中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (21): 5429-5436.doi: 10.12307/2026.125

• 人工假体 artificial prosthesis • 上一篇    下一篇

围塌陷期股骨头坏死髓芯减压陶瓷棒置入的有限元分析

梁英杰,袁伶俐,耿春辉,张仲传,郑文明,胡腾飞,唐昊旭,张坤坤   

  1. 蚌埠医科大学第二附属医院骨科,蚌埠医科大学数字骨科重点实验室,安徽省蚌埠市   233002
  • 接受日期:2025-06-17 出版日期:2026-07-28 发布日期:2026-03-04
  • 通讯作者: 袁伶俐,主任医师,副教授,蚌埠医科大学第二附属医院骨科,蚌埠医科大学数字骨科重点实验室,安徽省蚌埠市 233002
  • 作者简介:梁英杰,男,1997年生,安徽省阜阳市人,汉族,蚌埠医科大学在读硕士,主要从事关节外科方向的研究。
  • 基金资助:
    安徽省高等学校自然科学重点研究项目(KJ2021A0756),项目负责人:袁伶俐;安徽省高等学校自然科学重点研究项目(2024AH051221),项目负责人:张坤坤

Finite element analysis of core decompression with ceramic rod implantation in osteonecrosis of the femoral head during the peri-collapse stage

Liang Yingjie, Yuan Lingli, Geng Chunhui, Zhang Zhongchuan, Zheng Wenming, Hu Tengfei, Tang Haoxu, Zhang Kunkun   

  1. Department of Orthopedics of Second Affiliated Hospital of Bengbu Medical University, Key Laboratory of Digital Orthopedics of Bengbu Medical University, Bengbu 233002, Anhui Province, China

  • Accepted:2025-06-17 Online:2026-07-28 Published:2026-03-04
  • Contact: Yuan Lingli, Chief physician, Associate professor, Department of Orthopedics of Second Affiliated Hospital of Bengbu Medical University, Key Laboratory of Digital Orthopedics of Bengbu Medical University, Bengbu 233002, Anhui Province, China
  • About author:Liang Yingjie, Master candidate, Department of Orthopedics of Second Affiliated Hospital of Bengbu Medical University, Key Laboratory of Digital Orthopedics of Bengbu Medical University, Bengbu 233002, Anhui Province, China
  • Supported by:
    Anhui Provincial Key Research Project of Natural Sciences of Higher Education Institutions, No. KJ2021A0756 (to YLL); Anhui Provincial Key Research Project of Natural Sciences of Higher Education Institutions, No. 2024AH051221 (to ZKK)

摘要:

文题释义:

围塌陷期:是指股骨头坏死从稳定状态向塌陷发展的过渡阶段,包括塌陷前期和塌陷早期,对应于ARCOⅡ期/FicatⅡ期,坏死区累及股骨头前外侧壁,至 ARCOⅢB期/FicatⅢ期(塌陷≤4 mm,硬化带不明显者);且临床出现髋部疼痛时间一般少于6个月。
有限元分析:运用变分法原理来解决物理模型问题,将复杂的模型分解为有限数量的小单元,并为这些单元赋予相应的材料属性。通过静态力学分析对模型施加应力,进行数字化的受力分析。

摘要
背景:β-磷酸三钙生物陶瓷棒的弹性模量与正常骨组织较为接近,并且展现出卓越的生物兼容性和力学特性,可作为髓芯减压后股骨头内部的支撑材料。但目前股骨头坏死及陶瓷棒置入后股骨头相关应力位移变化情况等生物力学相关研究较少。
目的:探究围塌陷期股骨头坏死治疗过程中髓芯减压陶瓷棒置入对股骨头生物力学的影响。
方法:筛选围塌陷期股骨头坏死髓芯减压陶瓷棒置入患者19例共 21髋,获取术前术后影像学资料。在Mimics 21.0软件中载入患者髋关节CT图像,构建出股骨头的三维模型,创建包含皮质骨和松质骨的股骨近端整体模型,以及股骨近端松质骨模型。再将患者的术前MRI影像资料导入,运用图形匹配技术,制作坏死灶模型,并以.stl格式保存,将其转移到Geomagic 2012软件中,进行光滑和精确曲面处理。随后在SolidWorks 2021软件中进行陶瓷棒设计并建模,导入相关模型进行装配和布尔运算,确保干涉检查无误后,利用ANSYS 2021软件计算并观察单足站立及行走后蹬阶段股骨头负重区、坏死区应力及位移情况。
结果与结论:①股骨头承受最大应力的区域位于坏死部分的前外侧上方,在单足站位时,术后负重区及坏死区应力值较术前显著降低(P < 0.05),股骨头塌陷值(负重区位移值)较术前降低(P < 0.05);②在行走后蹬阶段,随着所受载荷的增加,术后负重区及坏死区应力值及股骨头塌陷值(负重区位移值)均有所增加,但仍低于术前(P < 0.05);③提示髓芯减压联合陶瓷棒置入有助于降低股骨头表面负重区域的负荷,使负重区域的应力得到有效分散,载荷部分向股骨矩方向传递,改善局部应力集中状态,有效支撑股骨头以防止进一步塌陷。


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: 股骨头坏死, 围塌陷期, 陶瓷棒, 髓芯减压, 生物力学, 有限元分析, 骨科植入物

Abstract: BACKGROUND: The elastic modulus of β-tricalcium phosphate bioceramic rods is close to that of normal bone tissue, and it exhibits excellent biocompatibility and mechanical properties. It can be used as a supporting material inside the femoral head after core decompression. However, there are few biomechanical studies on osteonecrosis of the femoral head and the changes in stress and displacement of the femoral head after ceramic rod implantation. 
OBJECTIVE: To explore the biomechanical effects of core decompression with ceramic rod implantation in the treatment of osteonecrosis of the femoral head during the peri-collapse stage. 
METHODS: A total of 21 hips were selected from 19 patients with osteonecrosis of the femoral head implanted with ceramic rods at the peri-collapse stage. Preoperative and postoperative imaging data were obtained, and relevant CT images were loaded in Mimics 21.0 software to construct a three-dimensional model of the femoral head. A global model of the proximal femur that includes cortical and cancellous bone, as well as a model of the proximal cancellous bone of the femur were created. The preoperative MRI image data of the patients were imported, and the necrotic lesion model was made by using the graphic matching technology, which was saved in .stl format. They were transferred to Geomagic 2012 software for smooth and precise surfacing processing. The ceramic rod was designed and modeled in SolidWorks 2021 software, and the relevant models were imported for assembly and Boolean operation. After ensuring that the interference check was correct, the stress and displacement of the weight-bearing area and necrotic area of the femoral head during the one-legged standing and walking post-pedal stages were calculated and observed by the ANSYS 2021 software.
RESULTS AND CONCLUSION: (1) The area of maximum stress on the femoral head was located above the anterolateral aspect of the necrotic part, and the stress values of the postoperative weight-bearing area and necrotic area were significantly lower than those before operation when standing on one foot (P < 0.05). The risk of femoral head collapse was lower than that before operation (P < 0.05). (2) In the postoperative pedaling stage, with the increase of the load, the stress values and collapse risk of the postoperative weight-bearing area and necrosis area increased, but they were still lower than those before the operation (P < 0.05). (3) Medullary core decompression combined with ceramic rod implantation can help to reduce the load on the weight-bearing area of the femoral head surface, so that the stress in the weight-bearing area can be effectively dispersed, and the load part is transferred to the direction of the femoral moment, which can improve the local stress concentration state and effectively support the femoral head to prevent further collapse. 

Key words: osteonecrosis of the femoral head, peri-collapse stage, ceramic rod, core decompression, biomechanics, finite element analysis, orthopedic implant

中图分类号: