- 期刊
骨質流失對人工髖關節骨柄介面應力之影響
The Influence of Bone Resorption on Interface Stresses of the Femoral Stem
摘要
人工髖關節已經普遍的施用於臨床上，但在經過一段時間後，股骨近端常有明顯的骨質流失現象。本研究嘗試由觀察股骨柄與疏鬆骨介面應力變化，來瞭解骨質流失是否對植入系統有不利的影響。本文首先建立一組有限元素模式，利用已完成之介面元素自動生成演繹法，在股骨柄與疏鬆骨介面上展出一層介面元素。研究中在股骨近端設定了六個骨質流失區域（內外側各分成三區），以及兩種不同的流失程度，以有限元素法計算正常步態週期時，介面應力在骨質流失前後的變化量；取蒙麥斯應力為判斷準則。而骨質流失的模擬是以密質骨的材料特性改變為參數。結果顯示，在骨質流失的區域上，介面應力都增加許多，流失程度愈嚴重，介面應力增加得愈多。當骨質流失發生在內側時，其影響的程度比在外側來得大；而內側下端的骨質流失將引起最為嚴重的介面應力增加。由結果預期，骨質流失現象是影響人工髖關節長期穩定性的一個因素。
並列摘要
Total hip replacement has been widely used in clinics. Osteolysis often occurs near the proximal femur when the prosthesis is implanted after a period of time. In order to understand whether these phenomena would influence the long-term stability of the implanted system, this study observed the interface stress variations around the stem. Three-dimensional femoral finite element models were reconstructed using an automatic algorithm. Using our previous studies, a layer of interface elements was produced at the boundary of stem and cancellous bone. Here, we divided the proximal femur into six regions, three for lateral site and three for medial site, and set two grades of osteolysis to analyze the interface stress variations under the normal gait percentage of 2, 13, 19, 50 and 63%. All the stresses were calculated by the finite element method and the von Mises stresses were adopted as judging criteria. The Young's modulus of the cortical bone elements that locate at the osteolysis region was changed smaller to simulate the osteolysis phenomena.Results reveal that the more serious the osteolysis is, the higher the interface stresses increase. Osteolysis occurs at the medial site will induce a larger stress increment than that at the lateral site. Nevertheless, if the lower medial site appears osteolysis phenomena, the interface stresses will increase much more than at the other regions. We concluded that osteolysis is one of the factors that will influence the long-term stability of the implanted system.
延伸閱讀
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