有限元分析髋关节假体球头直径、偏心距对股骨柄锥部应力的影响  

The influence of the ball-head diameter and offset of the hip prosthesis on the stress of the femoral stem cone using finite element analysis

作　　者：田文明[1] 徐汝斌 李邦国[1] 刘默然 周恩昌[1] TIAN Wen-ming;XU Ru-bin;LI Bang-guo;LIU Mo-ran;ZHOU En-chang(Dept of Joint Surgery,the Second People′s Hospital of Liaocheng City,Liaocheng,Shandong 252601,China)

机构地区：[1]聊城市第二人民医院关节外科,山东聊城252601

出　　处：《临床骨科杂志》2025年第2期292-296,共5页Journal of Clinical Orthopaedics

基　　金：山东省卫健委医药卫生科技发展计划项目(编号:2019WSA15003)。

摘　　要：目的通过有限元模型分析全髋关节置换术中髋关节假体球头直径、偏心距变化对股骨柄锥部应力分布的影响。方法CT扫描1名初次行全髋关节置换术志愿者的骨盆及股骨近端并获得Corail型股骨柄及球头模型。在Creo 3.0软件中设计28、32、36 mm金属球头,通过变更球头内部偏移量改变偏心距,建立28-4、28、28+4、32-4、32、32+4、36-4、36、36+4、36+8的股骨球头模型,在Abaqus 6.14软件中对股骨柄锥部(球头与股骨柄结合部)远端和近端加载垂直和扭转载荷,测量股骨柄锥部的应力、应变量。结果垂直载荷和扭转载荷下,股骨柄锥部应力主要集中在头颈交界远端,模型远端平均应力显著大于近端(P<0.01)。垂直载荷下,28+4、32+4、36+4、36+8模型股骨柄锥部应力显著大于同直径的其他模型(P<0.05),36+8、36+4模型远端应力显著大于28+4、32+4模型(P<0.05);扭转载荷下,36+8模型近端应力显著大于其他模型(P<0.05);垂直载荷下,28+4、32+4、36+4、36+8模型远端应变显著大于同直径的其他模型(P<0.05),36+8远端应变显著大于28+4、32+4、36+4模型(P<0.05)。结论髋关节股骨柄锥部磨损与球头直径、偏心距存在相关性,增加球头直径或股骨柄锥部偏心距离会增大锥部磨损的发生风险。Objective To analyze the influence of the changes of ball-head diameter and offset of hip prosthesis on femoral stem cone stress distribution during total hip arthroplasty(THA)by finite element model.Methods CT scan was performed on the pelvis and proximal femur of a volunteer undergoing primary THA,and the models of Corail femoral stem and ball-head were obtained.In Creo 3.0 software,the diameter of 28,32,36 mm metal ball-heads were designed,the offset was changed by changing the offset distance inside the ball-head,the femoral ball-head models of 28-4,28,28+4,32-4,32,32+4,36-4,36+4,36+4,36+8 were established.In Abaqus 6.14 software,vertical and torsional loads were applied to the distal and proximal parts of the femoral stem cone(the joint of ball-head and femoral stem)to measure the stress and strain in the femoral stem cone.Results Under vertical and torsional loads,the cone stress of femoral stem was mainly concentrated on the distal junction of the head-neck,and the average stress at the distal model was significantly greater than that at the proximal model(P<0.01).Under vertical load,the femoral stem cone stress of 28+4,32+4,36+4 and 36+8 models was significantly greater than that of other models with the same diameter(P<0.05),and the distal stress of 36+8,36+4 models was significantly greater than that of 28+4,32+4 models(P<0.05).Under torsional load,the proximal stress of 36+8 model was significantly greater than that of other models(P<0.05).Under vertical load,the distal strain of 28+4,32+4,36+4 and 36+8 models was significantly greater than that of other models with the same diameter(P<0.05),and the distal strain of 36+8 was significantly greater than that of 28+4,32+4 and 36+4 models(P<0.05).Conclusions The cone wear of hip prosthesis is related to the diameter and offset of the ball-head.Increasing the diameter of the ball-head or the offset of the femoral stem cone will increase the risk of cone wear.

关 键 词：髋关节置换术 锥部磨损 偏心距 有限元分析 

分 类 号：R687.4[医药卫生—骨科学] R608[医药卫生—外科学]