C．F．P．与THA术后股骨近端生物力学的比较研究

Proximal Femorl Biomechanics Research and Comparison on the CoUum Femoris Preserving Hip Prosthesis and the Hip Prosthesis after Total Hip Arthroplasty

目的 通过在股骨标本中模拟C.F.P（collum femoris preserving.保留股骨颈）假体置换术及THA（total hip arthroplasty,全髋关节成形术）,进行股骨近端的生物力学实验并进行比较,以了解C.F.P假体的生物力学特点,为其进一步的研究和应用范围提供坚实的理论依据.方法 取4副8根新鲜成人股骨标本,将其作为正常组.①廊力分析：分别在股骨标本上粘贴电阻应变片.通过静态电阻应变仪测定300N载荷下各测点的应变值.正常组做完后,将股骨标本按左右侧分为2组,每组4根.左侧安装C.F.P.人工髋关节假体,右侧安装传统生物型人工髋关节假体,重复上述实验.②疲劳实验：将安装了假体的股骨标本置于万能材料实验机的工作平台上.以300HZ的实验速度对标本进行压缩疲劳实验.最大的加载载荷为0.75kN.最小的加载载荷为0.075kN.直到股骨标本出现裂纹破坏为止.得出在人体正常的循环载荷下,假体组中股骨标本出现裂纹破坏所需的循环次数.结果 实验结果表明,C.F.P.假体组的张应力值差和压应力值差均明显小于传统生物型假体组,差异有显著性意义（P〈0.05）,更接近于正常组.在人体正常的循环载荷下,C.F.P.假体组中股骨标本出现裂纹破坏所需的循环次数多于传统生物型假体组,差异有极显著性意义（P〈0.01）.结论 与传统生物型假体相比,置入C.F.P.假体后股骨上段的应力分布和传导更接近正常生理状态,更符合人体生理需求.C.F.P.假体的使用寿命比传统生物型假体更长.C.F.P.人工髋关节假体适用于股骨颈完好、无骨质疏松的患者,尤其是年轻、运动量大且将来面临再次置换的患者.

Objective After implanted into the femoral specimen,the collum femoris preserving hip prosthesis was carried out with proximal femorl biological mechanics experiment,and was compared with the hip prosthesis after total hip arthroplasty, in order to acknowledge the biological mechanics feature of the c,f.p, hip prosthesis and offer theory basis for doing more research or popularizing it. Method We took 4 pairs of 8 fresh adult corpse femoral specimen as normal group.①Analyzing the stress：Pasting resistance strain flat respectively on 8 specimens.These 8 femoral specimens were carried out with electrical experiment to measure the resistance strain value of each survey station under 300N load.After normal group experiment was made,these 8 femoral specimens were divided into 2 groups according to the left side and the right side,4 femora of each group. According to X-ray photo before operation,we installed the c.f.p, hip prosthesis into the left femoral specimen group and install the traditional cementless hip prosthesis into the right group.Then above-mentioned experimentwas repeated.②Weary experiment：The femoral specimen were implanted to the biological mechanics machine. Compression weary experiment is tested with the speed of 300Hz/min.The biggest load is 0.75kN,the lest load is 0.075kN,exerting the load until the femora are destroyed to acquire the circulation times in these femoral specimens under human normal circulation load. Result Experiment result shows that the difference of pressure strain value and the difference of tension strain value of tile c.f.p, hip prosthesis are both obviously smaller than the traditional group（P〈0.05）,and more approach the normal group.Under human normal circulation load,the circulation times in femoral specimens the c.f.p, hip prosthesis group implanting is more than the traditional group（P〈0.01）. Conclusion Compared with the traditional cementless hip prosthesis,proximal femorl stress distributing and transmitting of the c.f.p, hip prosthesis more approaches natural physiological state,and more accords with human physiological demand.The life of the c.f.p, hip prosthesis is more than the traditional cementless hip prosthesis.The c.f.p, hip prosthesis is the same with the patients with intact collum femoris and without bone rarefaction,especially with the young patients having a mass of movement and facing second replacement in the future.