成人髋臼发育不良伴骨性关节炎行全髋置换术不同髋臼安装方法的力学比较

Comparative Analysis for Biomechanics of Different Implantation Methods of Acetabulum in Total Hip Arthroplasty for Adult Acetabulum Dysplasia Combined with Osteoarthritis

目的通过有限元实验对比四种髋臼安装方法的力学差异,探讨髋关节骨性关节炎行全髋置换的最佳髋臼安装方法。方法建立髋关节三维有限元模型,模拟四种不同髋臼安装方式,在单髋站立位时,分析髋臼假体周围的等效应力和位移大小。结果大假体臼穿透型的Mises应力和位移最大。小假体臼次之,Harris截骨加盖型Mises应力最小。结论对于髋臼发育不良所造成髋关节骨性关节炎在行全髋关节置换时,大假体臼内移穿透型局部有害应力增大,术后易诱发假体松动,小假体臼的完整性包容可减少髋关节置换术后并发症的发生。

Objective To investigate the best acetabulum implantation method in the total hip arthroplasty for the treatment of the hip osteoarthritis by comparing four types of acetabulum implantation methods in the finite experiment. Methods Three-D finite element model was established to simulate four types of the acetabulum implantation methods. The equivalent stress and the displacement around the acetabulum prosthesis were analyzed in the single hip stand position. Results The Mises stress and displacement was the biggest in the big penetration- type artificial acetabulum, followed by the small artificial acetabulum and the least in Harris arthroplasty. Conclusion The local adverse stress is increased in the big penetration-type artificial acetabulum and the loosening the prosthesis is easily induced postoperatively when the total hip arthroplasty is performed for the treatment of the hip osteoarthritis caused by the hip dysplasia. The intact containment of the small artificial acetabulum can reduce the occurrence of the postoperative complications.