Daniel Matej, Herman Srecko, Dolinar Drago, Iglic Ales, Sochor Miroslav, Kralj-Iglic Veronika
Czech Technical University, Praha, Czech Republic.
Clin Orthop Relat Res. 2006 Jun;447:92-9. doi: 10.1097/01.blo.0000203472.88926.c8.
Contact stress distribution in the articular surface of the hip is considered a factor in the development of osteoarthritis, a common complication in hips with aseptic necrosis of the femoral head. We present evidence supporting the hypothesis that osteoarthritis in hips with aseptic necrosis of the femoral head can be caused by elevated contact stress related to the reduced load-bearing ability of the necrotic bone. By using a previously validated mathematical model, we observed that hip contact stress may increase considerably if the load-bearing capacity of the necrotic lesion is decreased, if the size of the necrotic segment is increased, and if the necrotic segment is located more laterally. These effects are affected by the intrinsic shape of the hip. As the estimated values of stress in hips with osteonecrosis are in the range obtained by the same method in dysplastic hips, osteoarthritis in hips with osteonecrosis can be caused by elevated contact stress.
髋关节关节面的接触应力分布被认为是骨关节炎发展的一个因素，骨关节炎是股骨头无菌性坏死的髋关节常见并发症。我们提供证据支持这一假说：股骨头无菌性坏死的髋关节中的骨关节炎可能由与坏死骨承重能力降低相关的接触应力升高引起。通过使用先前验证过的数学模型，我们观察到，如果坏死病变的承重能力降低、坏死节段尺寸增加以及坏死节段位于更外侧，髋关节接触应力可能会显著增加。这些影响受髋关节的固有形状影响。由于骨坏死髋关节的应力估计值处于发育异常髋关节通过相同方法获得的范围内，骨坏死髋关节中的骨关节炎可能由接触应力升高引起。
