中国组织工程研究

中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (3): 380-384.doi: 10.3969/j.issn.2095-4344.0034

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

髋臼缺损程度对成人髋关节应力影响的三维有限元分析

田丰德1，2，赵德伟1，2，李东怡2，郭 林2，安 宁2，张 耀2，郝瑞胡2，崔大平1   

  1. 1大连理工大学电子信息与电气工程学部，辽宁省大连市 116024；2大连大学附属中山医院关节外科，辽宁省大连市 116001
  • 出版日期:2018-01-28 发布日期:2018-01-28
  • 通讯作者: 赵德伟，博士，主任医师，大连理工大学电子信息与电气工程学部，辽宁省大连市116024；大连大学附属中山医院关节外科，辽宁省大连市 116001
  • 作者简介:田丰德，男，1977年生，辽宁省沈阳市人，汉族，大连理工大学在读博士，副主任医师，主要研究方向为关节外科、生物力学及数字骨科。
  • 基金资助:

    国家自然科学基金资助项目(30670542)

Effect of acetabular defect on hip stress in adults: three-dimensional finite element analysis

Tian Feng-de1, 2, Zhao De-wei1, 2, Li Dong-yi2, Guo Lin2, An Ning2, Zhang Yao2, Hao Rui-hu2, Cui Da-ping1   

  1. 1Ministry of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian 116024, Liaoning Province, China; 2Department of Joint Surgery, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
  • Online:2018-01-28 Published:2018-01-28
  • Contact: Zhao De-wei, M.D., Chief physician, Ministry of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian 116024, Liaoning Province, China; Department of Joint Surgery, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
  • About author:Tian Feng-de, Studying for doctorate, Associate chief physician, Ministry of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian 116024, Liaoning Province, China; Department of Joint Surgery, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 30670542

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文题释义：
髋臼缺损：指髋臼部位的骨性缺损，是成人髋关节发育不良的典型特征之一，髋臼缺损也是导致和促进髋关节发育不良病情变化的主要因素。一般认为髋臼骨性缺损会导致髋臼对股骨头包容不足，二者间接触面积减少，在同样应力作用下就会导致关节接触面的压强增大，而长期异常增大的应力势必会造成髋关节磨损加快，髋关节骨组织进一步破坏，导致关节炎的发生，因而髋臼缺损与髋关节发育不良的发生和发展息息相关。
应力：物体由于外因(受力、湿度、温度场变化等)而变形时，在物体内各部分之间产生相互作用的内力，单位面积上的内力称为应力。髋关节是一球窝关节，一般情况下负荷通过关节负重面的中心，压应力平均分布关节接触面。髋关节发育不良患者的负荷一般作用在关节的边缘，臼的边缘应力最大，当应力超过骨所能耐受的阈值，则会出现骨吸收及囊性变。因而应力异常是导致髋关节发育不良发展主要原因。
 
摘要
背景：髋臼缺损是成人髋关节发育不良的典型特征之一。髋臼缺损导致其对股骨头包容不足，二者间接触面积减少，局部压强增大，久之势必造成髋关节磨损加快，导致关节炎甚至关节脱位的发生。但何种程度缺损才会导致髋关节生物力学改变，还没有公认的客观标准。
目的：应用三维有限元方法分析不同程度髋臼缺损对髋关节周围应力分布的影响，为临床治疗髋关节发育不良提供理论指导。
方法：选取正常成人髋关节CT薄层扫描数据，利用Mimics15.0和Hypermesh软件去除髋臼外缘部分骨性结构，模拟建立伴有不同程度骨缺损髋关节发育不良患者模型。以Ansys10.0加载关节负荷，分析单足着地情况下髋关节软骨下骨Von Mises应力分布情况。

结果与结论：各组模型计算结果与实际情况相符合，髋臼和股骨的最大Von Mises应力值出现在髋臼顶穹部及股骨颈后内侧；当模拟单腿站立时，其应力峰值随着CE角变小而增大，由CE角30°时的2.768 MPa和3.029 MPa 增加到5°时的11.075 MPa和15.322 MPa。CE角小于15°时该变化趋势更明显。提示髋臼缺损加大髋关节周围应力峰值，且缺损程度越大该影响越大，因而建议对于髋臼缺损患者尽早进行临床干预。

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
ORCID: 0000-0001-8451-7004(田丰德)

关键词: 骨科植入物, 成人, 髋关节发育不良, 髋臼, 缺损, 关节, 应力, 三维, 有限元

Abstract:

BACKGROUND: Acetabular defect is one of the typical characteristics of adult developmental dysplasia of the hip. The acetabular defect caused an insufficient coverage to the femoral head, which means the contact area between them decreased and the pressure increased. Stress concentration could quicken hip wear and lead to arthritis or dislocation of the hip. Till now, there is no accepted objective criterion about what degree defect could lead to biomechanics changes in the hip.

OBJECTIVE: To analyze the influence of different degrees of acetabular defect on the stress distribution of hip joint by using three-dimensional finite element method, and provide theoretical guidance for clinical treatment of hip dysplasia.
METHODS: CT thin layer scanning data of normal adult hip were selected. Hip dysplasia models with varying degrees of bone defect were built by using Mimics15.0 and Hypermesh software. Von Mises stress distribution on the subchondral bone of the hip was analyzed by using Ansys10.0 software in the case of single foot touchdown.
RESULTS AND CONCLUSION: Each model result was consistent with the actual situation. The maximum Von Mises stress value appeared at the top of the acetabulum dome and medial posterior femoral neck. When simulating one leg standing, the smaller the CE angle, the greater the maximum Von Mises stress on femoral head was; and acetabulum increased from 2.768 MPa and 3.029 MPa with 30° CE angle to 11.075 MPa and 15.322 MPa with 5° CE angle. This change was more obvious when CE angle was less than 15°. These findings confirmed that acetabular defect increases the peak stress of the hip joint, and the greater the defect, the greater the stress was. It is suggested that clinical intervention should be done as early as possible in patients with acetabular defect.

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

Key words: Hip Joint, Computer Simulation, Osteochondrodysplasias, Tissue Engineering

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