目的 模拟正常和膝外翻时胫骨近端的内部结构。方法 采用定量骨重建理论与有限元法相结合，对正常力学环境下胫骨近端的内部结构进行模拟，然后以此结构为初始模型，根据膝外翻情况下胫骨平台压力分布的改变规律，合力的作用点在胫骨外侧平台上，模拟膝外翻后胫骨近端内部结构。结果 模拟得到的骨密度分布与真实胫骨进行对比，无论是正常力学环境下还是膝外翻情况下，都与实际非常吻合。结论 本研究所采用的方法与载荷的分布方式能够正确地模拟预测胫骨近端内部结构，是进一步研究全膝关节置换术后假体周围骨重建行为的基础。

Objective To simulate the internal structure of proximal tibia in both normal and valgus knees. Methods The internal structure of proximal tibia under normal mechanical environment was simulated using quantitative bone remodeling theory combined with finite element method. Based on this structure as the initial model and the changing pattern of pressure distributions on tibial plateau in valgus knee, the internal structure of proximal tibia in valgus knee was simulated with the action point of resultant force on the lateral tibial plateau. Results The simulated distributions of bone mineral density (BMD) were compared with the real tibia, and found the simulated results highly consistent with the actual ones both under normal mechanical environment and in valgus cases. Conclusions The method and the load distributions adopted in this study can accurately simulate and predict the internal structure of proximal tibia, thus could be served as the basis for further study on periprosthetic bone remodeling behavior after the total knee arthroplasty.

国家自然科学基金资助项目（10972090, 10832012, 10872078），吉林大学科学前沿与交叉学科创新项目（200903169）