股骨偏心距对全髋关节置换术后肌肉被动阻力的影响。
Influence of the femoral offset on the muscles passive resistance in total hip arthroplasty.
机构信息
Department of Mechanics of Materials and Structures, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland.
II Clinic of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdansk, Gdańsk, Poland.
出版信息
PLoS One. 2021 May 4;16(5):e0250397. doi: 10.1371/journal.pone.0250397. eCollection 2021.
BACKGROUND
Soft tissue tension is treated as a crucial factor influencing the post-THA dislocation. The femoral offset is regarded as one of the major parameters responsible for the stabilization of the prosthesis. It is unclear which soft tissue is mostly affected by the offset changes.
METHODS
A finite element model of the hip was created. The model comprised muscles, bones, a stem, the acetabular component and a liner. The muscles were modelled as a Hill-type musculo-tendon nonlinear springs. Nonlinear analyses of the hip flexion and internal rotation were performed for the two values of the femoral stem offset.
RESULTS
We observed that the quadratus femoris and gluteus medius produce the largest resisting moment opposing the external load excreted by the surgeon during the intraoperative hip dislocation test.
CONCLUSIONS
An increased femoral offset increases the stretching of the quadratus femoris muscle significantly and provides the growth of its initial passive force. This muscle serves as a stiff band, providing stabilisation of the hip prosthesis, measured during the simulated intraoperative test.
背景
软组织张力被视为影响 THA 后脱位的关键因素。股骨偏心距被认为是稳定假体的主要参数之一。目前尚不清楚哪种软组织受偏心距变化的影响最大。
方法
创建了一个髋关节的有限元模型。该模型包括肌肉、骨骼、柄、髋臼部件和衬垫。肌肉采用 Hill 型肌肌腱非线性弹簧建模。对两种股骨柄偏心距值进行髋关节屈曲和内旋的非线性分析。
结果
我们观察到，在术中髋关节脱位试验中，股方肌和臀中肌产生最大的抵抗力矩，以对抗外科医生施加的外部负载。
结论
股骨偏心距的增加显著增加了股方肌的拉伸，并提供了其初始被动力的增长。在模拟的术中测试中，该肌肉作为一个刚性带，为髋关节假体的稳定性提供了保障。
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