不同填充块对内侧开放楔形胫骨高位截骨应力分布的影响

Stress Distributions Affected by Different Filling Blocks in Medial Opening Wedge High Tibial Osteotomy

目的 分析填充块材料和尺寸对胫骨截骨模型应力分布的影响。方法 建立3种不同材料(髂骨、松质骨和聚醚醚酮)、5种不同尺寸填充块,分别植入胫骨截骨模型,对模型进行力学加载,分析模型的应力分布和边缘位移。结果 就3种材料而言,植入髂骨材料的填充块模型在胫骨近端、钢板的应力和边缘位移低于松质骨和聚醚醚酮材料,但髂骨材料的填充块应力最高;在不同尺寸填充块植入截骨间隙时,胫骨截骨各部分应力分布和边缘位移存在差异,特别是填充块宽度从30 mm减小到10 mm,胫骨近端、钢板和填充块应力峰值平均分别增加了49.3%、92.7%、54.4%。结论 不同的填充块参数会影响胫骨截骨不同部位的应力分布。研究结果为临床胫骨截骨填充块参数的选择提供理论依据。

Objective To analyze the influence from material and size of the filling block on stress distributions of the tibial osteotomy model.Methods The filling blocks with three different materials(iliac bone,cancellous bone and polyetheretherketone(PEEK)) and five different sizes were established and implanted to the tibial osteotomy models,respectively.The mechanical loads were applied on the model,the stress distribution and edge displacement of the model were analyzed.Results For three kinds of materials,the stress at proximal end of the tibia and the plate,as well as edge displacement in the model implanted with filling block by iliac bone material were lower than those of the cancellous bone and PEEK,but the filling block by iliac bone material had the highest stress.When the filling blocks with different sizes were implanted in osteotomy space,the stress distribution on each part of the tibial osteotomy and edge displacement were different.Especially when the width of the filling block was reduced from 30 mm to 10 mm,the peak stress of the proximal tibia,steel plate and filling block was increased by 49.3%,92.7% and 54.4% on average.Conclusions Different filling block parameters will affect the stress distribution in different parts of the tibial osteotomy.The research results provide the theoretical basis for parameter selection of the tibial osteotomy filling block in clinic.