1.昆明理工大学 机电工程学院;2.昆明医科大学附属第二医院 骨科
1.Kunming university of science and technology Electrical and mechanical engineering department;2.Department of orthopedics, the second affiliated hospital of kunming medical university
目的 探究在Bernese髋臼截骨术的术前规划中不同的模型范围对髋臼应力分布和截骨最佳角度结果的影响,为临床术前规划的模型范围选择及其影响提供理论基础。方法 对一位髋关节发育不良患者按照模型范围不同建立两个模型M1和M2,M1包括患侧髋骨和股骨,M2包括完整骨盆及患侧股骨。对比分析两模型单腿站立情况下的髋臼软骨接触压力、面积和分布情况并进行模拟截骨分析两种建模方式对术前规划结果的影响。结果 术前M2相比M1接触压力大、接触面积小并且分布更靠近髋臼月状面上边缘,比较11个术后方案M1的接触压力变化幅值和最佳截骨角度均小于M2。结论 在模型范围只有患侧髋骨和股骨的术前分析结果会低估应力集中程度和误判应力集中点的位置,并且其最佳截骨旋转角度结果较小,为截骨术前规划建模提供一定理论依据。
Objective: To explore the influence of different model scopes on acetabular stress distribution and optimal osteotomy results in preoperative planning of Bernese acetabular osteotomy, so as to provide a theoretical basis for the selection and influence of model scopes in clinical preoperative planning. Methods: Two models M1 and M2 were established for a patient with hip dysplasia according to the model range, M1 including the affected hip bone and femur, M2 including the intact pelvis and the affected femur. The contact pressure, area and distribution of acetabular cartilage in the two models were compared and analyzed under the condition of standing on one leg. Results: Compared with M1 before surgery, M2 had higher contact pressure, smaller contact area and closer distribution to the meniscus edge of acetabulum. Compared with 11 postoperative plans, M1"s contact pressure variation amplitude and optimal osteotomy Angle were all less than M2. Conclusion: In the range of the model, only preoperative analysis results of the affected hip bone and femur would underestimate the degree of stress concentration and misjudge the location of the stress concentration point, and the optimal osteotomy rotation Angle would be relatively small, which would provide a certain theoretical basis for preoperative planning and modeling of osteotomy.