Feng Pin, Lian Shi-Hai, Duan Hong, Min Li, Zhou Yong, Liu Zhan, Tu Chong-Qi
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2012 Mar;43(2):206-9.
To compare the stress distribution of normal pelvis with those of postoperative contralateral pelvic and modular hemipelvic prosthesis under different positions, with an aim to providing biomechanical evidence support for safe reconstruction of pelvic ring using modular hemipelvic prosthesis.
Three-dimensional finite element models of normal pelvis, postoperative pelvic and modular hemipelvic prosthesis were established using thin-layer CT scanning (TLCS). The stress distributions of normal pelvis, postoperative pelvic and prosthesis were measured under three static positions: standing on two feet, standing on one foot on the defective side and sitting.
Little difference was found in contralateral pelvic stress between the normal pelvic and reconstructive pelvic models given the same load with different positions. The maximum stress level appeared at the upside of sacrum mesion, sacroiliac joints, superior greater sciatic notch and iscbial tuberosity, albeit a much lower level than fatigue strength. The maximum stress level of modular hemipelvic prosthesis appeared at the inner wall of connector bar between CS fixation and acetabular cup. Similarly, the stress level was also much lower than the fatigue strength of connector bar. The stress distribution of postoperative pelvic was similar to that of normal pelvic.
Reconstruction with modular hemipelvic prosthesis has little effect on contralateral pelvic. The maximum stress levels of contralateral pelvis and modular hemipelvic prosthesis are significantly lower than their fatigue strength, which indicates sound safety of contralateral pelvis and modular hemipelvic prosthesis. Pelvic reconstruction with modular hemipelvic prosthesis produces good biomechanical compatibility.
比较正常骨盆、术后对侧骨盆及模块化半骨盆假体在不同体位下的应力分布,旨在为采用模块化半骨盆假体安全重建骨盆环提供生物力学证据支持。
利用薄层CT扫描(TLCS)建立正常骨盆、术后骨盆及模块化半骨盆假体的三维有限元模型。在双脚站立、患侧单脚站立和坐姿三种静态体位下测量正常骨盆、术后骨盆及假体的应力分布。
在相同载荷及不同体位下,正常骨盆模型与重建骨盆模型的对侧骨盆应力差异不大。最大应力水平出现在骶骨中点上方、骶髂关节、坐骨大切迹上方和坐骨结节处,尽管该水平远低于疲劳强度。模块化半骨盆假体的最大应力水平出现在CS固定件与髋臼杯之间连接杆的内壁。同样,该应力水平也远低于连接杆的疲劳强度。术后骨盆的应力分布与正常骨盆相似。
采用模块化半骨盆假体进行重建对对侧骨盆影响较小。对侧骨盆和模块化半骨盆假体的最大应力水平显著低于其疲劳强度,这表明对侧骨盆和模块化半骨盆假体具有良好的安全性。采用模块化半骨盆假体进行骨盆重建具有良好的生物力学相容性。