中国骨伤2024，Vol.37Issue(5)：505-515,11.DOI:10.12200/j.issn.1003-0034.20221143
Crowe Ⅲ型髋关节发育不良人工全髋关节置换髋臼解剖重建与非解剖重建髋关节生物力学有限元分析
Hip joint biomechanical analysis of the acetabular anatomical reconstruction and nonanatomical reconstruction in to-tal hip arthroplasty for Crowe type Ⅲ developmental dysplasia of the hip by finite element method
摘要
Abstract
Objective To analyze the hip joint biomechanies of the acetabular anatomical reconstruction and nonanatomi-cal reconstruction in total hip arthroplasty(THA)for Crowe type Ⅲ developmental dysplasia of the hip(DDH)by finite ele-ment method,which provided theoretical foundation and experimental basis for the anatomical acetabular reconstruction dur-ing THA in clinical practice.Methods One patient with left end-stage hip arthritis secondary to Crowe type Ⅲ DDH was se-lected in this study,who underwent total hip arthroplasty in the orthopedic department of the First Affiliated Hospital of Bengbu Medical College in April 2020.This patient was female,57 years old.The preoperative and postoperative three dimentional CT scan of the patient's pelvis were performed.Fourteen acetabular cup models with different anteversion,inclination and rotation center height were established in Mimics and 3-Matic software.The boundary and load conditions were set in Abaqus software.The Von Mises and stress distribution of the hip joint were calculated and observed.Results In the Crowe type Ⅲ DDH THA,if the hip rotation center was restored anatomically and the acetabular cup's inclination was set as 40°,the cup's anteversion var-ied from 5° to 25°,the lowest Von Mises value of acetabular cup and polyethylene liner occured in 20°anteversioin;if the hip rotation center was restored anatomically and the acetabular cup's anteversion was set as 15°,the cup's inclination varied from 35° to 55°,the lowest Von Mises value of acetabular cup and polyethylene liner occured in 35° inclination;if the acetabular cup's anteversion and inclination were set as 15°and 40°respectively,the up migration of hip rotaion center varied from 0 mm to 20 mm,the lowest Von Mises value of acetabular cup and polyethylene liner occured in 10 mm up migration.In all fourteen models,the Von Mises value of the acetabulum,acetabulum cup and polyethylene liner were lowest when the acetabular cup's anteversion and inlcination were 15°,35° respectively,as well as the rotation center was restored anatomically.Conclusion In total hip arthroplasty for Crowe type Ⅲ DDH,the anatomical restoration of hip rotation center with 15° anteversion and 35° in-clination of the acetabular cup are suggested,bone graft above the acetabular cup and additional screws are recommended si-multaneously to further reduce the Von Mises of hip joint.关键词
全髋关节置换/髋臼重建/Crowe Ⅲ型髋关节发育不良/生物力学/有限元Key words
Total hip arthroplasty/Acetabular reconstruction/Crowe type Ⅲ DDH/Biomechanics/Finite element分类
医药卫生引用本文复制引用
张衡,周宇凡,李博闻,李宽新,刘扬,周建生,赵建宁..Crowe Ⅲ型髋关节发育不良人工全髋关节置换髋臼解剖重建与非解剖重建髋关节生物力学有限元分析[J].中国骨伤,2024,37(5):505-515,11.基金项目
安徽省自然科学基金项目(编号:2108085QH320) （编号:2108085QH320）
安徽省高校优秀青年人才支持计划项目(编号:gxyq2022043) （编号:gxyq2022043）
蚌埠医学院第一附属医院优秀青年科学基金项目(编号:2021byyfyyq04)Anhui Provincial Natural Science Foundation(No.2108085QH320) （编号:2021byyfyyq04）
