成人髋臼发育不良Bernese经髋臼周围骨盆截骨术的两维有限元分析

Biomechanical Analysis of Bernese Periacetabular Osteotomy on Adult Acetabular Dysplasia

目的 :建立成人髋臼发育不良Bernese经髋臼周围骨盆截骨术后模型 ,并进行生物力学有限元分析。方法 :制备尸体标本成人髋臼发育不良模型 ,并利用Ansys 6.0软件 ,对髋臼发育不良Bernese术后矫枉过正及合适矫正模型进行生物力学分析。结果 :术后矫枉过正模型组外侧、前侧髋臼边缘出现应力增加趋势 ,作用于髋臼及股骨头的水平分力及剪应力是正常组的 2～ 3倍。结论 :探讨髋臼合适矫正的标准。Bernese术后髋臼矫枉过正 ,将会导致髋臼进行性的向前侧、外侧突起畸形及股骨头颈髋臼盂唇撞击综合征。久之导致骨性关节炎。

Objective:To establish a model of Bernese Periacetabular Osteotomy on hip dysplasia and studied by finite element analysis. Methods: A resection osteoplasty was performed to make acetabular dysplasia model. Bernese periacetabular osteotomy is performed on all the hip dysplasia models. The dysplasia models were divided into two groups. One group includes 16 hip models of correct reorientation of the acetabular fragment, the other group includes 24 hip models of excessive correction. A two-dimension finite element web of the graphs of all the hip models were analyzed the biomechanical character through computer calculation. Results: The stress was focused on anterior and posterosuperior acetabular margin in postoperative models of excessive correction. The average horizontal and shearing stress on femoral head and acetabulum in postoperative models of excessive correction were two or three times than those of the normal group. Conclusion: A standard of correct reorientation of the acetabular fragment is analyzed. Overcorrection can result in a progressive protrusion deformity and a mild secondary impingement syndrome. The osteoarthritis will be resulted from the above pathological mechanical changing.