单髁置换术定位孔位置分布对术后胫骨平台力学性能的影响

Effect of Pin Holes Location of Unicompartmental Knee Arthroplasty on Postoperative Tibial Plateau Mechanical Properties

目的探究两引脚法下单髁置换术后胫骨生物力学特征,以降低术后胫骨骨折风险。方法该研究分割下肢CT图像并重建胫骨三维模型,构建术后胫骨平台有限元模型,模拟在4种不同的两引脚法打孔组合下,胫骨平台的应力分布。结果第3种模式下,胫骨平台近端内侧边缘的定位孔出现最高的应力数值,定位孔位置靠近胫骨平台近端内侧边缘出现应力集中。结论在膝关节单髁置换术的两引脚打孔方案下,应避免打孔位置靠近胫骨平台近端内侧。

Objective The purpose of this study is to explore the biomechanical characteristics of the tibia after unicompartmental knee arthroplasty with different distributions of two-pin holes,and to optimize the two-pin holes scheme to reduce the risk of tibial fractures after unicompartmental knee arthroplasty.Methods Lower limbs model is segmented and reconstructed from computed tomography images.Four combinations of two pin holes created for tibial cutting guide placement are simulated with finite element analysis.Results In the third mode,the positioning hole at the proximal medial edge of the tibial plateau has the highest stress value,and the position of the positioning hole near the medial edge of the proximal tibial plateau appears stress concentration.Conclusion The present study revealed that placing tibial cutting guide holding pins centrally would lower the risks of periprosthetic fracture of the medial tibial plateau.