不同结构骨块植入股骨头负重区缺损的力学性能比较
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国家自然科学基金(30330570)


Biomechanical comparison of different structural bone grafting in femoral heads’ defects of weight-bearing region
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    摘要:

    目的股骨头缺血坏死早中期手术中,为防止股骨头的进一步塌陷,常需要植骨填充坏死区。本文研究不同结构植入物填充股骨头负重区缺损后对股骨头力学性能的影响。方法选取人正常股骨近段4例,在股骨头负重区沿压力骨小梁方向制造直径20mm,深30mm的骨缺损,并在缺损区内植入三种不同结构的植入物。Ⅰ组为取自异体股骨头负重区骨块;Ⅱ组为取自异体股骨髁负重区骨块;Ⅲ组为松质骨粒打压植骨。模拟单腿站立相加载,记录股骨头颈结合部的应变分布。结果直径20mm深30mm骨缺损的股骨近段与正常相比,头颈结合部上方拉应变平均增加93.0%,下方压应变平均增加203.4%。植入不同结构的植入物后,Ⅰ组头颈结合部上方应变较正常平均增加6.6%,下方应变平均增加67.6%;Ⅱ组上方应变较正常平均增加33.7%,下方应变平均增加136.9%;Ⅲ组上方应变平均增加150.4%,下方应变平均增加206.1%。结论股骨头负重区的缺损会改变头颈结合部应力分布,其中结合部下方和上方出现应力的集中。植入与缺损区的骨小梁结构相似的异体股骨头骨块后,股骨头下方和上方头颈结合部的应力集中得到缓解,其植入效果优于骨小梁结构不同的股骨髁骨块;松质骨粒打压植骨不能改变股骨头头颈结合部的应变分布。

    Abstract:

    Objective In early stage of femoral head osteonecrosis, bone grafting in necrosis region are used to prevent collapse. This paper studied the influence on mechanical ability of bone defects in human femoral head’s weight bearing region and the restoration degree of mechanical ability after being planted by different structural bone. Methods Four normal proximal femur of human were harvested. Bone defects (20 mm in diameter and 30mm in depth) within the femoral heads’ principal weight-bearing region were drilled and the biomechanical properties of both the intact and the defected proximal femur were tested in vitro by simulating single-leg stance phase. Rigidity of the whole proximal femur and the strain value at the juncture of femoral head and neck under 1400N load were evaluated. And then, the bone defects were implanted with three different structural bone graftings. Group I was femoral head block allograft. Group II was femoral condyle block allograft. Group III was impacted with cancellous bone chips. The rigidity and the strain value were recorded same as above. Results Compared with the intact group, the strain of the top junction of femoral head and neck in defect group increased 93.0% and the strain of the bottom junction increased 203.4%. After implanted with different structural grafts and compared with the intact group, the strain of top conjunction of femoral head and neck increased 6.6% in group I, 33.7% in group II and 150.4% in group III,respectively, while the strain of bottom conjunction increased 67.6%, 136.9% and 206.1%. Conclusion Bone defects of the weight-bearing region in human femoral head would increase the strain distribution around the conjunction of femoral head and neck. The change of strain value would be found obviously in the top and bottom conjunction. After implanted with femoral head block allograft, the stress concentration could be lessened. However, there is no obvious improvement in biomechanical properties after implantedwith cancellous bone chips.

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汪爱媛,彭江,孙明学,眭祥,王鑫,田玥,卢世璧.不同结构骨块植入股骨头负重区缺损的力学性能比较[J].医用生物力学,2006,21(4):304-308

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