摘要
目的探讨金属对金属(MOM)髋关节表面置换术后不同的假体位置对股骨近端生物力学性能的影响。方法随机选择地区、种族、性别相同的青壮年福尔马林浸泡1年内的防腐股骨标本24个,X线摄片排除骨折、肿瘤、结核及先天畸形,随机分为3组,即中立位组、内偏组、外偏组,建立静止单腿站立位股骨头受力模型,MTS生物力学测试机测试800N载荷下标本在髋关节表面置换前后股骨近段的载荷-应变关系、垂直位移和刚度。结果不同的实验组,在正常生理载荷下的载荷-应变关系都基本呈线性变化;在载荷为800N时,未置换组和不同实验组的表面置换术后的股骨平均应变、最大平均位移、刚度等指标的测试结果,经统计学处理均有统计学差异(P<0.05)。结论中立位组的表面置换术后的股骨颈及近端股骨的应力传递较内偏组及外偏组更接近生理状态,未发现股骨颈及股骨近端的应力遮挡。因此,本研究认为中立位组的表面置换较内偏位及外偏位的假体位置更优,在表面置换术中应尽量避免股骨侧假体的内外侧移位。
Objective To explore the effect of metal-on-metal hip resurfacing on the mechanical characteristics of proximal femur among different position of femoral implantation.Methods Twenty-four femoral specimens kept in formalin for less than one year were selected.All specimens were from the adult cadaver of the same region,race,and sex,and were examined by X-ray to exclude fracture,tuberculosis,tumor and hereditary malformation in advance.By random they were divided to three groups （neutral position group,medial-leaning position group,lateral-leaning position group）.One leg standing position model was used in the measurement.The biomechanical test was performed on the WTS type machine to detect the vertical displacement,rigidity,as well as load and strain relationship of proximal femur,under the loading of 800 N before and after metal-on-metal hip resurfacing among different groups.Results The relation of load and strain before and after metal-on-metal hip resurfacing among different groups was approximate linear variation.Significant difference was found in vertical displacement and rigidity among different groups before and after metal-on-metal hip resurfacing.Conclusions After hip resurfacing,the neutral position group maintained more physiological transferring load to femur neck and the proximal femur than the other two groups,avoiding stress shielding around femur neck and the proximal femur.We consider that the neutral position of femoral implantation is better than the medial-leaning position or lateral-leaning position of femoral component implantation,and medial or lateral leaning displace of femoral component implantation should be avoided as far as possible.
出处
《中华关节外科杂志（电子版）》
CAS
2010年第5期36-39,共4页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
广东省科技计划项目(2007B031003013)
关键词
表面置换
假体植入
髋关节
股骨
生物力学
Resurfacing arthroplasty
Prosthesis implantation
Hip joint
Femur
Biomechanics
