Establishment of simulating three-dimensional model of China-Japan Friendship Hospital Classification for L type osteonecrosis of the femoral head

doi:10.3969/j.issn.2095-4344.2017.07.017

Abstract

Abstract:

BACKGROUND: Anterior and lateral columns of the femoral head integrity and stability have been reported to present a positive correlation with the prognosis of the osteonecrosis of the femoral head (ONFH) and efficacy of hip preserving. China-Japan Friendship Hospital Classification stressed that the retention of the anterior and lateral columns of the femoral head was of great importance to avoid the femoral head collapse, but there is little reported on its three-dimensional (3D) digital model.

OBJECTIVE: To explore the method of establishing highly-simulated 3D model of China-Japan Friendship Hospital Classification for ONFH.

METHODS: 3D reconstruction of normal and necrotic femoral head was established according to the CT and MRI of individuals with normal femoral head. A healthy adult male volunteer was selected and his CT image was collected; three adult male patients with types L1, L2 and L3 ONFH were selected, whose MRI images were obtained, respectively. 3D solid models were established based on CT and MRI data on Mimics 15.0, Geomagic Studio 13, Geomagic Design X, Solidworks2014 and Abauqus6.14 software.

RESULTS AND CONCLUSION: A highly-simulated 3D model of L type ONFH was established, including the cortical and cancellous bones of ilium and proximal femur, articular cartilage, necrotic articular cartilage, muscles, joint capsule and ligaments. It clearly showed the spatial structures of L type ONFH, by which different surgical programs could be compared in a virtual environment for selecting an appropriate treatment strategy to improve the success rate of hip preserving. The highly-simulated 3D model paves ways for surgical simulation and biomechanical analysis.

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: Femur Head Necrosis, Imaging, Three-Dimensional, Tissue Engineering

CLC Number:

R318

Ling Guan-han, Ou Zhi-xue, Yao Lan, Wen Li-chun, Wang Guo-xiang, Lin Heng-feng. Establishment of simulating three-dimensional model of China-Japan Friendship Hospital Classification for L type osteonecrosis of the femoral head[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(7): 1074-1079.

Figures/Tables 1

References

[1] 庞智晖.股骨头前外侧柱与激素性股骨头坏死预后和保髋疗效的相关性研究[D].广州:广州中医药大学,2008.

[2] 李子荣,刘朝晖,孙伟,等.基于三柱结构的股骨头坏死分型:中日友好医院分型[C]//全国骨关节与风湿病暨第三届武汉国际骨科高峰论坛论文汇编.2012:13-22.

[3] 李子荣.股骨头坏死:早期诊断与个体化治疗[J].中国矫形外科杂志,2013,21(19):1909-1911.

[4] 庞智晖,魏秋实,周广全,等.个体股骨头坏死三维有限元模型的建立与应用[J].生物医学工程学杂志,2012,29(2):251-255.

[5] Papini M, Zdero R, Schemitsch EH, et al. The biomechanics of human femurs in axial and torsional loading: comparison of finite element analysis, human cadaveric femurs, and synthetic femurs. J Biomech Eng. 2007;129(1):12-19.

[6] Brown TD, Way ME, Ferguson AB Jr. Mechanical characteristics of bone in femoral capital aseptic necrosis. Clin Orthop Relat Res. 1981;(156):240-247.

[7] Brown TD, Hild GL. Pre-collapse stress redistributions in femoral head osteonecrosis--a three-dimensional finite element analysis. J Biomech Eng. 1983;105(2):171-176.

[8] Stewart KJ, Edmonds-Wilson RH, Brand RA, et al. Spatial distribution of hip capsule structural and material properties. J Biomech. 2002;35(11):1491-1498.

[9] Grecu D, Pucalev I, Negru M, et al. Numerical simulations of the 3D virtual model of the human hip joint, using finite element method. Rom J Morphol Embryol. 2010;51(1): 151-155.

[10] Sverdlova NS, Witzel U. Principles of determination and verification of muscle forces in the human musculoskeletal system: Muscle forces to minimise bending stress. J Biomech. 2010;43(3):387-396.

[11] Wang C, Peng J, Lu S. Summary of the various treatments for osteonecrosis of the femoral head by mechanism: A review. Exp Ther Med. 2014;8(3):700-706.

[12] Chen SB, Hu H, Gao YS, et al. Prevalence of clinical anxiety, clinical depression and associated risk factors in chinese young and middle-aged patients with osteonecrosis of the femoral head. PLoS One. 2015;10(3):e0120234.

[13] 何伟.如何把握股骨头坏死患者的保髋治疗时机[J].中国骨与关节杂志,2016,5(2):82-86.

[14] Eward WC, Rineer CA, Urbaniak JR, et al. The vascularized fibular graft in precollapse osteonecrosis: is long-term hip preservation possible? Clin Orthop Relat Res. 2012;470(10): 2819-2826.

[15] Cui Q, Botchwey EA. Emerging ideas: treatment of precollapse osteonecrosis using stem cells and growth factors. Clin Orthop Relat Res. 2011;469(9):2665-2669.

[16] Liu ZH, Guo WS, Li ZR, et al. Porous tantalum rods for treating osteonecrosis of the femoral head. Genet Mol Res. 2014;13(4):8342-8352.

[17] 王金星,陈勇忠,卫秀洋.髓芯减压植骨?钽棒植入联合BMSCs治疗早期股骨头坏死疗效观察[J].中国医药科学, 2013,3(8): 17-19.

[18] Gao YS, Liu XL, Sheng JG, et al. Unilateral free vascularized fibula shared for the treatment of bilateral osteonecrosis of the femoral head. J Arthroplasty. 2013;28(3):531-536.

[19] Tetik C, Ba?ar H, Bezer M, et al. Comparison of early results of vascularized and non-vascularized fibular grafting in the treatment of osteonecrosis of the femoral head. Acta Orthop Traumatol Turc. 2011;45(5):326-334.

[20] Wei BF, Ge XH. Treatment of osteonecrosis of the femoral head with core decompression and bone grafting. Hip Int. 2011;21(2):206-210.

[21] Wang BL, Sun W, Shi ZC, et al. Treatment of nontraumatic osteonecrosis of the femoral head using bone impaction grafting through a femoral neck window. Int Orthop. 2010; 34(5):635-639.

[22] Zuo W, Sun W, Gao F, et al. Effectiveness of bone grafting through windowing at femoral head-neck junction for treatment of osteonecrosis with segmental collapse of femoral head. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016; 30(4):397-401.

[23] Liu D, Chen Q, Chen Y, et al. Long-term follow-up of early-middle stage avascular necrosis of femoral head with core decompression and bone grafting. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26(10):1165-1168.

[24] Papanagiotou M, Malizos KN, Vlychou M, et al. Autologous (non-vascularised) fibular grafting with recombinant bone morphogenetic protein-7 for the treatment of femoral head osteonecrosis: preliminary report. Bone Joint J. 2014; 96-B(1): 31-35.

[25] Lieberman JR, Conduah A, Urist MR. Treatment of osteonecrosis of the femoral head with core decompression and human bone morphogenetic protein. Clin Orthop Relat Res. 2004;(429):139-145.

[26] Zhou GQ, Pang ZH, Chen QQ, et al. Reconstruction of the biomechanical transfer path of femoral head necrosis: a subject-specific finite element investigation. Comput Biol Med. 2014;52:96-101.

[27] Zhou G, Zhang Y, Zeng L, et al. Should thorough Debridement be used in Fibular Allograft with impaction bone grafting to treat Femoral Head Necrosis: a biomechanical evaluation. BMC Musculoskelet Disord. 2015;16:140.

[28] 樊向利,郭征,宫赫,等.正常人股骨近端生物力学性能的区域性分析[J].中国骨与关节损伤杂志,2011,26(7):601-603.

[29] 王亦璁, 姜保国.骨与关节损伤[M].5版.北京:人民军医出版社, 2016:9,12.