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单髁膝关节置换胫骨元件不同固定柱形状的有限元分析
引用本文:马新硕,姚杰,王慧枝,祁昕征,危紫翼,刘博伦,张敏,郑诚功.单髁膝关节置换胫骨元件不同固定柱形状的有限元分析[J].医用生物力学,2019,34(2):186-192.
作者姓名:马新硕  姚杰  王慧枝  祁昕征  危紫翼  刘博伦  张敏  郑诚功
作者单位:北京航空航天大学 生物与医学工程学院,北京航空航天大学 生物与医学工程学院,北京航空航天大学 生物与医学工程学院,北京航空航天大学 生物与医学工程学院,北京航空航天大学 生物与医学工程学院,北京航空航天大学 生物与医学工程学院,北京航空航天大学 生物与医学工程学院,生物力学与力学生物学教育部重点实验室,北京航空航天大学 生物与医学工程学院,生物力学与力学生物学教育部重点实验室;北京航空航天大学 生物医学工程高精尖创新中心
基金项目:国家科技计划(国家重点研发计划)(210YBXM2016110002)
摘    要:目的针对单髁膝关节置换后胫骨前内侧疼痛、胫骨元件松动以及对侧关节炎恶化的问题,通过有限元方法比较分析胫骨元件固定柱的不同几何形状对胫骨应力分布的影响。方法建立有效的单髁膝关节置换有限元模型,对胫骨元件固定柱的形状进行设计。在相同的加载条件下,分别对双柱形、单脊形、双脊形和十字星形胫骨元件进行有限元分析,并与完整膝关节模型进行对比,评估胫骨元件固定柱不同形状设计对胫骨前内侧皮质骨应力、胫骨截骨面松质骨应力、胫骨对侧软骨应力的影响。结果单髁置换后胫骨前内侧皮质骨应力峰值均增大。与完整膝关节相比,在双柱形、单脊形、双脊形和十字星形胫骨元件固定柱的模型中,胫骨前内侧皮质骨应力峰值分别增加56.1%、55.9%、54.5%和68.4%。单脊形和双脊形胫骨元件松质骨截骨面应力峰值比完整胫骨分别减小8.1%和15.6%,而双柱形和十字星形则分别增大67.9%和121.5%,超过松质骨的疲劳屈服应力。双柱形、单脊形、双脊形和十字星形胫骨固定柱对应的胫骨对侧软骨应力峰值相比于完整胫骨分别减小42.1%、26.6%、24.2%和28.5%。结论单髁膝关节置换改变了胫骨内外侧的载荷分布,使置换侧承受更大的载荷。单脊形和双脊形胫骨元件在降低胫骨前内侧皮质骨和截骨面松质骨应力方面效果更好,其中单脊形胫骨元件更接近完整膝关节胫骨的应力分布。研究结果可为设计更符合膝关节力学性能的单髁膝关节假体提供理论依据。

关 键 词:单髁膝关节置换    胫骨元件    固定柱    应力    有限元分析
收稿时间:2018/2/21 0:00:00
修稿时间:2018/3/25 0:00:00

Finite Element Analysis on Different Geometric Shapes of Tibial Component Pegs in Unicompartmental Knee Arthroplasty
MA Xinshuo,YAO Jie,WANG Huizhi,QI Xinzheng,WEI Ziyi,LIU Bolun,ZHANG Min and CHENG Chengkung.Finite Element Analysis on Different Geometric Shapes of Tibial Component Pegs in Unicompartmental Knee Arthroplasty[J].Journal of Medical Biomechanics,2019,34(2):186-192.
Authors:MA Xinshuo  YAO Jie  WANG Huizhi  QI Xinzheng  WEI Ziyi  LIU Bolun  ZHANG Min and CHENG Chengkung
Institution:School of Biological Science and Medical Engineering, Beihang University,School of Biological Science and Medical Engineering, Beihang University,School of Biological Science and Medical Engineering, Beihang University,School of Biological Science and Medical Engineering, Beihang University,School of Biological Science and Medical Engineering, Beihang University,School of Biological Science and Medical Engineering, Beihang University,School of Biological Science and Medical Engineering, Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beihang University and School of Biological Science and Medical Engineering, Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beihang University;Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University
Abstract:Objective Aiming at solving the problems of pain on the anteromedial tibia, tibial component loosening and osteoarthritis progression after unicompartmental knee arthroplasty (UKA), the influence of different geometric shapes of tibial component pegs on stress distributions in tibia was analyzed by finite element method. Methods The finite element models with UKA were established and validated. Geometric shapes of tibial component were designed. Under the same loading condition, the tibial components with double-peg, single-keel, double-keel and cross-star were studied for finite element analysis and compared with intact model, so as to evaluate the influence of tibial component with different shapes on stresses of cortical bone in anteromedial tibia, cancellous bone under tibial component and cartilage in contralateral tibia. Results Compared with the intact model, the peak stress of cortical bone in anteromedial tibia with double-peg, single-keel, double-keel and cross-star tibial components increased by 56.1%, 55.9%, 54.5% and 68-4%, respectively. The peak stress of cancellous bone under tibial component with single-keel and double-keels decreased by 8.1% and 15.6% respectively, while the peak stress of cancellous bone under tibial component with double-peg and cross-star increased by 67-9% and 121-5%, which were higher than the fatigue yield stress of cancellous bone. The peak stress of cartilage in contralateral tibia with double-peg, single-keel, double-keel and cross-star tibial components decreased by 42.1%, 26.6%, 24.2% and 28.5%, respectively. ConclusionsThe load distribution of the medial and lateral tibia changed after UKA operation, and a greater load was observed on the replacement side. Single-keel and double-keel tibial components were more effective in reducing stresses on cortical bone in anteromedial tibia and cancellous bone, while the stress distribution in tibia with single-keel tibial component was closer to that of the intact tibia. The research findings can provide theoretical references for designing single-keel tibial component of unicompartmental knee prosthesis which conforms to better mechanical properties of the knee joint.
Keywords:unicompartmental knee arthroplasty (UKA)  tibial component  pegs  stress  finite element analysis
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