Peng Matthew Jian-Qiao, Chen Hai-Yan, Hu Yong, Ju XiangYang, Bai Bo
Guangdong Orthopedics Implantation key Lab, Orthopedics Department of 1st Affiliated Hospital, Guangzhou Medical University, 151 YanJiangXi Rd, Guangzhou, 510120, China.
Neural Electrophysiology Lab, University of Hong Kong, Room 501, Haking Wong Building, Pokfulam Road, Pok Fu Lam, Hong Kong.
BMC Musculoskelet Disord. 2017 Jul 11;18(1):295. doi: 10.1186/s12891-017-1651-9.
There is no universal hip implant suitably fills all femoral types, whether prostheses of porous short-stem suitable for Hip Arthroplasty is to be measured scientifically.
Ten specimens of femurs scanned by CT were input onto Mimics to rebuild 3D models; their *stl format dataset were imported into Geomagic-Studio for simulative osteotomy; the generated *.igs dataset were interacted by UG to fit solid models; the prosthesis were obtained by the same way from patients, and bored by punching bears designed by Pro-E virtually; cements between femora and prosthesis were extracted by deleting prosthesis; in HyperMesh, all compartments were assembled onto four artificial joint style as: (a) cemented long-stem prosthesis; (b) porous long-stem prosthesis; (c) cemented short-stem prosthesis; (d) porous short-stem prosthesis. Then, these numerical models of Finite Element Analysis were exported to AnSys for numerical solution.
Observed whatever from femur or prosthesis or combinational femora-prostheses, "Kruskal-Wallis" value p > 0.05 demonstrates that displacement of (d) ≈ (a) ≈ (b) ≈ (c) shows nothing different significantly by comparison with 600 N load. If stresses are tested upon prosthesis, (d) ≈ (a) ≈ (b) ≈ (c) is also displayed; if upon femora, (d) ≈ (a) ≈ (b) < (c) is suggested; if upon integral joint, (d) ≈ (a) < (b) < (c) is presented.
Mechanically, these four sorts of artificial joint replacement are stabilized in quantity. Cemented short-stem prostheses present the biggest stress, while porous short-stem & cemented long-stem designs are equivalently better than porous long-stem prostheses and alternatives for femoral-head replacement. The preferred design of those two depends on clinical conditions. The cemented long-stem is favorable for inactive elders with osteoporosis, and porously punched cementless short-stem design is suitable for patients with osteoporosis, while the porously punched cementless short-stem is favorable for those with a cement allergy. Clinically, the strength of this study is to enable preoperative strategy to provide acute correction and decrease procedure time.
尚无一种通用的髋关节植入物能适配所有股骨类型,适合髋关节置换术的多孔短柄假体是否科学尚待考量。
将10例经CT扫描的股骨标本输入Mimics软件重建三维模型;将其*.stl格式数据集导入Geomagic-Studio软件进行模拟截骨;生成的*.igs数据集在UG软件中进行交互以拟合实体模型;假体通过相同方式从患者身上获取,并在Pro-E软件设计的虚拟打孔熊模型上进行钻孔;通过删除假体提取股骨与假体之间的骨水泥;在HyperMesh软件中,将所有部件组装成四种人工关节类型:(a)骨水泥固定长柄假体;(b)多孔长柄假体;(c)骨水泥固定短柄假体;(d)多孔短柄假体。然后,将这些有限元分析数值模型导出至AnSys软件进行数值求解。
观察发现,无论从股骨、假体还是股骨-假体组合来看,“Kruskal-Wallis”值p>0.05表明,与600N载荷相比,(d)≈(a)≈(b)≈(c)的位移无显著差异。若对假体进行应力测试,也显示(d)≈(a)≈(b)≈(c);若对股骨进行应力测试,则提示(d)≈(a)≈(b)<(c);若对整体关节进行应力测试,则呈现(d)≈(a)<(b)<(c)。
从力学角度来看,这四种人工关节置换在数量上是稳定的。骨水泥固定短柄假体承受的应力最大,而多孔短柄和骨水泥固定长柄设计在股骨头置换方面比多孔长柄假体及其他假体同等程度地更优。这两种设计的首选取决于临床情况。骨水泥固定长柄假体适合骨质疏松的不活动老年人,多孔冲压非骨水泥短柄设计适合骨质疏松患者,而多孔冲压非骨水泥短柄假体适合对骨水泥过敏的患者。在临床上,本研究的优势在于能够制定术前策略以提供急性矫正并缩短手术时间。