【摘要】 目的通过生物力学实验验证全髋关节置换术中保留髋臼横韧带对减小髋臼应力集中、增强髋臼抗形变能力及维持髋臼假体初始稳定性的意义。方法自2012-01—2015-01采集新鲜成年健康男性尸体髋关节(包含完整髋臼-关节囊-股骨头)8个,将标本随机分为2组:A组去除关节囊但保留髋臼横韧带,B组一并切除关节囊和髋臼横韧带。所有髋臼按全髋关节置换手术要求打磨髋臼软骨面置入髋臼假体,然后对髋臼进行生物力学测量,得到其应变、位移、强度、刚度、接触面积和接触压力等力学量并进行统计分析。结果经手术打磨后,A组在髋臼强度和刚度上皆优于B组。两向应力状态:A组横向应力(σθ)为(0.62±0.05)MPa,纵向应力(σφ)为(0.70±0.06)MPa;B组σθ为(0.83±0.07)MPa,σφ为(0.88±0.09)MPa。差异均有统计学意义(P<0.05),说明A组承载时应力均匀,应力集中小,B组则相反,易导致关节不稳定。刚度:A组为(160.26±14.32)N/mm,B组为(108.23±9.32)N/mm,差异有统计学意义(P<0.05),说明A组抗形变的能力也明显优于B组。在接触特性上A组平均压力均高于B组而负重面积也大故应力反而小于B组。结论保留髋臼横韧带在全髋关节置换术中对减小髋臼应力、削弱应力集中、维持髋臼强度和刚度及假体初始稳定性具有重要意义。更多还原

【Abstract】 Objective To clarify whether the transverse acetabular ligament(TAL) plays an important role in minimising stress concentration, resisting anteroposterior widening and assisting stability of implanted cups during loading of the hip joint by biomechanical experiments. Methods Eight intact fresh hip joints(containing the acetabulum-the joint capsule-the femoral head) from healthy adult male cadavers, were randomly divided into 2 groups: A, removal of capsule and reservation of intact TAL; B, removal all of capsule and TAL. Then the acetabular cartilage surface was polished, and acetabular prosthesis was separately implanted. The specimens were tested for biomechanical data such as strain, displacement, strength, stiffness,contact area and contact pressure and the data were statistically analyzed. Results After polished, the strength and the stiffness of group A were all superior to group B. The two dimensional stress, group A σθ(0.62±0.05)Mpa, σφ(0.70±0.06)Mpa;group B σθ(0.83±0.07)MPa, σφ(0.88±0.09)MPa, the differences of which were respectively 25% and 21%, with significant differences(P <0.05), meaning that group A was under a more uniform stress and with less stress concentration during loading,while group B was on the opposite side and apt to dislocation. Stiffness, group A(160.26±14.32)N/mm, group B(108.23±9.32)N/mm, a difference of 32%, with significant difference(P <0.05). In the ability of anti-deformation group A was significantly superior to group B. The average pressure of group A was higher than that of group B, while the weight-bearing area of group A was larger, the stress was less than group B. Conclusion Reservation of TAL plays an important role in reducing the stress, weakening the stress concentration, maintaining the strength and stiffness of acetabulum and the initial stability of implanted acetabular prosthesis while loading.更多还原