髋臼周围截骨术后腰椎和髋关节的生物力学变化。
Biomechanical changes in the lumbar and hip joint after curved periacetabular osteotomy.
机构信息
Department of Orthopedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
School of Mechanical and Electrical Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China.
出版信息
J Orthop Surg Res. 2024 Nov 19;19(1):770. doi: 10.1186/s13018-024-05250-5.
BACKGROUND
The alignment of the spine and pelvis significantly impacts overall body balance; therefore, alterations in hip and lumbar spine biomechanics following curved acetabular osteotomy (CPO) can help surgeons optimize acetabular correction. To achieve this goal, we conducted patient-specific finite element analyses to compare hip and lumbar disc contact pressure (CP) between patients with developmental dysplasia of the hip (DDH) and healthy individuals. Additionally, we examined the influence of CPO on the CP of both the hip and lumbar discs in patients with DDH.
METHODS
We conducted finite element analyses of the hip and lumbar spine before and after CPO and compared them with those of a healthy human model. Subsequently, we simulated CPO on the preoperative model. Nonlinear contact analysis was employed to calculate the CP of the acetabular cartilage and lumbar discs during a single-leg stance.
RESULTS
The maximum and average acetabular CP in patients with DDH were 5.4 MPa and 4.5 MPa, respectively. The average CP for the five lumbar discs were 3 MPa, 2.5 MPa, 2 MPa, 3.5 MPa, and 4.4 MPa. In contrast, the maximum and average acetabular CP in normal subjects were 3.7 MPa and 2.1 MPa, respectively, and the average CP of their lumbar discs were 1 MPa, 2 MPA, 1.88 MPa, 2.1 MPa, and 2.1 MPa, respectively. After CPO, the maximum and average CP of the hip decreased, as did the average CP of the lumbar discs. The maximum and average compressive stress of the acetabulum decreased to 3.79 MPa and 2.3 MPa, respectively, and the average compressive stress of the five intervertebral discs decreased to 1.96 MPa, 0.79 MPa, 0.78 MPa, 1.13 MPa, and 3.14 MPa, respectively.
CONCLUSION
Our finite element analysis indicated that CPO effectively normalizes hip contact pressure while reducing lumbar disc contact pressure. However, further investigation is required to elucidate the specific biomechanical mechanisms underlying these changes.
背景
脊柱和骨盆的对线显著影响整体身体平衡；因此，髋关节和腰椎生物力学在髋臼截骨术后（CPO）的改变可以帮助外科医生优化髋臼矫正。为了实现这一目标，我们进行了患者特异性有限元分析，以比较髋关节发育不良（DDH）患者和健康个体之间的髋关节和腰椎间盘接触压力（CP）。此外，我们研究了 CPO 对 DDH 患者髋关节和腰椎间盘 CP 的影响。
方法
我们对 CPO 前后的髋关节和腰椎进行了有限元分析，并与健康人体模型进行了比较。随后，我们在术前模型上模拟了 CPO。非线性接触分析用于计算单腿站立时髋臼软骨和腰椎间盘的 CP。
结果
DDH 患者的最大和平均髋臼 CP 分别为 5.4 MPa 和 4.5 MPa。五个腰椎间盘的平均 CP 分别为 3 MPa、2.5 MPa、2 MPa、3.5 MPa 和 4.4 MPa。相比之下，正常受试者的最大和平均髋臼 CP 分别为 3.7 MPa 和 2.1 MPa，五个腰椎间盘的平均 CP 分别为 1 MPa、2 MPa、1.88 MPa、2.1 MPa 和 2.1 MPa。CPO 后，髋关节的最大和平均 CP 以及腰椎间盘的平均 CP 均降低。髋臼的最大和平均压缩应力降低至 3.79 MPa 和 2.3 MPa，五个椎间盘的平均压缩应力降低至 1.96 MPa、0.79 MPa、0.78 MPa、1.13 MPa 和 3.14 MPa。
结论
我们的有限元分析表明，CPO 有效降低了髋关节接触压力，同时降低了腰椎间盘接触压力。然而，需要进一步研究阐明这些变化的具体生物力学机制。
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