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[1]陸舜,林天燁,何敏聰,等.髖關(guān)節(jié)內(nèi)側(cè)間隙比值和臀中肌狀態(tài)對(duì)股骨頭壞死塌陷影響的有限元分析[J].中醫(yī)正骨,2024,36(11):1-9.
　LU Shun,LIN Tianye,HE Mincong,et al.Effects of hip joint medial space ratio and gluteus medius status on collapse in osteonecrosis of the femoral head:a finite element analysis-based biomechanical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(11):1-9.
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髖關(guān)節(jié)內(nèi)側(cè)間隙比值和臀中肌狀態(tài)對(duì)股骨頭壞死塌陷影響的有限元分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年11期
頁(yè)碼:
1-9
欄目:
基礎(chǔ)研究
出版日期:
2024-11-20

文章信息/Info

Title:
Effects of hip joint medial space ratio and gluteus medius status on collapse in osteonecrosis of the femoral head:a finite element analysis-based biomechanical study
作者:
陸舜1; 林天燁2; 何敏聰2; 林錕1; 田佳慶1; 何憲順1; 魏騰飛1; 楊帆2; 何曉銘2; 魏秋實(shí)2
1.廣州中醫(yī)藥大學(xué)第三臨床醫(yī)學(xué)院,廣東 廣州 510006; 2.廣州中醫(yī)藥大學(xué)第三附屬醫(yī)院,廣東 廣州 510378
Author(s):
LU Shun1; LIN Tianye2; HE Mincong2; LIN Kun1; TIAN Jiaqing1; HE Xianshun1; WEI Tengfei1; YANG Fan2; HE Xiao-ming2; WEI Qiushi2
1.The Third Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China 2.The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378,Guangdong,China
關(guān)鍵詞:
股骨頭壞死;  髖關(guān)節(jié)內(nèi)側(cè)間隙比值;  臀中肌;  限定因素分析;  生物力學(xué)現(xiàn)象
Keywords:
femur head necrosis;  hip joint medial space ratio;  gluteus medius muscle;  finite element analysis;  biomechanical phenomena
摘要:
目的:探討髖關(guān)節(jié)內(nèi)側(cè)間隙比值(the medial space ratio,MSR)和臀中肌狀態(tài)對(duì)股骨頭壞死(osteonecrosis of the femoral head,ONFH)塌陷的影響。方法:基于3名健康志愿者的髖部CT數(shù)據(jù),建立7種不同MSR(14.35、16.35、18.35、20.35、22.35、24.35、26.35)的左側(cè)ONFH有限元模型。基于其中1名健康志愿者的正常MSR的ONFH有限元模型,構(gòu)建7種不同臀中肌狀態(tài)的ONFH有限元模型(75%、80%、85%、90%、95%、100%、105%),其中100%臀中肌狀態(tài)對(duì)應(yīng)臀中肌肌力為700 N。所有模型均基于日本骨壞死調(diào)查委員會(huì)分型C1型建模,并將股骨頭前側(cè)保留角和外側(cè)保留角均設(shè)置為70°,同時(shí)將壞死區(qū)體積定義為股骨頭體積的30%。模擬雙下肢靜立狀態(tài)下模型的受力情況,測(cè)定不同MSR的ONFH有限元模型的股骨頭最大應(yīng)力、壞死區(qū)最大應(yīng)力及壞死區(qū)最大位移,測(cè)定不同臀中肌狀態(tài)的ONFH有限元模型的股骨頭最大應(yīng)力、壞死區(qū)最大應(yīng)力及股骨頭向外側(cè)位移。結(jié)果:①模型驗(yàn)證結(jié)果。本研究建立的ONFH有限元模型的主要負(fù)重區(qū)為股骨頭前、外側(cè)區(qū)域,應(yīng)力集中現(xiàn)象出現(xiàn)在壞死區(qū)上方與受力區(qū)重疊部位,股骨頭最大應(yīng)力為(5.050±0.377)MPa,與既往研究報(bào)道的壞死股骨頭應(yīng)力傳導(dǎo)特征基本一致。②不同MSR的ONFH有限元模型應(yīng)力和位移測(cè)定結(jié)果。當(dāng)MSR≤20.35時(shí)(即MSR為14.35、16.35、18.35、20.35),模型的股骨頭最大應(yīng)力、壞死區(qū)最大應(yīng)力、壞死區(qū)最大位移的組間差異均無(wú)統(tǒng)計(jì)學(xué)意義。當(dāng)MSR>20.35時(shí)(即MSR為22.35、24.35、26.35),模型的股骨頭最大應(yīng)力、壞死區(qū)最大應(yīng)力、壞死區(qū)最大位移均高于MSR≤20.35的模型。③不同臀中肌狀態(tài)的ONFH有限元模型應(yīng)力和股骨頭向外側(cè)位移測(cè)定結(jié)果。在正常MSR的ONFH有限元模型中,隨著臀中肌狀態(tài)好轉(zhuǎn),股骨頭最大應(yīng)力、壞死區(qū)最大應(yīng)力、股骨頭向外側(cè)位移隨之不斷減小。結(jié)論:MSR>20.35時(shí),股骨頭和壞死區(qū)應(yīng)力明顯增大,塌陷風(fēng)險(xiǎn)增高; 良好的臀中肌狀態(tài)不僅能降低股骨頭和壞死區(qū)應(yīng)力,而且能對(duì)抗股骨頭外移,降低股骨頭塌陷風(fēng)險(xiǎn)。
Abstract:
Objective:To explore the effects of hip joint medial space ratio(MSR)and gluteus medius(GM)status on collapse in osteonecrosis of the femoral head(ONFH).Methods:Three healthy volunteers were selected,and the CT data of their hips were extracted,based on which the finite element models of left ONFH with different MSRs(14.35,16.35,18.35,20.35,22.35,24.35 and 26.35)were established.Furthermore,based on the finite element model of ONFH with a normal MSR in one of the healthy volunteers,the finite element models of ONFH with different GM statuses(75%,80%,85%,90%,95%,100%,and 105%)were built,among which the 100% GM status corresponded to a GM force of 700 N.The models were constructed according to the Japanese Investigation Committee(JIC)classification for ONFH(type C1),with the anterior and lateral preserved angles of the femoral head set to 70 degrees,and the volume of the necrotic zone defined as 30% of the total volume of the femoral head.The load-bearing situation of the model in the static standing state of lower limbs was simulated to measure the maximum stress of the femoral head,the maximum stress of the necrotic zone,and the maximum displacement of the necrotic zone of the ONFH finite element models with different MSRs,as well as the maximum stress of the femoral head,the maximum stress of the necrotic zone,and the lateral displacement of the femoral head of the ONFH finite element models with different GM statuses.Results:①The model verification results.The main load-bearing zones of the ONFH finite element models established in this study presented in the anterior and lateral regions of the femoral head.The stress concentrated in the overlapping area of the necrotic zone with the load-bearing zone,with the maximum stress as 5.050±0.377 MPa in the femoral head,which was basically consistent with the stress conduction characteristics of the necrotic femoral heads reported in previous studies.②The stress and displacement of ONFH finite element models with different MSRs.In the case of MSR≤20.35(i.e.,MSR was 14.35,16.35,18.35,and 20.35,respectively),the difference was not statistically significant among the groups in the maximum stress of the femoral head,the maximum stress of the necrotic zone,and the maximum displacement of the necrotic zone,while,in the case of MSR>20.35(i.e.,MSR was 22.35,24.35,and 26.35,respectively),the maximum stress of the femoral head,the maximum stress of the necrotic zone,and the maximum displacement of the necrotic zone in the models were all greater than those in the models with MS≤20.35.③The stress and lateral displacement of the femoral head in ONFH finite element models with different GM statuses.In the finite element model of ONFH with a normal MSR,the maximum stress of the femoral head,the maximum stress of the necrotic zone,and the lateral displacement of the femoral head kept decreasing as the GM status improved.Conclusion:In the case of MSR>20.35,the stresses of the femoral head and necrotic zone significantly enhanced,which increased the risk of collapse.A good status in GM can not only reduce the stresses of the femoral head and necrotic zone but also counteract the lateral displacement of the femoral head,thereby reducing the risk of collapse in the femoral head.

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備注/Memo:
基金項(xiàng)目:國(guó)家自然科學(xué)基金項(xiàng)目(82274544,82004392); 廣東省基礎(chǔ)與應(yīng)用基礎(chǔ)研究基金項(xiàng)目(2023A1515010551); 畢節(jié)市科學(xué)技術(shù)局2022年度“揭榜掛帥”項(xiàng)目(畢科合重大專(zhuān)項(xiàng)〔2022〕1號(hào)); 2021年廣東省中醫(yī)骨傷研究院開(kāi)放課題重點(diǎn)項(xiàng)目(GYH202101-01,GYH202101-04)
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更新日期/Last Update: 1900-01-01