全膝關節(jié)置換術對脛骨近端骨重建的影響
發(fā)布時間：2018-12-16 13:04
【摘要】：全膝關節(jié)置換手術是減輕關節(jié)炎患者病痛最有效的手段之一，但術后特別容易出現(xiàn)假體下沉、松動等一系列不良癥狀，導致假體的使用壽命縮短。其中，假體的應力遮擋效應導致的骨密度降低是誘發(fā)術后癥狀的重要原因。骨重建模擬可以實現(xiàn)對脛骨密度分布的數(shù)值模擬，還可以預測全膝關節(jié)置換術后骨密度變化及脛骨重建情況，對研究臨床假體失效機理和防治置換術后不良癥狀的出現(xiàn)具有重要作用。 目前，國內(nèi)外采用骨功能適應性理論對脛骨近端骨重建的模擬研究，大多是以平面模擬為主，三維結(jié)構(gòu)模擬很少。本文采用三維脛骨模型，能夠更為全面細致的研究不同材料的假體對脛骨重建的影響。本文的主要內(nèi)容為：首先采用CATIA軟件建立脛骨近端三維幾何模型，以及短柄假體三維模型，然后將實體模型導入ANSYS軟件中，利用智能網(wǎng)格劃分法劃分四面體網(wǎng)格。采用ANSYS中的APDL語言編寫有限元計算程序，，結(jié)合MATLAB中編寫骨重建程序，通過MATLAB調(diào)用ANSYS實現(xiàn)了對脛骨近端骨重建過程的模擬。然后模擬人工膝關節(jié)置換術后脛骨的骨重建過程，建立了四個脛骨-假體有限元模型，四個模型的假體結(jié)構(gòu)相同，但是材料不同（包括兩種功能梯度材料、傳統(tǒng)的鈦合金材料和作為對照的理想骨材料），以此分析四種不同的假體材料對脛骨骨重建的影響。 分析結(jié)果表明，采用功能梯度材料假體的模型相對于采用鈦合金材料假體的模型，其脛骨承擔的Von Mises應力更高，在一定程度上減輕了假體的應力遮擋效應；同時采用功能梯度材料假體的模型其脛骨與假體交界處切應力分布更為均勻，脛骨與假體間的應力能夠更加有效地傳遞。但是，這四種材料假體骨密度分布的模擬結(jié)果差異并不明顯，說明短柄膝關節(jié)假體對于骨重建的影響是很有限的。通過本文的研究，能夠為膝關節(jié)假體材料和結(jié)構(gòu)的改善提供一定的理論依據(jù)，同時是深入研究膝關節(jié)假體與骨之間相互作用的基礎。
[Abstract]:Total knee arthroplasty is one of the most effective methods to alleviate the pain in patients with arthritis, but it is easy to appear a series of adverse symptoms such as prosthesis sinking and loosening after operation, which results in the shortening of the service life of the prosthesis. The decrease of bone mineral density caused by stress occlusion of prosthesis is an important cause of postoperative symptoms. Bone reconstruction simulation can simulate the density distribution of tibia and predict the changes of bone mineral density and tibial reconstruction after total knee arthroplasty. It plays an important role in studying the mechanism of clinical prosthesis failure and preventing the occurrence of adverse symptoms after replacement. At present, the theory of bone functional adaptability is used to simulate the proximal tibia bone reconstruction, most of which are plane simulation, and the three-dimensional structure simulation is seldom. In this paper, a three-dimensional tibial model is used to study the effects of different materials on tibial reconstruction. The main contents of this paper are as follows: firstly, the three-dimensional geometric model of proximal tibia and the three-dimensional model of short handle prosthesis are established by using CATIA software, then the entity model is imported into ANSYS software, and the tetrahedron mesh is divided by intelligent mesh division method. The process of proximal tibial bone reconstruction was simulated by MATLAB calling ANSYS with APDL language in ANSYS and bone reconstruction program in MATLAB. Four finite element models of tibial prosthesis were established. The four models had the same structure but different materials (including two kinds of functionally gradient materials). Traditional titanium alloy materials and ideal bone materials as control were used to analyze the effects of four different prosthetic materials on tibial bone reconstruction. The results show that the tibia bearing Von Mises stress of the model with functionally graded material is higher than that with titanium alloy, and the stress shielding effect of the prosthesis is alleviated to a certain extent. At the same time, the shear stress distribution at the tibia and the prosthesis is more uniform, and the stress between the tibia and the prosthesis can be transferred more effectively by using the model of functionally gradient material prosthesis. However, there is no significant difference in bone mineral density distribution between the four prostheses, indicating that the effects of short handle knee prosthesis on bone reconstruction are very limited. The research in this paper can provide a theoretical basis for the improvement of the material and structure of the knee joint prosthesis, and it is also the basis for the in-depth study of the interaction between the knee joint prosthesis and the bone.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.4
本文編號：2382394
[Abstract]:Total knee arthroplasty is one of the most effective methods to alleviate the pain in patients with arthritis, but it is easy to appear a series of adverse symptoms such as prosthesis sinking and loosening after operation, which results in the shortening of the service life of the prosthesis. The decrease of bone mineral density caused by stress occlusion of prosthesis is an important cause of postoperative symptoms. Bone reconstruction simulation can simulate the density distribution of tibia and predict the changes of bone mineral density and tibial reconstruction after total knee arthroplasty. It plays an important role in studying the mechanism of clinical prosthesis failure and preventing the occurrence of adverse symptoms after replacement. At present, the theory of bone functional adaptability is used to simulate the proximal tibia bone reconstruction, most of which are plane simulation, and the three-dimensional structure simulation is seldom. In this paper, a three-dimensional tibial model is used to study the effects of different materials on tibial reconstruction. The main contents of this paper are as follows: firstly, the three-dimensional geometric model of proximal tibia and the three-dimensional model of short handle prosthesis are established by using CATIA software, then the entity model is imported into ANSYS software, and the tetrahedron mesh is divided by intelligent mesh division method. The process of proximal tibial bone reconstruction was simulated by MATLAB calling ANSYS with APDL language in ANSYS and bone reconstruction program in MATLAB. Four finite element models of tibial prosthesis were established. The four models had the same structure but different materials (including two kinds of functionally gradient materials). Traditional titanium alloy materials and ideal bone materials as control were used to analyze the effects of four different prosthetic materials on tibial bone reconstruction. The results show that the tibia bearing Von Mises stress of the model with functionally graded material is higher than that with titanium alloy, and the stress shielding effect of the prosthesis is alleviated to a certain extent. At the same time, the shear stress distribution at the tibia and the prosthesis is more uniform, and the stress between the tibia and the prosthesis can be transferred more effectively by using the model of functionally gradient material prosthesis. However, there is no significant difference in bone mineral density distribution between the four prostheses, indicating that the effects of short handle knee prosthesis on bone reconstruction are very limited. The research in this paper can provide a theoretical basis for the improvement of the material and structure of the knee joint prosthesis, and it is also the basis for the in-depth study of the interaction between the knee joint prosthesis and the bone.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.4
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