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[目的]建立骨质疏松患者全髋关节置换术后股骨三维有限元模型,分析骨质疏松患者全髋关节置换术后股骨侧应力分布,为手术操作及假体的选择提供生物力学依据。[方法]采用64排螺旋CT扫描骨质疏松患者(骨密度检查提示)行全髋置换术后数据,建立骨质疏松患者全髋关节置换术后股骨三维有限元模型。对该模型进行模拟加载及仿真计算。分析骨质疏松患者全髋置换术后股骨的应力分布特点。[结果]骨质疏松患者行髋关节置换术后股骨侧应力分布由股骨近端向远端逐渐增大,应力峰值为股骨假体末端周围皮质,主要集中在假体末端与股骨内侧骨皮质交界处。通过有限元力学分析,在骨质疏松患者行关节置换术后,假体周围力学分布在各区域存在差异,差异有统计学意义(P<0.05)。[结论]通过对骨质疏松患者行全髋关节置换术后假体周围应力分布特点的分析,在手术操作过程中,应选择远端压配型假体,假体放置需避免内外翻,以减少假体远端与股骨皮质的应力集中区。
[Objective] To establish a three-dimensional finite element model of femur after total hip arthroplasty in patients with osteoporosis and to analyze the distribution of stress on the femur after total hip arthroplasty in osteoporosis patients, and to provide biomechanical evidence for surgical operation and choice of prosthesis. [Method] Three-dimensional finite element models of femur after total hip arthroplasty in osteoporosis patients were established by using 64-slice spiral CT scan of osteoporosis patients (bone density examination tips) after total hip arthroplasty. The model is simulated and simulated. Analysis of osteoporosis patients after total hip replacement stress distribution characteristics of the femur. [Results] The stress distribution on the femur side in patients with osteoporosis increased gradually from the proximal femur to the distal femur, and the peak value of stress was the cortex around the distal end of the femoral prosthesis, which mainly concentrated at the junction of the prosthesis and the medial femoral cortex Department. Through mechanical analysis of finite element method, the mechanical distribution around the prosthesis is different in all regions after osteoarthroplasty, the difference is statistically significant (P <0.05). [Conclusion] By analyzing the characteristics of the stress distribution around the prosthesis after total hip arthroplasty in patients with osteoporosis, the distal compression fitting prosthesis should be selected during the surgical operation. The prosthesis should be placed inside and out to avoid Reduce the stress concentration area distal to the femoral cortex.