INBONE Ⅱ和INFINITY型人工踝关节的生物力学特征
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国家自然科学基金项目(52035012)


Biomechanical Characteristics of INBONE II and INFINITY Artificial Ankle Joints
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    摘要:

    目的 评估人工踝关节INBONE Ⅱ和INFINITY全踝关节置换术(total ankle arthroplasty, TAA)后生物力学特征差异,为患者提供更加科学和个体化的治疗选择。方法 基于骨肌(musculoskeletal, MSK)多体动力学(multibody dynamics, MBD)软件AnyBody,建立患者个体化TAA下肢MSK MBD 模型。预测踝关节接触力、踝关节运动和人工踝关节关节面接触特征。结果 人工踝关节关节面几何形状对踝关节接触力没有显著影响,但会对活动度和关节面接触特征造成影响。相比于INBONE II,INFINITY 冠状面关节面弧高较低,内翻-外翻和外旋-内旋运动分别增加7.91%和2.61%;矢状面匹配度较低,后移-前移和下移-上移运动分别减小 21.75%和21.23%,内移-外移运动增加 49.26%;INFINITY匹配度较低,内侧、外侧和总关节面接触面积分别减少18.48%、30.42%和26.36%,但接触压力中心运动轨迹集中在距骨组件边缘内侧,避免边缘接触应力集中,降低关节脱位和胫骨衬垫过早磨损的风险。结论 INFINITY型人工踝关节更小的几何限制,表现出更好的生物力学性能,更有利于恢复术后踝关节运动功能。

    Abstract:

    Objective To assess the biomechanical differences between the artificial ankle joints INBONE II and INFINITY after total ankle arthroplasty (TAA) to provide more scientific and individualized treatment options for patients. Methods A patient-individualized TAA lower extremity MSK MBD model was established using the musculoskeletal (MSK) multibody dynamics (MBD) software AnyBody. The ankle joint contact force, motion, and contact characteristics of artificial ankle joint surfaces were predicted. Results The geometric shape of the articular surface of the artificial ankle had no significant effect on the ankle contact force, but it affected the range of motion and contact characteristics of the articular surface. Compared with INBONE II, the coronal plane articular surface arc height of INFINITY was lower, and increased the inversion-eversion and external rotation-internal rotation movements by 7.91% and 2.61%, respectively. Sagittal plane matching was lower, and reduced posterior-anterior and inferior-superior movements by 21.75% and 21.23%, respectively, and medial-lateral movement increased by 49.26%. INFINITY exhibited lower matching with decreases of 18.48%, 30.42%, and 26.36% in the medial, lateral, and total joint surface contact areas, respectively. However, the center of the pressure motion trajectory was concentrated on the medial side, while avoiding edge contact stress concentration and reducing the risk of joint dislocation and premature wear of the tibial component. Conclusions The smaller geometric constraints of the INFINITY artificial ankle joint demonstrated better biomechanical performance, thereby promoting improved postoperative ankle joint functional recovery.

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王闯,张小刚,张延伟,靳忠民. INBONE Ⅱ和INFINITY型人工踝关节的生物力学特征[J].医用生物力学,2024,39(5):873-880

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  • 收稿日期:2024-03-08
  • 最后修改日期:2024-03-28
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  • 在线发布日期: 2024-10-25
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