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全膝关节置换术中股骨延长杆对股骨生物力学的影响

王磊   

  1. 天津市人民医院关节外科
  • 收稿日期:2013-04-26 修回日期:2013-07-08 出版日期:2013-09-15 发布日期:2013-09-15
  • 通讯作者: 王磊

Femur Biomechanical Changes Caused by Femoral Stem Extension Implant in Total Knee Arthroplasty

WANG Lei   

  1. Department of Orthopedics, People’s Hospital of Tianji
  • Received:2013-04-26 Revised:2013-07-08 Published:2013-09-15 Online:2013-09-15
  • Contact: WANG Lei

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摘要：

 【摘要】 目的 明确全膝关节置换（TKA）翻修术中不同长度股骨延长杆对股骨生物力学影响的有限元分析。方法  选择健康志愿者进行股骨全长CT扫描，以Mimics10.01和Geomagic Studio10.0软件建立股骨数字化模型，同时采用激光扫描仪对股骨假体和延长杆进行扫描建模。按照常见的3种髋关节负荷模式（1586N、1690N、2132N）采用ANSYS Workbench v13.0软件进行三维有限元分析，记录股骨最大主应力（MPS）、最大主弹性形变（MPES）和MPES分布情况并分析。结果  TKA前股骨头负荷为1586N、1690N、2132N时股骨干MPS分别为98.54、147.36、143.51MPa。随着股骨假体延长杆增长，MPS、MPES逐渐降低。自由股骨比值与MPES之间呈正相关（P<0.05）。随着延长杆长度增加，MPES逐渐集中于延长杆顶端。结论  股骨MPS和MPES随着延长杆长度增加逐渐降低，自由股骨比值与MPES之间存在线性正相关，延长杆大于120mm明显导致顶端应力集中。

关键词: 关节成形术, 置换, 膝, 膝关节, 人工, 有限元分析

Abstract:

[Abstract]   Objective   To evaluate the femur biomechanical changes of finite analysis with different femoral stem extension implants in total knee arthroplasty (TKA). Methods   The full- length femoral CT scan was performed in selectedhealthy volunteers. The femoral digital model was established with Mimics10.0and Geomagic Studio10.0software. The models of femoral prosthesis and stem extension implant were created by laser scanner. According to the common three hiploading modes (1586N,1690N and2132N), the maximum principal stress (MPS), the maximum principal elastic deformation (MPES) and MPES distribution changes were recorded and analyzed by three-dimensional finite element analysis with ANSYS Workbench13.0software. Results   The MPS values before TKA were98.54, 147.36and143.51MPa respectively when values of femoral head loading were1586N,1690N and2132N. With the increase in the length of the femoral prosthesis extension rod, the MPS and MPES showed a decreasing trend. There was a positive correlation between free femur ratio (FFR) and MPES (P<0.05). The MPES distribution was gradually concentrated at the top point of femur stem extension implant with the increase in the length of the femoral prosthesis extension rod. Conclusion   The values of MPS and MPES were gradually decreased with the increase in the length of the femoral stem extension implant. There was a positive linear correlation between FFR and MPES. The stress concentration was focused obviously at the top end of femoral stem extension implant with its length more than120mm.

Key words: arthroplasty, replacement, knee, knee prosthesis, finite element analysis