基于三柱结构分型股骨头坏死的有限元研究3D finite element analysis on femoral head necrosis based on three-column classification
王宏润;李宏宇;韦明照;
摘要(Abstract):
[目的]本研究基于三柱结构中日友好医院(CJFH)分型对股骨头进行三维有限元分析,研究不同坏死体积的股骨头受力情况,为临床保髋治疗提供理论依据。[方法]选取正常25岁男性青年髋关节CT片股骨头有限元模型,按CJFH分型中的每一型建立占股骨头总体积5%,15%,30%,50%的坏死体积模型,划分网格后进行力学分析。[结果]根据股骨头位移云图及数据,坏死组织的位移偏大,位移峰值均处在负重区的坏死组织上,不同坏死体积坏死带的力学分布可以发现,在坏死体积<15%的情况下,压力最高峰值未达到塌陷压力,当坏死体积达到30%时,L2型及L3型塌陷风险极高,L3型以有超过50%坏死区域应力大于塌陷应力。[结论]坏死组织体积越大,位移越大,越容易塌陷,当涉及外侧柱的坏死体积达30%时,塌陷概率大大增加。
关键词(KeyWords): 股骨头坏死;CJFH分型;髋关节CT;坏死体积模型;3D有限元
基金项目(Foundation): 广西医疗卫生适宜技术开发与推广应用项目(编号:S201643)
作者(Author): 王宏润;李宏宇;韦明照;
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DOI:
参考文献(References):
- [1] Larson E, Jones LC, Goodman SB, et al. Early-stage osteonecrosis of the femoral head:where are we and where are we going in year2018[J]. Int Orthop, 2018, 42(7):1723-1728.
- [2]李子荣,刘朝晖,孙伟,等.基于三柱结构的股骨头坏死分型——中日友好医院分型[J].中华骨科杂志, 2012, 32(6):515-520.
- [3]周思佳,姜文学.基于CJFH分型的股骨头坏死三维分型及塌陷预测[J].中国组织工程研究, 2018, 22(19):3033-3038.
- [4]金新蒙,刘杰,刘冬旭,等.腰骶稳定性对组配式人工半骨盆假体置换后骨盆力学特性的有限元分析[J].中国矫形外科杂志,2017, 24(25):2269-2273.
- [5] Ruiz Wills C, Olivares AL, Tassani S, et al. 3D patient-specific finite element models of the proximal femur based on DXA towards the classification of fracture and non-fracture cases[J]. Bone,2019, 9(121):89-99.
- [6] Nishii T, Sugano N, Ohzono K, et al. Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head:a new three-dimensional quantification using magnetic resonance imaging[J]. J Orthop Res, 2002, 20(1):130-136.
- [7] Kaku N, Hara K, Tabata T, et al. Influence of the volume of bone defect, bone grafting methods, and hook fixation on stress on the Kerboull-type plate and screw in total hip arthroplasty:three-dimensional finite element analysis[J]. Eur J Orthop Surg Traumatol, 2015, 25(2):321-329.
- [8]张洪涛,李鉴轶,梅良斌,等.不同面积的髋臼后壁骨折对髋臼应力分布影响的三维有限元分析[J].中国矫形外科杂志,2015, 16(23):1510-1513.
- [9] Bujtar P, Simonovics J, Vimonovi, et al. Refinements in osteotomy design to improve structural integrity:a finite element analysis study[J]. Br J Oral Maxillofac Surg, 2013, 51(6):479-485.
- [10] Yang JW, Koo KH, Lee MC, et al. Mechanics of femoral head osteonecrosis using three-dimensional finite element method[J].Arch Orthop Trauma Surg, 2002, 122(2):88-92.
- [11]赵万鹏,林峰,卢清萍,等.三维重建及有限元分析预测股骨头坏死塌陷[J].中国生物医学工程学报, 2005(6):784-787.
- [12]高耀东,段宇星,郭鹏年.基于髋关节CT图像三维实体髋骨重建及髋骨承受力数据有限元分析[J].中国组织工程研究,2019, 23(28):4564-4569.
- [13]魏秋实,何伟.有限元分析在股骨头坏死领域中的应用研究[J].中国矫形外科杂志, 2010, 19(18):1611-1614.
- [14] Matsushita R, Nakasa T, Ishikawa M, et al. Repair of an osteochondral defect with minced cartilage embedded in atelocollagen gel:a rabbit model[J]. Am J Sports Med, 2019, 47(9):2216-2224.
- [15]石少辉,李子荣,王佰亮,等.激素性股骨头坏死硬化带与骨形态蛋白关系的研究[J].中华外科杂志, 2010, 48(17):1305-1308.
- [16] Wang HC, Lin TH, Chang NJ, et al. Continuous passive motion promotes and maintains chondrogenesis in autologous endothelial progenitor Cell-Loaded Porous PLGA scaffolds during osteochondral defect repair in a rabbit model[J]. Int J Mol Sci, 2019, 10(2):164-169.