AORIⅠ、 Ⅱ型胫骨平台骨缺损对胫骨假体稳定性影响的有限元分析
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莆田学院附属医院

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福建省自然科学基金项目(2018J01194)、福建省临床重点专科建设项目(2018145)、福建省莆田市临床重点专科建设项目(2016228)


Finite element analysis of the stability of tibial plateau defects in AORI type I and II
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the Affiliated Hospital of Putian University Fujian Putian

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    摘要:

    目的 通过有限元分析研究AORIⅠ、 Ⅱ型胫骨平台骨缺损对胫骨假体稳定性影响,为临床选择合适的重建方案提供依据。方法 : 将志愿者膝关节CT扫描,膝关节假体采用EinScan-S激光扫描仪进行三维扫描获得模型的点云,然后在Mimics 17.0、Geomagic2002软件建立三维模型。在CERO4.0、Hypermesh13.0装配,按照AORI分型制作出胫骨平台缺损面积分别为10%、20%、30%、40%的有限元模型。在abaqus6.1中加载压力载荷和扭转载荷,分析各模型中胫骨假体最大应力和最大位移的变化。结果 ①在压力载荷下,胫骨内侧非包容性缺损模型中, 30%模型、40%模型的胫骨假体最大应力比较差异有统计学意义(p<0.05),而在包容性缺损模型和胫骨外侧各模型中,40%模型最大应力显著大于其他三个模型,差异有统计学意义(p<0.01)。②在扭转载荷作用下,胫骨平台非包容性缺损模型和包容性缺损模型中,40%模型显著大于其他三个模型(p<0.01)。③胫骨假体的最大移位量均集中在假体中柱远端,其中胫骨平台内侧非包容性缺损和包容性缺损模型中,30%模型最大位移量显著大于10%模型、20%模型(p<0.05),而30%模型、40%模型比较差异亦有统计学意义(p<0.01)。在胫骨平台外侧各模型中,40%模型的最大位移量显著大于其他三个模型,差异有统计学意义(p<0.01)。结论: 胫骨平台的骨缺损面积的大小会显著影响胫骨假体的稳定。20%-30%的缺损可进行骨重建。40%及以上的骨缺损,在骨重建的同时应增加延长杆以加强假体的稳定性,避免骨重建的失败。

    Abstract:

    To study the influence of AORI type I and II tibial plateau defect on the stability of tibial prosthesis ,and provide the basis for choosing the appropriate reconstruction method in clinic. Methods:The volunteers'' knee joint was scanned by CT and the knee joint prosthesis were scanned by EinScan-S laser scanner to obtain the point cloud of the model, and then the 3D model was established in Mimics 17 and Geomagic2002 software. All the models assemblied in CERO4.0 and Hypermesh13.0. According to AORI classification, the finite element model of with defect area 10%, 20%, 30% and 40% were established respectively. The maximum stress and displacement of the tibial prosthesis in each model were analyzed by loading the pressure load and torsion load in ABAQUS 6.1. Results ①Under the pressure load, the maximum stress between 30% model and 40% model of the tibial defect was statistically significant (p<0.05) in the non inclusive defect model of the medial tibia. The maximum stress of the 40% model was significantly greater than the other three models in the inclusive defect model and the tibial lateral model, the difference was statistically significant (p<0.01). ②Under torsional loading, the maximum stress in 40% model were significantly larger than those of the other three models (p < 0.01).③The maximum displacement of tibial prosthesis was concentrated in the distal part of the prosthesis. In the non inclusive defect and inclusive defect model of the tibial plateau, the maximum displacement of the 30% model was significantly greater than that of the 10% model and the 20% model (p<0.05), while the 30% model and the 40% model were also statistically significant (p<0.01). The maximum displacement of 40% of the models was significantly greater than that of the other three models (p < 0.01).Conclusion:The tibial plateau bone defect significantly affects the stability of tibial prosthesis. The defect of 20%-30% could be rebuilt. but 40% or more bone defects, lengthening rods should be added to enhance the stability of the prosthesis and avoid the failure of bone reconstruction.

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  • 收稿日期:2019-07-01
  • 最后修改日期:2019-07-01
  • 录用日期:2019-07-15
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