Zhou Rongqi, Xue Haowen, Wang Jincheng, Wang Xiaonan, Wang Yanbing, Zhang Aobo, Zhang Jiaxin, Han Qing, Zhao Xin
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China.
Front Bioeng Biotechnol. 2022 May 30;10:892385. doi: 10.3389/fbioe.2022.892385. eCollection 2022.
In pelvic reconstruction surgery, the hemipelvic prosthesis can cause significant changes in stress distribution due to its high stiffness, and its solid structure is not suitable for osseointegration. The purpose of this study was to identify a novel bone mineral density screw channel and design the structure of the prosthesis so as to improve the distribution of stress, promote bone growth, and enhance the biomechanical properties of the prosthesis. The mechanical characteristics of bone mineral density screw and traditional screw were compared by finite element analysis method, and redesigned by topology optimization. The direction of the newly proposed screw channel was the posterolateral entrance of the auricular surface, ending at the contralateral sacral cape. Compared to the original group, the maximum stress of the optimized prosthesis was decreased by 24.39%, the maximum stress of the sacrum in the optimized group was decreased by 27.23%, and the average strain energy density of the sacrum in the optimized group was increased by 8.43%. On the surface of screw and connecting plate, the area with micromotion more than 28 μm is reduced by 12.17%. On the screw surface, the area with micromotion more than 28 μm is reduced by 22.9%. The newly determined screw channel and optimized prosthesis design can effectively improve the biomechanical properties of a prosthesis and the microenvironment of osseointegration. This method can provide a reference for the fixation of prostheses in clinical pelvic reconstruction.
在骨盆重建手术中，半骨盆假体因其高刚度会导致应力分布发生显著变化，且其实心结构不适合骨整合。本研究的目的是确定一种新型骨密度螺钉通道并设计假体结构，以改善应力分布、促进骨生长并增强假体的生物力学性能。通过有限元分析方法比较骨密度螺钉和传统螺钉的力学特性，并通过拓扑优化进行重新设计。新提出的螺钉通道方向为耳状面的后外侧入口，止于对侧骶岬。与原组相比，优化后假体的最大应力降低了24.39%，优化组骶骨的最大应力降低了27.23%，优化组骶骨的平均应变能密度增加了8.43%。在螺钉和连接板表面，微动超过28μm的区域减少了12.17%。在螺钉表面，微动超过28μm的区域减少了22.9%。新确定的螺钉通道和优化的假体设计可有效改善假体的生物力学性能和骨整合微环境。该方法可为临床骨盆重建中假体的固定提供参考。
