目的 探讨全髋关节置换(total hip arthroplasty,THA)假体股骨柄颈干角、偏心距和前倾角等设计参数对髋关节接触力的影响。 方法 基于 AnyBody 软件建立 THA 骨肌多体动力学模型,参数研究股骨柄颈干角在±10°、偏心距在±20 mm 和前倾角在±10°内变化时单因素或多因素对髋关节接触力的影响规律。 结果 偏心距减小 20 mm, 最大髋关节接触力增加 26. 08% 。 颈干角增加 10°,最大髋关节接触力增加 5. 99% 。 前倾角增加 10°,会减小步态周期 0% ~ 24% 时髋关节接触力,峰值减小 19. 16% ;但会显著增加步态周期 38% ~ 70% 时髋关节接触力,峰值增加67. 78% 。 结论 在进行股骨柄髓外个性化设计时,在重建患者解剖参数的基础上,可以适当增加股骨柄偏置距离,减小颈干角和前倾角,以避免增加髋关节受力。
Objective To investigate the effects of design parameters such as neck-shaft angle, femoral offset and anteversion angle of total hip arthroplasty ( THA) prosthesis on contact forces of the hip. Methods A musculoskeletal multi-body dynamic model of THA was established based on AnyBody software. The effects of single or multiple factors on hip contact force were studied when the neck-shaft angle, eccentricity and anteversion angle varied within ±10°, ±20 mm and ±10°, respectively. Results The maximum hip contact force increased by 26. 08% when femoral offset was reduced by 20 mm. The maximum hip contact force increased by 5. 99% when the neck-shaft angle increased by 10°. When the anteversion angle increased by 10°, the hip contact force decreased at 0% -24% of gait cycle, with the peak decreasing by 19. 16% . However, the hip contact force was significantly increased at 38% -70% of gait cycle, with the peak increasing by 67. 78% . Conclusions In extramedullary design of the femoral stem, based on reconstruction of the patient’s anatomical parameters, the offset of the femoral stem can be appropriately increased, and the neck-shaft angle and anteversion angle can bereduced to avoid increasing forces on the hip.