目的利用三维有限元仿真方法研究全髋关节置换术后假体位置对髋关节功能的影响,便于指导手术操作,并为临床提供评价标准。方法采用专门的生物力学有限元网格划分器从髋关节发育不良的CT扫描数据建立高度仿真的个性化髋骨三维有限元模型,并采用直接在真臼位置重建安放臼杯假体,将髋臼内壁打磨穿透进行内移安放,和髋臼上位方重建进行上移高位安放3种常见的临床手术方案,模拟臼杯假体位置对全髋关节置换术的影响。结果 (1)直接在真臼位置安放的效果是最好的,出现应力集中和大剪切应力的可能性最小;(2)穿透内移安放的模拟应力分布略高于真臼位置;(3)而在上移高位安放的模拟则出现预测应力大幅增加的结果。结论全髋关节置换术中应尽可能在真臼位置重建和安放臼杯假体,以达到最优的应力分布和功能修复。
Objective To investigate the effects of acetabular prosthesis position on the reconstructed hip funcion after the total hip arthroplasty by 3D finite element analysis.Methods Using a special designed biomechanical semi-automatic mesh generator,a high quality specific 3D finite element model of the hip bone was generated from the CT scan data of a patient with hip joint dysplasia.And then the acetabular prosthesis was integrated at the true acetabular position,compared with penetration position,and the position above the true acetabular,to investigate the position infuence of acetabular prosthesis for the total hip arthroplasty.Finally,all models were simulated under same loading conditions.Results(1) The model with acetabular prosthesis placed at the true acetabular position provided the optimal silumation result,with smallest principal stresses and sheer stresses;(2) The model with penetration position resulted some bigger stresses than the true acetabular position;(3) The model with position above the true acetabular resulted much bigger stresses.Conclusions The acetabular prosthesis for the total hip arthroplasty should be placed at the true acetabular position as possible,to provide the optimal stresses distribution and functinal repair.