摘要
背景:股骨头缺血性坏死这一难治性骨科疾病严重影响患者的正常生活,受限于假体寿命与翻修的问题,临床建议年轻患者采取保髋治疗,在早期精准预测坏死区力学性能而后施加干预治疗是保髋的关键。目的:建立基于人体髋关节CT数据的包含髋骨和髋臼软骨的坏死股骨头有限元接触动力学模型,预测步行运动过程中不同坏死体积和坏死位置对坏死区域力学性能的影响。方法:采集志愿者髋关节CT影像学数据,重建了髋关节三维几何模型。基于Abaqus有限元软件建立股骨头坏死模型,构建了小、中、大体积坏死耦合坏死区域与力线重合、中度偏离和远离力线共9种不同坏死模型。预测在静态3000N载荷和一个ISO标准步行完整周期内不同坏死模型坏死区域的应力,对比评估坏死区域塌陷风险。结果与结论:①坏死体积增大和坏死区域靠近力线时坏死区内的最大等效应力显著增加,坏死区塌陷风险也随之增加;②对不同载荷类型,运动时相同坏死体积和坏死位置条件下的股骨头坏死区最大应力较静载作用下的最大应力显著提高;③表明运动过程中,步行运动使股骨头坏死区的最大等效应力较静载时显著增大,故局部塌陷风险会因为更大的局部应力而增大,但整体塌陷风险因承载区域动态变化较静载有所降低,在临床评估时骨科医生需考虑运动对力学性能的影响。
BACKGROUND:Avascular necrosis of the femoral head is a refractory orthopedic disease that seriously affects the normal life of patients.Hip preservation is recommended for young patients due to the limited prosthesis longevity and revision.Accurate prediction of the mechanical properties of the necrotic area in the early stage and then intervention is the key to hip preservation.OBJECTIVE:To establish a dynamic contact mechanics finite element model of necrotic femoral head based on human hip CT data and predict effects of both necrotic volume magnitude and its position on biomechanics of the necrotic region under walking movement.METHODS:CT data of a volunteer were collected and then geometry model of the hip was rebuilt.Finite element model of the necrotic femoral head was established using the Abaqus software.Nine different necrotic femoral models were constructed by combined both three different necrotic volume magnitudes(small,medium and big volume)and three different necrotic positions(coincided with,medium deviated with and kept away from the line of the force).The Von Mises of the necrotic region for all models were predicted under both 3000 N static load and dynamical loads of one whole ISO walking gait cycle.The collapse risk for all models was evaluated based on collapse criterion.RESULTS AND CONCLUSION:(1)More approaching of the necrotic region to the line of force and bigger collapse volume made the maximum Von Mises increasing.This also enlarged the collapse risk of the necrotic region.(2)For different load types,walking movement increased the maximum Von Mises of the necrotic region than that of the value under static load under the same necrotic volume and location.(3)In conclusion,dynamic load would result in increasing of the maximum Von Mises of the necrotic region comparing to static load during exercise.Therefore,the risk of local collapse will increase due to greater Von Mises.However,the overall collapse risk is lower than that of static load due to the dynamic change of bearing area.This factor should be carefully considered by surgeons when they evaluate the mechanical performance of the necrotic femoral head.
作者
高永昌
付彦涛
赵昕
崔庆峰
张志峰
陈世斌
Gao Yongchang;Fu Yantao;Zhao Xin;Cui Qingfeng;Zhang Zhifeng;Chen Shibin(National Engineering Laboratory for Highway Maintenance Equipment,School of Engineering Machinery,Chang’an University,Xi’an 710064,Shaanxi Province,China;Department of Joint Surgery,The Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,Inner Mongolia Autonomous Region,China;Dabo Medical Technology Co.,Ltd.,Xiamen 361000,Fujian Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2024年第33期5265-5269,共5页
Chinese Journal of Tissue Engineering Research
关键词
股骨头缺血性坏死
步行运动
有限元分析
塌陷风险
应力
avascular necrosis of femoral head
walking movement
finite element analysis
collapse risk
stress
作者简介
第一作者:高永昌,2016年西安交通大学毕业,博士,讲师,硕士生导师,主要从事生物力学和生物摩擦学方面的研究,https://orcid.org/0000-0002-7815-3790;通讯作者:张志峰,博士,主任医师,内蒙古医科大学第二附属医院关节外科,内蒙古自治区呼和浩特市010030;通讯作者:陈世斌,博士,教授,博士生导师,长安大学工程机械学院,公路养护装备国家工程实验室,陕西省西安市710064。
