Zhang Zhaoming, Lin Tianye, Zhong Yuan, Song Wenting, Yang Peng, Wang Ding, Yang Fan, Zhang Qingwen, Wei Qiushi, He Wei
Department of Orthopedics, The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, China.
Department of Orthopedics, Affiliated Foshan Hospital, Guangzhou University of Traditional Chinese Medicine, Foshan 528000, China.
Open Med (Wars). 2022 Jul 13;17(1):1282-1291. doi: 10.1515/med-2022-0506. eCollection 2022.
The purpose of this study was to investigate the effect of cystic areas of osteonecrosis of the femoral head (ONFH) on stress distribution and disease progression in the femoral head. A total of 85 patients (106 hips) diagnosed with Association Research Circulation Osseous stage II non-traumatic and non-surgical treatment were retrospectively analyzed. The presence of cystic areas and diameter of cystic areas were compared between the two groups. In addition, five spherical cystic areas of different diameters were constructed and the maximum stress was observed. There was a difference between the two groups in whether cystic areas appeared in the femoral head, with 49.1% in the collapse group showing cystic areas, which was significantly higher than that in the non-collapse group (18.4%) ( < 0.05). In addition, the diameter of the cystic areas was significantly larger in the collapsed group than in the non-collapsed group ( < 0.05). The maximum and mean von Mises stress value around the necrotic area and around the cystic area of the femoral head increased with the increase of the cystic diameter. Stress concentration areas can be generated around the cystic areas. The presence and increased diameter of the cystic areas accelerates the collapse of the ONFH femoral head.
本研究的目的是探讨股骨头坏死（ONFH）囊性区域对股骨头应力分布和疾病进展的影响。回顾性分析了85例（106髋）诊断为骨循环研究协会II期非创伤性且非手术治疗的患者。比较两组患者囊性区域的存在情况及囊性区域直径。此外，构建了5个不同直径的球形囊性区域并观察最大应力。两组在股骨头是否出现囊性区域方面存在差异，塌陷组中49.1%出现囊性区域，显著高于非塌陷组（18.4%）（<0.05）。此外，塌陷组囊性区域直径明显大于非塌陷组（<0.05）。股骨头坏死区域及囊性区域周围的最大和平均冯·米塞斯应力值随囊性直径的增加而增加。囊性区域周围可产生应力集中区域。囊性区域的存在及直径增大加速了ONFH股骨头的塌陷。
