中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (15): 3780-3790.doi: 10.12307/2026.682

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

前交叉韧带断裂时胫骨平台假体后倾角度影响单髁置换假体寿命的有限元分析

王继东,陶率先,刘  硕,季首璋,聂海涛,蒲鑫伟,洛松久美,李钊伟,任  荣   

  1. 青海大学附属医院,青海省西宁市  810001
  • 接受日期:2025-05-19 出版日期:2026-05-28 发布日期:2025-11-05
  • 通讯作者: 李钊伟,主任医师,教授,博士生导师,主任,青海大学附属医院,青海省西宁市 810001 共同通讯作者:任荣,副主任医师,硕士生导师,青海大学附属医院,青海省西宁市 810001
  • 作者简介:王继东,男,1997年生,青海省人,汉族,在读硕士,主要从事骨关节方面的研究。 共同第一作者:刘硕,男,1998年生,河南省人,汉族,在读硕士,主要从事骨关节方面的研究。

Finite element analysis of effect of tibial plateau prosthesis posterior tilt angle on life of unicompartmental knee replacement prosthesis during anterior cruciate ligament rupture

Wang Jidong, Tao Shuaixian, Liu Shuo, Ji Shouzhang, Nie Haitao, Pu Xinwei, Luo Songjiumei, Li Zhaowei, Ren Rong   

  1. Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China
  • Accepted:2025-05-19 Online:2026-05-28 Published:2025-11-05
  • Contact: Li Zhaowei, Chief physician, Professor, Doctoral supervisor, Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China Co-corresponding author: Ren Rong, Associate chief physician, Master’s supervisor, Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China
  • About author:Liu Shuo, Master candidate, Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China Wang Jidong and Liu Shuo contributed equally to this article.

摘要:

文题释义:

胫骨平台假体后倾角度:是单髁置换术中冠状面截骨平面与胫骨解剖轴垂线的夹角,直接影响膝关节屈曲间隙和衬垫应力。推荐范围3°-7°,超过10°时前皮质撞击风险增加34%,负角度致屈曲受限率升高27%。因此手术过程中需结合假体类型调整、个体化精准测量。
有限元分析:是一种基于数学建模的力学仿真技术,通过将复杂结构离散为有限单元,量化评估应力、应变及位移分布。在骨科植入物研究中,三维有限元分析可精确模拟置入假体-骨界面的生物力学行为。

摘要
背景:膝关节单髁置换的临床应用受限于前交叉韧带断裂导致的膝关节动力学异常,而胫骨平台假体后倾角度作为调节胫股关节应力分布的关键参数,两者与假体长期磨损的关系尚未明晰。
目的:通过有限元分析探究前交叉韧带断裂时膝关节单髁置换中不同胫骨平台假体后倾角度对假体使用寿命的影响,寻求适合的胫骨平台假体后倾角。
方法:提取1名健康志愿者膝关节CT薄层扫描数据建立前交叉韧带完整和断裂情况下的膝关节模型,按照单髁置换标准手术步骤将假体模型以3°,5°,7°,9°,11°不同胫骨平台假体后倾角进行装配,通过有限元分析模型,得出各部分假体的最大主应力、受力云图及最大主应力变化率。
结果与结论:①胫骨平台假体后倾3°,5°,7°,9°,11°时,股骨髁假体、胫骨平台垫假体、胫骨平台假体各假体在前交叉韧带断裂前后最大主应力接近,各假体最大主应力无明显的变化规律,胫骨平台假体、股骨假体、胫骨平台衬垫假体所受应力依次减小;②胫骨平台假体后倾角为5°时各假体最大应力变化率最小,胫骨平台假体所受到的最大主应力较大;③提示在不修复韧带的情况下若施行膝关节单髁置换治疗,推荐术中胫骨平台假体后倾角度取值为3°-5°或可弥补前交叉韧带断裂对假体使用寿命的不利影响。


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: 韧带断裂, 膝关节, 骨关节炎, 单髁置换, 最大主应力

Abstract: BACKGROUND: Clinical application of unicompartmental knee replacement is limited by the abnormal knee joint dynamics caused by anterior cruciate ligament rupture. The posterior tilt angle of the tibial plateau prosthesis is a key parameter for regulating the stress distribution of the tibiofemoral joint. The relationship between the two and the long-term wear of the prosthesis is not clear.
OBJECTIVE: To explore the effects of different tibial plateau tilt angles on prosthesis life in unicompartmental knee arthroplasty with anterior cruciate ligament rupture using finite element analysis, aiming to identify an optimal tibial plateau tilt angle.
METHODS: Thin-slice CT scan data of the knee joint of a healthy volunteer were used to construct knee models with intact and ruptured anterior cruciate ligaments. Prosthesis models were assembled according to standard unicompartmental knee arthroplasty surgical procedures at varying tibial plateau tilt angles of 3°, 5°, 7°, 9°, and 11°. Finite element analysis of the models revealed the maximum principal stress, force contours, and maximum principal stress change rates of each prosthesis component.
RESULTS AND CONCLUSION: (1) When the tibial plateau prosthesis was tilted 3°, 5°, 7°, 9°, and 11°, the maximum principal stress of the femoral condyle prosthesis, tibial plateau pad prosthesis, and tibial plateau prosthesis before and after the anterior cruciate ligament rupture was close, and there was no obvious change pattern in the maximum principal stress of each prosthesis. The stress of the tibial plateau prosthesis, femoral prosthesis, and tibial plateau pad prosthesis decreased in turn. (2) When the tibial plateau prosthesis tilted 5°, the maximum stress change rate of each prosthesis was the smallest, and the maximum principal stress of the tibial plateau prosthesis was greater. (3) It is suggested that if unicompartmental knee replacement is performed without repairing the ligament, it is recommended that the intraoperative tibial plateau prosthesis tilt angle should be 3°-5°, which may compensate for the adverse effects of anterior cruciate ligament rupture on the prosthesis service life.


Key words: ligament rupture, knee, osteoarthritis, unicompartmental replacement, maximum principal stress

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