人工膝关节置换术中的应用现状与进展。方法:使用计算机检索PubMed、CNKI、万方数据库发表的关于有限元分析与人工膝关节置换的相关文献,文献发表时间为从各数据库建库至2022年8月,英文检索词:finite element analysis,TKA,UKA,revision total knee arthroplasty,knee osteoarthritis,knee joint,femoral component,tibia component;中文检索词:有限元分析,全膝关节置换术,单髁置换术,膝关节翻修术,膝关节,股骨假体,胫骨假体,最终共纳入53篇文献进行综述。结果与结论:①在全膝关节置换过程中,活动平台较固定平台降低了胫股关节接触面应力,从而减少了聚乙烯垫片的磨损;相对于机械对线,采用运动对线的全膝关节置换人工关节的股骨假体与聚乙烯垫片的最大应力与最大应变值均减小,产生的应力更低,从而减少关节接触面的磨损,延长假体寿命;②在单髁置换过程中,活动平台股骨和胫骨假体形合性较好,能够减少假体磨损;而固定平台假体单髁置换应避免过度形合引起局部应力集中而导致加速假体磨损;③在人工膝关节翻修术中,延长杆的设计长度应在保留骨质和植入后减少假体周围应力之间保持最佳平衡;与骨水泥延长杆相比,压配式延长杆显示出更高的微动;④相对于传统的力学研究而言,有限元分析可以进行相对较为准确的模拟,弥补了传统力学在膝关节研究上的不足,因此在医学领域具有较高的应用价值。BACKGROUND:Artificial knee arthroplasty is widely used in the field of joint surgery as the most effective treatment for various end-stage joint diseases such as knee osteoarthritis and rheumatoid arthritis.Finite element analysis is a biomechanical research method developed gradually with the continuous progress of computer technology,which has a strong modeling function and three-dimensional simulation characteristics.At present,finite element analysis has been widely used in orthopedic biomechanical studies.OBJECTIVE:To review the current status and progress of finite element analysis in various types of total knee arthroplasty.METHODS:Articles related to finite element analysis and artificial knee arthroplasty published from inception to August 2022 were searched on PubMed,CNKI and WanFang databases by computer.English search terms were“finite element analysis,TKA,UKA,revision total knee arthroplasty,knee osteoarthritis,knee joint,femoral component,tibia component”.Chinese search terms were“finite element analysis,total knee arthroplasty,unicompartmental knee arthroplasty,knee revision,knee,femoral prosthesis,tibial prosthesis”.A total of 53 articles were finally included for review.RESULTS AND CONCLUSION:(1)In total knee arthroplasty,the mobile bearing reduces the tibiofemoral joint contact surface stress compared with the fixed bearing,thereby reducing the wear of the polyethylene bearing.Compared with mechanical alignment,total knee arthroplasty with kinematic alignment reduces the maximum stress and maximum strain value of femoral prosthesis and polyethylene insert of the artificial joint,and generates lower stress,thus reducing the wear of joint contact surface and prolonging the life of the prosthesis.(2)In unicompartmental knee arthroplasty,the femoral and tibial prostheses of the mobile platform have better conformity and can reduce prosthesis wear;while the fixed platform prosthesis in unicompartmental knee arthroplasty should avoid local stress concentration caused by overconformity and lead

关 键 词：有限元分析法 全膝关节置换 单髁置换 膝关节翻修 膝关节 股骨假体 胫骨假体 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687