Biomechanical changes of avascular necrosis of the femoral head treated by core decompression and allogeneic bone grafting: a finite element analysis(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2020年第2期
- Page:
- 243-248
- Research Field:
- 生物材料与力学
- Publishing date:
Info
- Title:
- Biomechanical changes of avascular necrosis of the femoral head treated by core decompression and allogeneic bone grafting: a finite element analysis
- Author(s):
- HU Yuanbin1; ZHOU Yuelai2; LI Yongshun3; LIU Dong3
- 1. Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, China; 2. Department of Orthopedic Trauma, Jiangsu Subei People’s Hospital, Yangzhou 225000, China; 3. Department of Orthopedics, Jiangbei District Hospital of Zhongda Hospital, Southeast University, Nanjing 210044, China
- Keywords:
- Keywords: femoral head; avascular necrosis; finite element analysis; core decompression; allogeneic bone grafting; biomechanics
- PACS:
- R318.01
- DOI:
- DOI:10.3969/j.issn.1005-202X.2020.02.019
- Abstract:
- Abstract: Objective To analyze the clinical application of core decompression combined with allogeneic bone grafting in the treatment of early avascular necrosis of the femoral head. Methods A patients with early avascular necrosis of the femoral head was enrolled. Multi-slice spiral CT scan was performed on the affected femoral head before operation, and the obtained CT image was then imported into a professional finite element analysis software for establishing a finite element model of avascular necrosis of the femoral head. The simulation of core decompression was conducted on the finite element model. The allogeneic bone was grafted to the subchondral bone at about 0-6 mm through compression channel, and the autologous cancellous bone was compacted. Biped standing position was adopted as the simulated force position of the femoral head. The load-bearing conditions of the hip joint were as follow: the abductor muscle force M, iliotibial tract tendon force T and hip joint contact force J were 1 060, 1 721 and 1 621 N, respectively. The necrosis angles of 90°, 120° and 150° were used to calculate the collapse value of the untreated femoral head necrosis model and the collapse values after treatments with core decompression only or core decompression combined with bone grafting. Results The Young’s modulus of the normal bone of the femoral head was higher than that of the necrotic bone, while the lateral deformation coefficient of the normal bone was lower than that of the necrotic bone. After the femoral head core decompression, the collapse value of the femoral head was obviously increased, and after that the allogeneic bone was grafted in the decompression channel, the collapse value was remarkably reduced, but still higher than that of the normal femoral head. Meanwhile, due to the increase in the necrosis angles of the femoral head, its collapse value was also significantly increased. Conclusion Core decompression combined with allogeneic bone grafting can effectively improve the bone repair in the necrotic area, strengthen the deformation of the femoral head support structure caused by the decompression channel, and prevent the collapse of the femoral head joint surface.
Last Update: 2020-03-03