基于前外侧保留角预测股骨头坏死塌陷的有限元分析  

Finite element analysis for predicting osteonecrosis of the femoral head collapse based on the preserved angles

作　　者：陆舜 林天烨 何敏聪 何晓铭 何宪顺 田佳庆 魏腾飞 詹芝玮 林锟 魏秋实 LU Shun;LIN Tianye;HE Mincong;HE Xiaoming;HE Xianshun;TIAN Jiaqing;WEI Tengfei;ZHAN Zhiwei;LIN Kun;WEI Qiushi(Third Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou Guangdong,510405,P.R.China;Guangdong Academy of Traditional Chinese Medicine Orthopedics and Traumatology,Guangzhou Guangdong,510378,P.R.China;Joint Center,Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong,510378,P.R.China)

机构地区：[1]广州中医药大学第三临床医学院,广州510405 [2]广东省中医骨伤研究院,广州510378 [3]广州中医药大学第三附属医院关节中心,广州510378

出　　处：《中国修复重建外科杂志》2023年第11期1394-1402,共9页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(82274544、82004392);广东省中医药管理局重点项目(20223012);广州中医药大学“双一流”与高水平大学学科协同创新团队重大项目/培育项目(2021XK05、2021XK41);2021年广东省中医骨伤研究院开放课题重点项目(GYH202101-01、GYH202101-04)。

摘　　要：目的建立股骨头坏死(osteonecrosis of the femoral head,ONFH)不同保留角有限元模型进行生物力学分析,为以股骨头前侧保留角(anterior preserved angle,APA)和外侧保留角(lateral preserved angle,LPA)预测ONFH塌陷风险提供力学依据。方法选择1名健康成人左侧股骨头为研究对象,获取CT数据导入Mimics21.0软件,重建完整股骨近端模型以及构建3个体积相等、形态不同的ONFH模型,导入Solidworks 2022软件中分别构建APA为60°且LPA分别为45°、50°、55°、60°、65°、70°、75°的21个ONFH有限元模型,以及LPA为60°且APA分别为45°、50°、55°、60°、65°、70°、75°的21个ONFH有限元模型。根据生理状态下股骨头负荷情况,股骨远端设置完全固定,在股骨头表面负重区施加与股骨干成25°夹角、方向向下且大小为受试者3.5倍体质量的合力,利用有限元分析软件Abaqus 2021计算并观察股骨头表面、坏死区最大应力及股骨头负重区最大位移情况。结果研究建立的ONFH模型基本符合ONFH力学情况。在相同载荷条件下,3个不同形态相同体积的坏死区构成的42个ONFH不同保留角模型中,坏死区周围均有应力集中现象。APA为60°时,LPA<60°模型的股骨头表面、坏死区最大应力和股骨头负重区最大位移明显高于LPA≥60°模型(P<0.05);LPA≥60°模型间的各指标差异无统计学意义(P>0.05)。LPA为60°时,APA<60°模型的各指标明显高于APA≥60°模型(P<0.05);APA≥60°模型间的各指标差异无统计学意义(P>0.05)。结论从生物力学角度来看,当ONFH保留角小于临界值时,股骨头应力集中现象更为明显,提示此种状态下坏死股骨头发生塌陷风险更高。Objective To establish finite element models of different preserved angles of osteonecrosis of the femoral head(ONFH)for the biomechanical analysis,and to provide mechanical evidence for predicting the risk of ONFH collapse with anterior preserved angle(APA)and lateral preserved angle(LPA).Methods A healthy adult was selected as the study object,and the CT data of the left femoral head was acquired and imported into Mimics 21.0 software to reconstruct a complete proximal femur model and construct 3 models of necrotic area with equal volume and different morphology,all models were imported into Solidworks 2022 software to construct 21 finite element models of ONFH with LPA of 45°,50°,55°,60°,65°,70°,and 75°when APA was 45°,respectively,and 21 finite element models of ONFH with APA of 45°,50°,55°,60°,65°,70°,75°when LPA was 45°,respectively.According to the physiological load condition of the femoral head,the distal femur was completely fixed,and a force with an angle of 25°,downward direction,and a magnitude of 3.5 times the subject’s body mass was applied to the weight-bearing area of the femoral head surface.The maximum Von Mises stress of the surface of the femoral head and the necrotic area and the maximum displacement of the weight-bearing area of the femoral head were calculated and observed by Abaqus 2021 software.Results The finite element models of ONFH were basically consistent with biomechanics of ONFH.Under the same loading condition,there was stress concentration around the necrotic area in the 42 ONFH models with different preserved angles composed of 3 necrotic areas with equal volume and different morphology.When APA was 60°,the maximum Von Mises stress of the surface of the femoral head and the necrotic area and the maximum displacement of the weight-bearing area of the femoral head of the ONFH models with LPA<60°were significantly higher than those of the models with LPA≥60°(P<0.05);there was no significant difference in each index among the ONFH models with LPA≥60°(P>0

关 键 词：股骨头坏死 前侧保留角 外侧保留角 股骨头塌陷 生物力学分析 

分 类 号：R687.3[医药卫生—骨科学]