摘要
目的分析膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)和全膝置换术(total knee arthroplasty,TKA)后长期胫骨近端力学性能的变化,探究UKA和TKA的失效原因。方法建立健康、UKA、TKA胫骨近端有限元模型,利用Wolff骨重建理论结合有限元法预测胫骨近端的密度分布和应力分布。结果UKA外侧踝平均应力基本不变,但呈增大趋势,平均密度增加2%,内侧踝平均密度减小13%,平均应力均减少11%。TKA外侧踝平均密度减少1.5%,平均应力减少14%,内侧踝平均密度减少1.4%,平均应力减少19%,假体末端平均密度增加10%,平均应力增加15%。结论UKA、TKA假体的植入会造成应力遮挡现象,可能是产生术后假体松动的主要原因。TKA假体末端应力增大,可能导致TKA失效。UKA非置换侧平均应力随着骨重建的进行不断增大,可能导致UKA中远期对侧骨关节炎恶化。研究结果可以为降低UKA、TKA并发症发生概率提供数据支持。
Objective To analyze long-term mechanical properties of the proximal tibia after unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA),and explore the causes of UKA and TKA failure.Methods The healthy,UKA,TKA proximal tibial finite element models were established.The density distribution and stress distribution of the proximal tibia were predicted using Wolff’s bone reconstruction theory combined with the finite element method.Results The average stress in UKA lateral ankle was basically unchanged,but with an increasing tendency.There was a 2%increase in average density,the average density of the medial ankle was reduced by 13%and the average stresses were reduced by 11%.There was a 1.5%reduction in average density,and a 14%reduction in average stress in TKA lateral ankle.The average density of the medial ankle was reduced by 1.4%,and the average stress was reduced by 19%.There was a 10%increase in average density at the prosthetic end,and a 15%increase in average stress.Conclusions Implantation of UKA and TKA prostheses can cause stress shielding,which may be the main cause of post-operative loosening of the prosthesis.There is an increase in the stress at the end of TKA prosthesis,which may lead to the failure of TKA.The average stress on the non-replacement side of the UKA increases with the bone reconstruction,which may lead to worsening of osteoarthritis on the contralateral side of the UKA in the medium to long term.The results of this study may provide data support for reducing probability of UKA and TKA complications.
作者
吕林蔚
杨晨
宋阳
张春秋
LÜLinwei;YANG Chen;SONG Yang;ZHANG Chunqiu(Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control,Tianjin University of Technology,Tianjin 300384,China;National Demonstration Center for Experimental Mechanical and Electrical Engineering Education,Tianjin University of Technology,Tianjin 300384,China)
出处
《医用生物力学》
CAS
CSCD
北大核心
2023年第3期542-548,共7页
Journal of Medical Biomechanics
基金
天津市自然科学基金项目(21JCYBJC00910)
国家自然科学基金项目(12072235)。
关键词
单髁置换术
全膝置换术
胫骨近端
骨重建
骨密度
unicompartmental knee arthroplasty(UKA)
total knee arthroplasty(TKA)
proximal tibia
bone remodeling
bone density
