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一种用于预测骨水泥型全膝关节置换术结果的有限元分析。

A finite element analysis for predicting outcomes of cemented total knee arthroplasty.

作者信息

Gheorghiu Nicolae, Socea Bogdan, Dimitriu Mihai C T, Bacalbasa Nicolae, Stan Gabriel, Orban Horia

机构信息

Department of Orthopedics, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Department of Orthopedics, Elias Emergency Clinical Hospital, 011416 Bucharest, Romania.

出版信息

Exp Ther Med. 2021 Mar;21(3):267. doi: 10.3892/etm.2021.9698. Epub 2021 Jan 25.

Abstract

The study was designed to assess the validity of a finite element analysis for predicting the behavior of cemented knee implant used in total knee arthroplasty (TKA), for different mechanical loads, and correlation with clinical outcomes of this procedure. We conducted computational simulations using finite element analysis of two situations: i) The ideal prosthetic component positioning; and ii) variable varus tibial malposition, but with a balanced knee. A total of 80 cemented TKAs performed on 70 patients were divided into two groups. Patients from one group required secondary asymmetric tibial recut for balancing the prosthetic knee and patients from the other group, did not. In regards to the results, we observed no differences upon analysis of the postoperative results of the Knee Society Score (KSS), the angle between the femur and tibia, the range of motion and frontal laxity between groups. The finite element analysis showed that in a 3˚ varus inclination of the joint interline, but with a balanced knee, the maximum contact stress, measured on the tibial plateau surface, increased by 11% compared to the value of mechanical alignment. In conclusion, analysis of the computational model using finite elements showed predictable results of cemented TKA for the different situations of mechanical loads.

摘要

本研究旨在评估有限元分析对于预测全膝关节置换术(TKA)中使用的骨水泥型膝关节植入物在不同机械负荷下的行为的有效性,以及与该手术临床结果的相关性。我们使用有限元分析对两种情况进行了计算模拟:i)理想的假体组件定位;ii)可变的胫骨内翻畸形,但膝关节平衡。对70例患者进行的80例骨水泥型TKA被分为两组。一组患者需要进行二次不对称胫骨截骨以平衡假体膝关节,另一组患者则不需要。关于结果,我们在分析膝关节协会评分(KSS)的术后结果、股骨与胫骨之间的角度、活动范围和两组之间的额状面松弛度时未观察到差异。有限元分析表明,在关节间线有3˚内翻倾斜但膝关节平衡的情况下,在胫骨平台表面测量的最大接触应力与机械对线值相比增加了11%。总之,使用有限元对计算模型进行的分析显示了骨水泥型TKA在不同机械负荷情况下的可预测结果。

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