【摘要】 [目的]比较外镶式与髓内股骨近端假体的应力遮挡和对股骨生物力学性能。[方法]采集sawbones股骨CT数据建立股骨模型，分别构建外镶式假体、髓内假体植入模型。在Abaqus软件中基于ISO 7206-4标准施加2 300 N静态载荷，对比分析外镶组与髓内组植入后的应力遮挡程度、股骨应力分布。[结果]在2 300 N生理载荷下，外镶组的IX1[(-10.6±0.5)%vs(48.2±0.5)%, P=0.008]、I2[(-26.0±3.2)%vs(42.4±0.5)%, P=0.008]、IX2[(-13.0±2.1)%vs(45.4±2.1)%, P<0.001]、I3[(-16.4±3.9)%vs(46.2±2.3)%, P<0.001]、I4[(-22.6±7.4)%vs(39.0±2.3)%, P<0.001]、O1[(14.2±13.6)%vs(57.6±6.2)%, P=0.008]、O2[(-27.8±13.0)%vs(42.6±6.6)%, P<0.001]、O3[(-54.0±17.6)%vs(43.2±7.3)%, P<0.001]、O4[(-52.0±10.4)%vs(15.4±8.8)%, P<0.001]应力遮挡程度均显著小于髓内组。在I1部位，两组的应力遮挡程度差异无统计学意义（P>0.05）。两组模型股骨上的应力均值在I1部位差异无统计学意义（P>0.05）。其余部位外镶组的应力均值均显著大于髓内组（P<0.05）。[结论]外镶式股骨近端假体可显著降低应力遮挡效应，增强股骨的生物力学强度，其生物力学优势为髋关节假体设计提供了新思路。更多还原

【Abstract】 [Objective] To compare the stress shielding and biomechanical performance of the extramedullary proximal femoral prosthesis versus the intramedullary counterpart. [Methods] CT data of the sawbones femur were collected to establish the femoral model. Models of the extramedullary prosthesis and intramedullary prosthesis were respectively constructed, and the static load of 2 300 N was applied based on ISO 7206-4 standard in the Abaqus software, and the stress shielding and stress distribution of the femur after implantation in the extramedullary group and intramedullary group were compared and analyzed. [Results] Under a physiological load of 2 300 N, the extramedullary group was significantly lower than the intramedullary group in terms of stress shielding IX1 [(-10.6±0.5)% vs(48.2±0.5)%, P=0.008], I2 [(-26.0±3.2)% vs(42.4±0.5)%, P=0.008], IX2 [(-13.0±2.1)% vs(45.4±2.1)%, P<0.001], I3 [(-16.4±3.9)% vs(46.2±2.3)%, P<0.001], I4 [(-22.6±7.4)% vs(39.0±2.3)%, P<0.001], O1 [(14.2±13.6)% vs(57.6±6.2)%, P=0.008], O2 [(-27.8±13.0)% vs(42.6±6.6)%, P<0.001], O3 [(-54.0±17.6)% vs(43.2±7.3)%, P<0.001], and O4 [(-52.0±10.4)% vs(15.4±8.8)%, P<0.001]. There was no statistically significant difference in the stress shielding degree at the I1 site between the two groups(P>0.05). However, there was no a statistically significant difference in the mean stress on the femur at the I1 site between the two groups(P>0.05). The extramedullary group was significantly higher than the intramedullary group regarding the mean stress at the other sites(P<0.05). [Conclusion] The extramedullary proximal femoral prosthesis can significantly reduce the stress shielding effect and enhance the biomechanical strength on the femur, providing a new idea for the design of hip prostheses.更多还原