Leng Joanna, Al-Hajjar Mazen, Wilcox Ruth, Jones Alison, Barton David, Fisher John
Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.
Proc Inst Mech Eng H. 2017 Apr;231(4):299-306. doi: 10.1177/0954411917693261. Epub 2017 Feb 17.
Variation in the surgical positioning of total hip replacement can result in edge loading of the femoral head on the rim of the acetabular cup. Previous work has reported the effect of edge loading on the wear of hip replacement bearings with a fixed level of dynamic biomechanical hip separation. Variations in both rotational and translational surgical positioning of the hip joint replacement combine to influence both the biomechanics and the tribology including the severity of edge loading, the amount of dynamic separation, the force acting on the rim of the cup and the resultant wear and torque acting on the cup. In this study, a virtual model of a hip joint simulator has been developed to predict the effect of variations in some surgical positioning (inclination and medial-lateral offset) on the level of dynamic separation and the contact force of the head acting on the rim as a measure of severity of edge loading. The level of dynamic separation and force acting on the rim increased with increased translational mismatch between the centres of the femoral head and the acetabular cup from 0 to 4 mm and with increased cup inclination angle from 45° to 65°. The virtual model closely replicated the dynamics of the experimental hip simulator previously reported, which showed similar dynamic biomechanical trends, with the highest level of separation being found with a mismatch of 4 mm between the centres of the femoral head and acetabular cup and 65° cup inclination angle.
全髋关节置换手术定位的变化可能导致股骨头在髋臼杯边缘的边缘负荷。先前的研究报告了在固定水平的动态生物力学髋关节分离情况下,边缘负荷对髋关节置换轴承磨损的影响。髋关节置换手术在旋转和平移定位上的变化共同影响生物力学和摩擦学,包括边缘负荷的严重程度、动态分离量、作用在髋臼杯边缘的力以及作用在髋臼杯上的磨损和扭矩。在本研究中,开发了一种髋关节模拟器的虚拟模型,以预测某些手术定位(倾斜度和内外侧偏移)的变化对动态分离水平以及股骨头作用在髋臼杯边缘的接触力的影响,以此作为边缘负荷严重程度的衡量指标。随着股骨头和髋臼杯中心之间的平移不匹配从0增加到4毫米,以及髋臼杯倾斜角度从45°增加到65°,动态分离水平和作用在髋臼杯边缘的力也随之增加。该虚拟模型紧密复制了先前报道的实验性髋关节模拟器的动力学,显示出相似的动态生物力学趋势,在股骨头和髋臼杯中心之间的不匹配为4毫米且髋臼杯倾斜角度为65°时,分离水平最高。