高吻合度股胫关节面人工膝关节假体的磨损
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摘要
目的探讨人工膝关节假体股胫关节面高吻合度对假体运动和衬垫磨损的影响。方法设计和制作一款冠状面高吻合度膝关节假体,并用体外磨损实验和有限元模拟相结合的方法研究该假体衬垫的磨损。结果体外试验和有限元模拟所得的衬垫质量磨损率分别为(14.29±3.19)mg/MC和14.67 mg/MC(million cycle,MC,百万次循环)。5 MC后,体外试验和有限元模拟得到的衬垫磨损区域大致吻合,在中部区域会出现较为严重的磨损。结论有限元模拟与体外试验结果较为一致,股胫关节面冠状面高吻合度假体的磨损率较低。研究结果对高吻合度人工膝关节假体的磨损评估及临床应用具有实际意义。
Objective To investigate the effect of the tibiofemoral joint surface with high conformity on total knee prosthesis motion and insert wear. Methods A type of knee prosthesis with a high coronal conformity was designed and manufactured,and its insert wear was studied by in vitro wear testing combined with finite element simulation. Results The mass wear rates calculated by the in vitro wear testing and finite element simulation were( 14. 29 ± 3. 19) mg/MC and 14. 67 mg/MC( MC,million cycle),respectively. After five MCs,the areas of the insert wear obtained by both the methods were basically consistent,and severe wear was found to occur in the middle part of the insert. Conclusions The result of the finite element simulation coincided with that of the in vitro testing. The wear rate of the tibiofemoral joint surface of the total knee prosthesis with a high coronal conformity was relatively low. The research outcomes have practical significance for the evaluation and clinical application of the total knee prosthesis with a high conformity.
Objective To investigate the effect of the tibiofemoral joint surface with high conformity on total knee prosthesis motion and insert wear. Methods A type of knee prosthesis with a high coronal conformity was designed and manufactured,and its insert wear was studied by in vitro wear testing combined with finite element simulation. Results The mass wear rates calculated by the in vitro wear testing and finite element simulation were( 14. 29 ± 3. 19) mg/MC and 14. 67 mg/MC( MC,million cycle),respectively. After five MCs,the areas of the insert wear obtained by both the methods were basically consistent,and severe wear was found to occur in the middle part of the insert. Conclusions The result of the finite element simulation coincided with that of the in vitro testing. The wear rate of the tibiofemoral joint surface of the total knee prosthesis with a high coronal conformity was relatively low. The research outcomes have practical significance for the evaluation and clinical application of the total knee prosthesis with a high conformity.
引文
[1]KURTZ SM,ONG KL,LAU E,et al.International survey of primary and revision total knee replacement[J].Int Orthop,2011,35(12):1783-1789.
[2]NAUDIED DD,AMMEEN DJ,ENGH GA,et al.Wear and osteolysis around total knee arthroplasty[J].J Am Acad Orthop Surg,2007,15(1):53-64
[3]王成焘,黄嘉华,戴尅戎.人工关节失效的统计分析及其在技术发展中的重要作用[J].医用生物力学,2012,27(1):1-6.WANG CT,HUANG JH,DAI KR.Statistical analysis on artificial joint failure and its role in technology development[J].J Med Biomech,2012,27(2):1-6.
[4]WILLING R,KIM IY.A holistic numerical model to predict strain hardening and damage of UHMWPE under multiple total knee replacement kinematics and experimental validation[J].J Biomech,2009,42(15):2520-2527.
[5]O'BRIEN S,LUO Y,WU C,et al.Computational development of a polyethylene wear model for the articular and backside surfaces in modular total knee replacements[J].Tribol Int,2013,59(59):284-291.
[6]STRICKLAND MA,DRESSLER MR,TAYLOR M.Predicting implant UHMWPE wear in-silico:A robust,adaptable computational-numerical framework for future theoretical models[J].Wear,2012,274-275:100-108.
[7]ABDELGAIED A,LIU F,BROCKETT C,et al.Computational wear prediction of artificial knee joints based on a new wear law and formulation[J].J Biomech,2011,44(6):1108-1116.
[8]赵峰,王川,樊瑜波.全膝关节置换术中聚乙烯衬垫的磨损测评研究进展[J].中国医疗器械杂志,2015,39(1):39-42.
[9]KANG KT,SON J,KIM HJ,et al.Wear predictions for UHMWPE material with various surface properties used on the femoral component in total knee arthroplasty:A computational simulation study[J].J Mater Sci Mater Med,2017,28(7):105.
[10]张先龙.胫股关节吻合性对人工膝关节聚乙烯磨损的影响[J].中华外科杂志,2001,39(3):248-250.
[11]BARTEL DL,RAWLINSON JJ,BURSTEIN AH,et al.Stresses in polyethylene components of contemporary total knee replacements[J].Clin Orthop Relat Res,1995,317:76-82.
[12]FREGLY BJ,MARQUEZ-BARRIENTOS C,BANKS SA,et al.Increased conformity offers diminishing returns for reducing total knee replacement wear[J].J Biomech Eng,2010,132(2):021007.
[13]BLUNN GW,JOSHI RJ,MINNS RJ,et al.Wear in retrieved condylar knee arthroplasties.A comparison of wear in different designs of 280 retrieved condylar knee prostheses[J].J Arthroplasty,1997,12(3):281-290.
[14]ISO 14243-1.Implants for surgery.Wear of total hip-joint prostheses.Part 1:Loading and displacement parameters for wear-testing machines and corresponding environmental conditions for test[S].2009.
[15]KNIGHT LA,PAL S,COLEMAN JC,et al.Comparison of long-term numerical and experimental total knee replacement wear during simulated gait loading[J].J Biomech,2007,40(7):1550-1558.
[16]ARCHARD JF.Contact and rubbing of flat surfaces[J].J Appl Phys,1953,24(8):981-988.
[17]王川,赵峰,丁文宇,等.上楼梯对人工膝关节假体磨损影响的有限元研究[J].医用生物力学,2017,32(2):109-114.WANG C,ZHAO F,DING WY,et al.Finite element study on total knee prosthesis wear during stair ascent[J].J Med Biomech,2017,32(2):109-114.
[18]STOLLER AP,JOHNSON TS,POPOOLA OO,et al.Highly crosslinked polyethylene in posterior-stabilized total knee arthroplasty:In vitro performance evaluation of wear,delamination,and tibial post durability[J].J Arthroplasty,2011,26(3):483-491.
[19]BRANDT JM,CHARRON KDJ,ZHAO L,et al.Commissioning of a displacement-controlled knee wear simulator and exploration of some issues related to the lubricant[J].Proc Inst Mech Eng,2011,225(8):736-752.
[20]BARNETT PI,FISHER J,AUGER DD,et al.Comparison of wear in a total knee replacement under different kinematic conditions[J].J Mater Sci Mater Med,2001,12(10):1039-1042.
[21]ARDESTANI MM,MOAZEN M,JIN Z.Contribution of geometric design parameters to knee implant performance:Conflicting impact of conformity on kinematics and contact mechanics[J].Knee,2015,22(3):217-224.
[22]STRICKLAND MA,DRESSLER MR,TAYLOR M.Predicting implant UHMWPE wear in-silico:A robust,adaptable computational-numerical framework for future theoretical models[J].Wear,2011,274(3):100-108.
[23]PETRELLA AJ,ARMSTRONG JR,LAZ PJ,et al.A novel cross-shear metric for application in computer simulation of ultra-high molecular weight polyethylene wear[J].Comput Method Biomed,2012,15(11):1223-1232.
[2]NAUDIED DD,AMMEEN DJ,ENGH GA,et al.Wear and osteolysis around total knee arthroplasty[J].J Am Acad Orthop Surg,2007,15(1):53-64
[3]王成焘,黄嘉华,戴尅戎.人工关节失效的统计分析及其在技术发展中的重要作用[J].医用生物力学,2012,27(1):1-6.WANG CT,HUANG JH,DAI KR.Statistical analysis on artificial joint failure and its role in technology development[J].J Med Biomech,2012,27(2):1-6.
[4]WILLING R,KIM IY.A holistic numerical model to predict strain hardening and damage of UHMWPE under multiple total knee replacement kinematics and experimental validation[J].J Biomech,2009,42(15):2520-2527.
[5]O'BRIEN S,LUO Y,WU C,et al.Computational development of a polyethylene wear model for the articular and backside surfaces in modular total knee replacements[J].Tribol Int,2013,59(59):284-291.
[6]STRICKLAND MA,DRESSLER MR,TAYLOR M.Predicting implant UHMWPE wear in-silico:A robust,adaptable computational-numerical framework for future theoretical models[J].Wear,2012,274-275:100-108.
[7]ABDELGAIED A,LIU F,BROCKETT C,et al.Computational wear prediction of artificial knee joints based on a new wear law and formulation[J].J Biomech,2011,44(6):1108-1116.
[8]赵峰,王川,樊瑜波.全膝关节置换术中聚乙烯衬垫的磨损测评研究进展[J].中国医疗器械杂志,2015,39(1):39-42.
[9]KANG KT,SON J,KIM HJ,et al.Wear predictions for UHMWPE material with various surface properties used on the femoral component in total knee arthroplasty:A computational simulation study[J].J Mater Sci Mater Med,2017,28(7):105.
[10]张先龙.胫股关节吻合性对人工膝关节聚乙烯磨损的影响[J].中华外科杂志,2001,39(3):248-250.
[11]BARTEL DL,RAWLINSON JJ,BURSTEIN AH,et al.Stresses in polyethylene components of contemporary total knee replacements[J].Clin Orthop Relat Res,1995,317:76-82.
[12]FREGLY BJ,MARQUEZ-BARRIENTOS C,BANKS SA,et al.Increased conformity offers diminishing returns for reducing total knee replacement wear[J].J Biomech Eng,2010,132(2):021007.
[13]BLUNN GW,JOSHI RJ,MINNS RJ,et al.Wear in retrieved condylar knee arthroplasties.A comparison of wear in different designs of 280 retrieved condylar knee prostheses[J].J Arthroplasty,1997,12(3):281-290.
[14]ISO 14243-1.Implants for surgery.Wear of total hip-joint prostheses.Part 1:Loading and displacement parameters for wear-testing machines and corresponding environmental conditions for test[S].2009.
[15]KNIGHT LA,PAL S,COLEMAN JC,et al.Comparison of long-term numerical and experimental total knee replacement wear during simulated gait loading[J].J Biomech,2007,40(7):1550-1558.
[16]ARCHARD JF.Contact and rubbing of flat surfaces[J].J Appl Phys,1953,24(8):981-988.
[17]王川,赵峰,丁文宇,等.上楼梯对人工膝关节假体磨损影响的有限元研究[J].医用生物力学,2017,32(2):109-114.WANG C,ZHAO F,DING WY,et al.Finite element study on total knee prosthesis wear during stair ascent[J].J Med Biomech,2017,32(2):109-114.
[18]STOLLER AP,JOHNSON TS,POPOOLA OO,et al.Highly crosslinked polyethylene in posterior-stabilized total knee arthroplasty:In vitro performance evaluation of wear,delamination,and tibial post durability[J].J Arthroplasty,2011,26(3):483-491.
[19]BRANDT JM,CHARRON KDJ,ZHAO L,et al.Commissioning of a displacement-controlled knee wear simulator and exploration of some issues related to the lubricant[J].Proc Inst Mech Eng,2011,225(8):736-752.
[20]BARNETT PI,FISHER J,AUGER DD,et al.Comparison of wear in a total knee replacement under different kinematic conditions[J].J Mater Sci Mater Med,2001,12(10):1039-1042.
[21]ARDESTANI MM,MOAZEN M,JIN Z.Contribution of geometric design parameters to knee implant performance:Conflicting impact of conformity on kinematics and contact mechanics[J].Knee,2015,22(3):217-224.
[22]STRICKLAND MA,DRESSLER MR,TAYLOR M.Predicting implant UHMWPE wear in-silico:A robust,adaptable computational-numerical framework for future theoretical models[J].Wear,2011,274(3):100-108.
[23]PETRELLA AJ,ARMSTRONG JR,LAZ PJ,et al.A novel cross-shear metric for application in computer simulation of ultra-high molecular weight polyethylene wear[J].Comput Method Biomed,2012,15(11):1223-1232.