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依诺肝素钠-壳聚糖-聚甲基丙烯酸甲酯骨水泥在髋关节置换术中的生物力学影响:初步有限元分析

Biomechanical impact of enoxaparin sodium-chitosan-PMMA bone cement in hip arthroplasty: a preliminary finite element analysis.

作者信息

Chen Jianchao, Ma Xinzhe, Li Zhiyong, Fan Weiye, Ma Lijie

机构信息

Department of Orthopaedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, China.

出版信息

Front Surg. 2025 Jun 24;12:1615456. doi: 10.3389/fsurg.2025.1615456. eCollection 2025.


DOI:10.3389/fsurg.2025.1615456
PMID:40630863
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12234562/
Abstract

OBJECTIVE: To determine the material parameters of PMMA and ES-CS-PMMA, and compare the stress distribution differences in hip arthroplasty postoperatively using finite element analysis. METHODS: The Young's modulus and Poisson's ratio of PMMA and ES-CS-PMMA were calculated by measuring the propagation speed of ultrasound waves through the bone cements. Using CT images of a healthy adult male, a three-dimensional model of the natural femur and two postoperative 3D models (with PMMA and ES-CS-PMMA as adhesives) were established. Simulating slow walking motion, stress distribution differences in the cement sheath and femur were observed between the two postoperative models. RESULTS: The Young's modulus of PMMA was 4,127 MPa with a Poisson's ratio of 0.25; ES-CS-PMMA exhibited an Young's modulus of 4,331 MPa and a Poisson's ratio of 0.28. In the two postoperative models, no significant differences were observed in stress distribution within the cement sheath or femur after prosthesis implantation. Compared to the natural femur, both PMMA and ES-CS-PMMA reduced cortical stress postoperatively, transferring stress to the femoral stem. In the distal region of the prosthesis, mean stress was significantly reduced post-implantation. In the midsection of the prosthesis, the implanted prosthesis bore higher peak stress than the natural femur. CONCLUSIONS: This study measured the material parameters of PMMA and ES-CS-PMMA. Compared to PMMA, using ES-CS-PMMA as an adhesive in hip arthroplasty did not alter the stress distribution of the cement sheath or femur post-implantation.

摘要

目的:确定聚甲基丙烯酸甲酯(PMMA)和乙磺半胱氨酸-壳聚糖-聚甲基丙烯酸甲酯(ES-CS-PMMA)的材料参数,并通过有限元分析比较髋关节置换术后的应力分布差异。 方法:通过测量超声波在骨水泥中的传播速度来计算PMMA和ES-CS-PMMA的杨氏模量和泊松比。利用一名健康成年男性的CT图像,建立天然股骨的三维模型以及两个术后三维模型(分别以PMMA和ES-CS-PMMA作为黏合剂)。模拟慢走运动,观察两个术后模型中骨水泥鞘和股骨的应力分布差异。 结果:PMMA的杨氏模量为4127 MPa,泊松比为0.25;ES-CS-PMMA的杨氏模量为4331 MPa,泊松比为0.28。在两个术后模型中,假体植入后骨水泥鞘或股骨内的应力分布未观察到显著差异。与天然股骨相比,PMMA和ES-CS-PMMA术后均降低了皮质骨应力,将应力转移至股骨干。在假体远端区域,植入后平均应力显著降低。在假体中部,植入的假体承受的峰值应力高于天然股骨。 结论:本研究测量了PMMA和ES-CS-PMMA的材料参数。与PMMA相比,在髋关节置换术中使用ES-CS-PMMA作为黏合剂不会改变植入后骨水泥鞘或股骨的应力分布。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/74c3e630a2bd/fsurg-12-1615456-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/50fb0b585e7e/fsurg-12-1615456-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/c78fde7b59cd/fsurg-12-1615456-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/16918352ad78/fsurg-12-1615456-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/47882939a144/fsurg-12-1615456-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/96681261c22f/fsurg-12-1615456-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/81cc134ce554/fsurg-12-1615456-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/74c3e630a2bd/fsurg-12-1615456-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/50fb0b585e7e/fsurg-12-1615456-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/c78fde7b59cd/fsurg-12-1615456-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/16918352ad78/fsurg-12-1615456-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/47882939a144/fsurg-12-1615456-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/96681261c22f/fsurg-12-1615456-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/81cc134ce554/fsurg-12-1615456-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1352/12234562/74c3e630a2bd/fsurg-12-1615456-g007.jpg

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本文引用的文献

[1]
Cementless Hemiarthroplasty Complication Risk Does Not Support Contemporary Utilization Patterns.

J Arthroplasty. 2025-8

[2]
Mechanical Integrity Assessment of Polymethylmethacrylate Bone Cement Incorporating Local Anesthetics: Implications for Joint Arthroplasty.

J Arthroplasty. 2025-8

[3]
High and Low Dosage of Vancomycin in Polymethylmethacrylate Cements: Efficacy and Mechanical Properties.

Antibiotics (Basel). 2024-8-28

[4]
Finite element modeling of stress distribution and safety factors in a Ti-27Nb alloy hip implant under real-world physiological loading scenarios.

PLoS One. 2024

[5]
Study of the cement implantation syndrome: A review.

Medicine (Baltimore). 2024-6-14

[6]
Borate bonds-containing pH-responsive chitosan hydrogel for postoperative tumor recurrence and wound infection prevention.

Carbohydr Polym. 2024-9-1

[7]
Partial femoral head replacement: a new innovative hip-preserving approach for treating osteonecrosis of the femoral head and its finite element analysis.

Front Bioeng Biotechnol. 2024-1-23

[8]
Effects of vancomycin and tobramycin on compressive and tensile strengths of antibiotic bone cement: A biomechanical study.

J Orthop. 2023-11-25

[9]
The Bone Cement Hypercoagulation Syndrome: Pathophysiology, Mortality, and Prevention.

Clin Appl Thromb Hemost. 2023

[10]
Enoxaparin sodium bone cement plays an anti-inflammatory immunomodulatory role by inducing the polarization of M2 macrophages.

J Orthop Surg Res. 2023-5-23

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