首页|开放式胫骨高位截骨术中三维打印填充块设计的生物力学研究

开放式胫骨高位截骨术中三维打印填充块设计的生物力学研究

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使用填充块可以改善开放式胫骨高位截骨术(OWHTO)初始稳定性,促进骨愈合.然而,填充块结构及材料对OWHTO的生物力学影响依然不清楚.本文通过对OWHTO解剖型填充块进行设计建模,采用有限元方法,研究了填充块结构及材料对OWHTO固定系统固定板、胫骨、螺钉、填充块的应力和楔形间隙处的微位移影响.在OWHTO引入填充块后固定板最大应力降低了 30%以上,胫骨最大应力下降了 15%以上,外侧铰链区域最大应力下降了 81%.填充块采用楔形间隙后侧位置填充设计时,固定系统最大应力为97.8 MPa,明显小于其他填充方式,且截骨间隙微位移最小为-2.9 μm,大于其他填充方式.与钛合金和钽金属相比,填充块采用多孔羟基磷灰石(HA)时可获得较大的截骨开口间隙微位移以刺激骨愈合.本研究结果表明OWHTO固定系统引入填充块更好地平衡了整体的应力分布,填充块结构采用楔形间隙后侧位置填充设计可以获得更优的固定效果,填充块材料采用多孔HA时骨愈合效果会更好.
Biomechanical study of three-dimensional printed filler block design in open wedge high tibial osteotomy
The use of a filling block can improve the initial stability of the fixation plate in the open wedge high tibial osteotomy(OWHTO),and promote bone healing.However,the biomechanical effects of filling block structures and materials on OWHTO remain unclear.OWHTO anatomical filling block model was designed and built.The finite element analysis method was adopted to study the influence of six filling block structure designs and four different materials on the stress of the fixed plate,tibia,screw,and filling block,and the micro-displacement at the wedge gap of the OWHTO fixation system.After the filling block was introduced in the OWHTO,the maximum von Mises stress of the fixation plate was reduced by more than 30%,the maximum von Mises stress of the tibia decreased by more than 15%,and the lateral hinge decreased by 81%.When the filling block was designed to be filled in the posterior position of the wedge gap,the maximum von Mises stress of the fixation system was 97.8 MPa,which was smaller than other filling methods.The minimum micro-displacement of osteotomy space was-2.9 μm,which was larger than that of other filling methods.Compared with titanium alloy and tantalum metal materials,porous hydroxyapatite material could obtain larger micro-displacement in the osteotomy cavity,which is conducive to stimulating bone healing.The results demonstrate that OWHTO with a filling block can better balance the stress distribution of the fixation system,and a better fixation effect can be obtained by using a filling block filled in the posterior position.Porous HA used as the material of the filling block can obtain a better bone healing effect.

Open wedge high tibial osteotomyFilling block designBiomechanics

张静、张嘉宁、郭磊、陈世斌、靳忠民、陈瑱贤

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长安大学工程机械学院(西安 710064)

西南交通大学机械工程学院(成都 610031)

开放式胫骨高位截骨术 填充块设计 生物力学

国家自然科学基金国家自然科学基金陕西省自然科学基金陕西省自然科学基金陕西省自然科学基金中央高校基本科研业务费专项长安大学项目

1190204812200210152022JQ-5292023-JC-YB-4022022JM-254300102252106

2024

生物医学工程学杂志
四川大学华西医院 四川省生物医学工程学会

生物医学工程学杂志

CSTPCD北大核心
影响因子:0.432
ISSN:1001-5515
年,卷(期):2024.41(4)