中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (3): 561-569.doi: 10.12307/2025.877

• 骨与关节有限元分析Finite element analysis of bones and joints • 上一篇    下一篇

有限元分析肩袖撕裂时在不同骨密度条件下锚钉不同置入深度的应力分布

王  猛，路  坦，李敏杰，刘志成，郭霄勇   

  1. 新乡医学院第一附属医院，河南省卫辉市   453100
  • 收稿日期:2024-11-27 接受日期:2025-03-15 出版日期:2026-01-28 发布日期:2025-07-03
  • 通讯作者: 路坦，博士，副主任医师， 新乡医学院第一附属医院，河南省卫辉市 453100
  • 作者简介:王猛，男，1998年生，河南省汝南县人，汉族，在读硕士，医师，主要从事关节与运动医学生物力学及三维有限元分析研究。
  • 基金资助:
    2024年河南省医学科技攻关计划项目(LHGJ20240491)，项目负责人：路坦；教育部产学合作协同育人项目(231105079300854)，项目负责人：路坦

Finite element analysis of stress distribution of anchors at different implantation depths under different bone density conditions in rotator cuff tears

Wang Meng, Lu Tan, Li Minjie, Liu Zhicheng, Guo Xiaoyong   

  1. First Affiliated Hospital of Xinxiang Medical College, Weihui 453100, Henan Province, China
  • Received:2024-11-27 Accepted:2025-03-15 Online:2026-01-28 Published:2025-07-03
  • Contact: Lu Tan, MD, Associate chief physician, First Affiliated Hospital of Xinxiang Medical College, Weihui 453100, Henan Province, China
  • About author:Wang Meng, Master candidate, Physician, First Affiliated Hospital of Xinxiang Medical College, Weihui 453100, Henan Province, China
  • Supported by:
    2024 Henan Medical Science and Technology Project, No. LHGJ20240491 (to LT); Ministry of Education Industry-University Cooperation and Collaborative Education Project, No. 231105079300854 (to LT)

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摘要：

文题释义：

肩袖：指起于肩胛骨止于肱骨大小结节的肩胛下肌、冈上肌、冈下肌、小圆肌包绕肱盂关节形成的袖套状结构，对维持肩关节的活动和稳定起重要作用。
有限元分析：利用数学方法将连续物体划分为有限个单元，根据单元间节点数目以及实际承受的节点载荷，对每一单元假定一个适宜的近似结果，最后推导出域总的满足条件，得出最终解释结果。有限元分析是一种新兴的数字化研究方法，目前在骨科领域应用广泛。

摘要
背景：关节镜下锚钉修复已成为目前肩袖撕裂主要的治疗方式，其中锚钉置入状况是手术成败的关键因素；然而，目前不同骨密度条件下锚钉置入深度对骨道及锚钉应力的影响尚不明确。
目的：运用三维有限元分析技术探究不同骨密度条件下锚钉置入深度不同时骨道及锚钉的应力分布情况。
方法：采集志愿者肱骨CT影像数据，利用Mimics、3-Matic、Solidworks软件构建肱骨和锚钉模型；在3-Matic中，于肱骨相同位置分别创建距其表面0，2，4，6，8 mm 的孔洞并与锚钉装配；在Mimics中基于CT灰度值赋值，得到骨量正常(T值≥-1.0)的模型，改变参数构建骨量减少(-2.5 < T值< - 1.0)和骨质疏松(T值≤-2.5)模型；在各模型中沿与骨道内侧边缘相切方向给锚钉施加70 N拉力，观察不同骨密度条件下置入不同深度时骨道及锚钉应力分布及大小。 
结果与结论：①置入深度相同，骨密度降低时，锚钉最大等效应力增加，骨道最大等效应力降低；②骨密度相同，随锚钉置入深度增加，锚钉最大等效应力减小，置入深度为 4 mm时骨道应力最小且分布较均匀；锚钉应力主要分布在下方锚孔和近端螺纹周围，骨道应力主要在与近端螺纹接触部分，置入深度增加会改变应力分布的均匀性及模式，而骨密度对应力分布模式影响较小；③提示肱骨骨密度对肩袖撕裂锚钉修复至关重要，建议临床医生术前应测量肱骨大结节骨密度；锚钉置入过深并未显著增加其稳定性，临床医师可结合患者实际情况使用有限元分析法进行个性化术前评估，以达到最佳修复效果。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 肩袖撕裂, 锚钉, 置入深度, 骨道, 有限元分析, 骨质疏松, 骨科植入物

Abstract: BACKGROUND: Arthroscopic anchor repair has become the main treatment method for rotator cuff tears at present. Among them, the insertion status of the anchor is a key factor in the success or failure of the operation. However, currently, the impact of the insertion depth of the anchor on the stress of the bone tunnel and the anchor under different bone density conditions remains unclear.
OBJECTIVE: To explore the stress distribution of the bone tunnel and the anchor when the insertion depth of the anchor varies under different bone density conditions by using three-dimensional finite element analysis technology.
METHODS: The CT image data of the humerus of volunteers were collected, and the models of the humerus and the anchor were constructed by using Mimics, 3-Matic, and Solidworks software. In 3-Matic, holes with distances of 0, 2, 4, 6, and 8 mm from the surface of the humerus were respectively created at the same position of the humerus and assembled with the anchor. In Mimics, values were assigned based on the CT gray value to obtain a model with normal bone mass (T value ≥ -1.0). The parameters were changed to construct models with reduced bone mass (-2.5 < T value < -1.0) and osteoporosis (T value ≤ -2.5). In each model, a 70 N pulling force was applied to the anchor along the direction tangent to the inner edge of the bone tunnel. The stress distribution and magnitude of the bone tunnel and the anchor when inserted at different depths under different bone density conditions were observed.
RESULTS AND CONCLUSION: (1) When the insertion depth was the same, as the bone density decreased, the maximum equivalent stress of the anchor increased, while the maximum equivalent stress of the bone tunnel decreased. (2) When the bone density was the same, as the insertion depth of the anchor increased, the maximum equivalent stress of the anchor decreased. When the insertion depth was 4 mm, the stress of the bone tunnel was the smallest and the distribution was relatively uniform. The stress of the anchor was mainly distributed around the lower anchor hole and the proximal thread, and the stress of the bone tunnel was mainly at the part in contact with the proximal thread. The increase in the insertion depth would change the uniformity and pattern of the stress distribution, while the bone density had a relatively small impact on the stress distribution pattern. (3) It is concluded that the bone density of the humerus is crucial for the anchor repair of rotator cuff tears. It is recommended that clinicians measure the bone density of the greater tuberosity of the humerus before the operation. Excessive insertion depth of the anchor does not significantly increase its stability. Clinicians can conduct personalized preoperative assessments by using the finite element analysis method in combination with the actual situation of patients to achieve the best surgical results.

Key words: rotator cuff tear, anchor, insertion depth, bone tunnel, finite element analysis, osteoporosis, orthopedic implant

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