Miles Brad, Kolos Elizabeth, Appleyard Richard, Theodore Willy, Zheng Keke, Li Qing, Ruys Andrew J
Biomedical Engineering, School of Aerospace, Mechanical and Mechatronic Engineering (AMME), University of Sydney, Sydney, NSW, Australia.
Biomedical Engineering, School of Aerospace, Mechanical and Mechatronic Engineering (AMME), University of Sydney, Sydney, NSW, Australia
Proc Inst Mech Eng H. 2016 Jul;230(7):668-74. doi: 10.1177/0954411916644633. Epub 2016 Apr 19.
Peri-prosthetic femoral neck fracture after femoral head resurfacing can be either patient-related or surgical technique-related. The study aimed to develop a patient-specific finite element modelling technique that can reliably predict an optimal implant position and give minimal strain in the peri-prosthetic bone tissue, thereby reducing the risk of peri-prosthetic femoral neck fracture. The subject-specific finite element modelling was integrated with optimization techniques including design of experiments to best possibly position the implant for achieving minimal strain for femoral head resurfacing. Sample space was defined by varying the floating point to find the extremes at which the cylindrical reaming operation actually cuts into the femoral neck causing a notch during hip resurfacing surgery. The study showed that the location of the maximum strain, for all non-notching positions, was on the superior femoral neck, in the peri-prosthetic bone tissue. It demonstrated that varus positioning resulted in a higher strain, while valgus positioning reduced the strain, and further that neutral version had a lower strain.
股骨头表面置换术后假体周围股骨颈骨折可能与患者自身因素或手术技术因素有关。本研究旨在开发一种针对患者的有限元建模技术，该技术能够可靠地预测最佳植入位置，并使假体周围骨组织中的应变最小，从而降低假体周围股骨颈骨折的风险。将个体特异性有限元建模与包括实验设计在内的优化技术相结合，以尽可能最佳地定位植入物，从而实现股骨头表面置换时的应变最小化。通过改变浮点数来定义样本空间，以找到在髋关节表面置换手术中圆柱形扩孔操作实际切入股骨颈并造成切口的极端情况。研究表明，在所有无切口位置，最大应变的位置位于股骨颈上方的假体周围骨组织中。结果显示，内翻位会导致更高的应变，而外翻位会降低应变，此外中立位的应变更低。
