摘要
目的探讨先天性髋关节发育不良(developmental dysplasia of the hip,DDH)患者全髋关节置换(total hip arthroplasty,THA)中股骨偏心距的生物力学影响。方法以1例CroweⅣ型DDH女性患者的相关数据为材料,基于骨肌多体动力学软件AnyBody,建立与患者对应的个体化THA下肢骨肌多体动力学模型,分析股骨偏心距在±20 mm内变化时髋关节力、外展肌力的改变。同时建立不同偏心距下股骨-S-ROM假体动态有限元模型,由骨肌模型计算的不同偏心距下水平匀速行走步态内的动态载荷被加载至相应的有限元模型,对S-ROM假体柄与袖套之间的应力、接触应力和微动进行分析。结果股骨偏心距±20 mm内的变化对髋关节力峰值影响较小,股骨偏心距减小会导致外展肌力峰值显著增加,股骨偏心距增大会导致柄的最大应力、接触应力和微动显著增加。结论 DDH患者THA中股骨偏心距改变对外展肌力和假体最大应力、接触应力与微动影响显著,医生应予以考虑。
Objective To investigate the biomechanical effects of femoral offset(FO) on total hip arthroplasty(THA) patients with developmental dysplasia of the hip(DDH). Methods Based on the musculoskeletal dynamic software AnyBody and the related data from a female patient with Crowe Ⅳ DDH, the corresponding patient-specific lower extremity musculoskeletal multi-body dynamic model was constructed to analyze both hip joint forces and abductor forces within ±20 mm variation of FOs. The dynamic finite element(FE) model of S-ROM stem with varying offsets was also established. The dynamic load during a whole walking gait cycle calculated by the multi-body musculoskeletal model was applied to this FE models, and the Von Mises stress, contact stress, and stem-sleeve micromotion were then analyzed. Results A variation of ±20 mm offset had small influences on peak forces of hip joints. However, the decrease in FO could lead to an obvious increase in peak abductor force, while the increase in FO could lead to an obvious increase in the maximum Von Mises stress, contact stress, and micromotion of S-ROM prosthesis stem. Conclusions The change in FO had an obvious influence on the abductor forces, the maximum Von Mises stress, the contact pressure and the consequent fretting wear of THA patients with DDH, which should be carefully considered by surgeons.
作者
陈夕辉
柴伟
高永昌
张志峰
靳忠民
CHEN Xihui;CHAI Wei;GAO Yongchang;ZHANG Zhifeng;JIN Zhongmin(State Key Laboratory for Manufacturing System Engineering,School of Mechanical Engineering,Xi'an Jiaotong University,Xi'an 710054,China;Department of Orthopaedics,General Hospital of PLA,Beijing 100853,China;School of Construction Machinery,Chang'an University,Xi'an 710054,China)
出处
《医用生物力学》
EI
CAS
CSCD
北大核心
2019年第3期225-231,共7页
Journal of Medical Biomechanics
基金
国家自然科学基金项目(51323007)
中央高校基金项目(300102258106)
关键词
先天性髋关节发育不良
全髋关节置换
骨肌多体动力学
有限元分析
生物力学
developmental dysplasia of the hip(DDH)
total hip arthroplasty(THA)
muscluloskeletal multibody dynamics
finite element analysis
biomechanics
