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用于评估老龄化人群髋部骨折风险的患者特异性有限元分析。

Patient-specific finite element analysis for assessing hip fracture risk in aging populations.

机构信息

Department of Aeronautical & Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India.

Department of Mechanical Engineering, University of Erlangen-Nuremberg, Erlangen, Germany.

出版信息

Biomed Phys Eng Express. 2024 Mar 13;10(3). doi: 10.1088/2057-1976/ad2ff3.

Abstract

The femur is one of the most important bone in the human body, as it supports the body's weight and helps with movement. The aging global population presents a significant challenge, leading to an increasing demand for artificial joints, particularly in knee and hip replacements, which are among the most prevalent surgical procedures worldwide. This study focuses on hip fractures, a common consequence of osteoporotic fractures in the elderly population. To accurately predict individual bone properties and assess fracture risk, patient-specific finite element models (FEM) were developed using CT data from healthy male individuals. The study employed ANSYS 2023 R2 software to estimate fracture loads under simulated single stance loading conditions, considering strain-based failure criteria. The FEM bone models underwent meticulous reconstruction, incorporating geometrical and mechanical properties crucial for fracture risk assessment. Results revealed an underestimation of the ultimate bearing capacity of bones, indicating potential fractures even during routine activities. The study explored variations in bone density, failure loads, and density/load ratios among different specimens, emphasizing the complexity of bone strength determination. Discussion of findings highlighted discrepancies between simulation results and previous studies, suggesting the need for optimization in modelling approaches. The strain-based yield criterion proved accurate in predicting fracture initiation but required adjustments for better load predictions. The study underscores the importance of refining density-elasticity relationships, investigating boundary conditions, and optimizing models throughtesting for enhanced clinical applicability in assessing hip fracture risk. In conclusion, this research contributes valuable insights into developing patient-specific FEM bone models for clinical hip fracture risk assessment, emphasizing the need for further refinement and optimization for accurate predictions and enhanced clinical utility.

摘要

股骨是人身体中最重要的骨头之一,因为它支撑着身体的重量并帮助运动。全球老龄化人口带来了重大挑战,导致对人工关节的需求不断增加,特别是在膝关节和髋关节置换方面,这些手术在全球范围内最为常见。本研究专注于髋部骨折,这是老年人群中骨质疏松性骨折的常见后果。为了准确预测个体骨骼特性和评估骨折风险,使用来自健康男性个体的 CT 数据开发了患者特异性有限元模型 (FEM)。该研究采用 ANSYS 2023 R2 软件,根据模拟单足站立负荷条件下的应变失效准则来估计骨折负荷。FEM 骨骼模型经过精心重建,纳入了对骨折风险评估至关重要的几何和机械特性。结果表明,骨骼的极限承载能力被低估,这表明即使在日常活动中也可能发生潜在的骨折。该研究探讨了不同样本之间的骨密度、失效负荷和密度/负荷比的变化,强调了确定骨强度的复杂性。对研究结果的讨论强调了模拟结果与先前研究之间的差异,表明需要对建模方法进行优化。基于应变的屈服准则在预测骨折起始时准确,但需要进行调整以更好地预测负荷。该研究强调了细化密度-弹性关系、研究边界条件以及通过测试进行模型优化以提高临床应用在评估髋部骨折风险中的重要性。总之,这项研究为开发用于临床髋部骨折风险评估的患者特异性 FEM 骨骼模型提供了有价值的见解,强调需要进一步细化和优化,以实现更准确的预测和增强临床实用性。

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