[1]莫诒向,邓羽平,黄文华,等.腓骨高位截骨术对胫骨平台的生物力学分析[J].中国医学物理学杂志,2020,37(5):644-648.[doi:10.3969/j.issn.1005-202X.2020.05.022]
　MO Yixiang,DENG Yuping,et al.Effects of proximal fibular osteotomy on tibial plateau: a biomechanical analysis[J].Chinese Journal of Medical Physics,2020,37(5):644-648.[doi:10.3969/j.issn.1005-202X.2020.05.022]
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腓骨高位截骨术对胫骨平台的生物力学分析()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第5期
页码:
644-648
栏目:
医学影像物理
出版日期:
2020-05-25

文章信息/Info

Title:
Effects of proximal fibular osteotomy on tibial plateau: a biomechanical analysis
文章编号:
1005-202X（2020）05-0644-05
作者:
莫诒向1; 2; 邓羽平1; 2; 黄文华1; 2; 3; 欧阳汉斌4
1. 南方医科大学基础医学院人体解剖学国家重点学科，广东广州510515；2. 广东省医学3D打印应用转化工程技术研究中心， 广东广州510515；3. 广东医科大学基础医学院人体解剖教研室，广东湛江524023；4. 广东医科大学附属医院骨科中心，广东 湛江524000
Author(s):
MO Yixiang1;  2;  DENG Yuping1;  2;  HUANG Wenhua1;  2;  3;  OUYANG Hanbin4
1. National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China 2. Guangdong Province Medical 3D Printing Application Transformation Engineering Research Center, Guangzhou 510515, China 3. Department of Human Anatomy, School of Basic Medical Sciences, Guangdong Medical University, Zhanjiang 524023, China 4. Orthopedics Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China
关键词:
膝关节炎; 内翻畸形; 腓骨高位截骨; 胫骨平台; 生物力学; 有限元分析
Keywords:
knee osteoarthritis varus deformity proximal fibular osteotomy tibial plateau biomechanics finite element analysis
分类号:
R318.01
DOI:
10.3969/j.issn.1005-202X.2020.05.022
文献标志码:
A
摘要:
目的：采用三维有限元方法分析腓骨高位截骨对胫骨平台造成的生物力学改变，为腓骨高位截骨在伴有内翻畸形 的膝关节炎中的应用提供生物力学数据参考。方法：根据一例健康志愿者的CT数据，采用Mimics、Geomagic Studio2013 以及Abaqus6.13软件建立个体化的膝关节有限元模型，通过对模型设定边界条件、加载材料属性、载荷设置以及模拟腓骨 高位截骨术，计算腓骨高位截骨术前后胫骨平台的不同截面上任意节点的应力大小。结果：经手术去除腓骨的支撑后，内 侧胫骨平台的应力值变化情况不一致，内部的应力降低，中部的不变，外部的增大。而外侧胫骨平台的应力值均增加，且 其内部的应力值最大。整个胫骨平台上应力呈现往中间集中的态势。结论：腓骨高位截骨术有助于减小胫骨平台内侧的 应力，从而达到缓解膝关节炎病人的疼痛及活动不便的症状。由于术后应力的重新分布，故该术式的长期疗效及适应症 等仍需观察。
Abstract:
Objective To investigate the biomechanical changes of the tibial plateau following proximal fibula osteotomy by three-dimensional finite element analysis for providing biomechanical evidences for the application of proximal fibular osteotomy in knee osteoarthritis with varus deformity. Methods Based on the CT data of a healthy volunteer, an individual knee joint finite element model was constructed by Mimics, Geomagic Studio2013 and Abaqus6.13 software. The stress of any node on different sections of the tibial plateau before and after proximal fibular osteotomy was calculated by setting the boundary conditions, loading material properties, applying loads and simulating proximal fibular osteotomy in the finite element model. Results After the surgical removal of the fibular support, the stress of the medial tibial plateau was inconsistent. The internal stress was reduced and the middle remained unchanged but the lateral was increased. However, the stress of the lateral tibial plateau was increased, and the internal stress was the maximum. There was a trend that the stress on the entire tibial plateau was concentrated in the middle. Conclusion Proximal fibular osteotomy is conductive to reducing the stress on the medial tibial plateau, thus alleviating the pain and inconvenience of patients with knee osteoarthritis. Due to the postoperative stress redistribution, the long-term efficacy and indications of the operation strategy still need to be further researched.

相似文献/References:

[1]李昱川. 臭氧联合腓骨近端截骨治疗膝关节炎的疗效分析[J].中国医学物理学杂志,2019,36(4):483.[doi:DOI:10.3969/j.issn.1005-202X.2019.04.022]
　LI Yuchuan. Therapeutic effects of ozone combined with proximal fibular osteotomy on knee osteoarthritis[J].Chinese Journal of Medical Physics,2019,36(5):483.[doi:DOI:10.3969/j.issn.1005-202X.2019.04.022]

备注/Memo

备注/Memo:
【收稿日期】2019-12-03 【基金项目】国家重点研发计划（2017YFC1103400）；广东省科技计划项目（2016B090917001, 2016B090925001, 2016B090913004, 2017B090912006）； 深圳市医疗卫生“三名工程”高层次医学团队（SZSM201612019）；佛山市科技计划（2017AG100243） 【作者简介】莫诒向，研究方向：骨外科，E-mail: myxiang15@126.com 【通信作者】黄文华，博士，教授，研究方向：临床应用解剖学、数字医学及医学3D打印，E-mail: huangwenhua2009@139.com
更新日期/Last Update: 2020-06-03