组配式髋表面置换股骨头假体植入后股骨近段应力变化的有限元分析
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常州市社会发展科技计划(CS2007212)


Finite element analysis of changes in proximal femur stress after modular hip resurfacing arthroplasty
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    摘要:

    目的研究组配式髋表面置换股骨头假体植入后,股骨近段及假体周围骨质区应力分布的变化。方法建立正常股骨近段、传统表面髋置换假体(本实验选用Wright假体)、组配式表面髋假体三维有限元模型,关节加载后分析假体植入前后股骨近段应力分布变化,并对股骨近端假体周围区域骨质应力分布进行分区量化研究。结果传统假体沿着杆体周围骨质上有多处的应力集中区域,在股骨颈的下方(4、10区)应力明显增加,股骨头上方假体杯下缘(1、7区)应力遮挡;组配式假体螺钉周围骨质上虽有应力集中,但是数值相对较小,股骨颈下方(4、10区)应力分布接近正常股骨。结论与传统表面髋假体置换相比,组配式假体在股骨颈下方区域有较好的应力分布,接近正常股骨,降低了股骨颈骨折的危险。

    Abstract:

    Objective To study the biomechanical variation in proximal femoral stress pattern and periprosthetic femoral stresses distribution after modular hip resurfacing arthroplasty.Methods Three-dimensional finite element model of intact femur, traditional prostheses and modular hip resurfacing arthroplasty were developed.Applied with physiological loading and related muscles forces, the stresses changes in proximal femur with implants were analyzed.Results Compared with intact femur, Stress concentrations were located around the stem in traditional model, high stresses occurred in the inferior of femoral neck(sections 4,10), stress shielding were found in the proximal sections(sections 1, 7).While in modular hip resurfacing arthroplasty model, stress concentrations were also located around the stem but lower, stress distribution in sections of 4,10 were closer to the intact condition.Conclusion The modular hip resurfacing arthroplasty may loaded the proximal femur in a more physiological manner and decreased the risk of femoral neck fracture compared with traditional prostheses.

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徐南伟,孙荣彬,王禹基,侯丽丽,赵峰.组配式髋表面置换股骨头假体植入后股骨近段应力变化的有限元分析[J].医用生物力学,2008,23(6):459-464

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