Effect of sagittal pelvic tilt on joint stress distribution in hip dysplasia: A finite element analysis
Effect of sagittal pelvic tilt on joint stress distribution in hip dysplasia: A finite element analysis
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DOI：
10.1016/j.clinbiomech.2020.02.011
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发表时间：
2020-04-01
影响因子：
1.8
通讯作者：
Nakashima, Yasuharu
中科院分区：
文献类型：
--
作者：
Kitamura, Kenji;Fujii, Masanori;Nakashima, Yasuharu
背景：生理性骨盆倾斜可以改变髋关节发育不良患者髋臼的方向和覆盖范围。在这项研究中，我们旨在阐明骨盆矢状面倾斜变化对发育不良髋关节关节应力分布的影响。方法：我们建立了21例发育不良髋关节和21例正常髋关节的患者特异性有限元模型。评估关节接触面积、接触压力和髋臼软骨的等效应力在三个相对于功能骨盆平面的骨盆倾斜位置：前倾斜10度、不倾斜10度和后倾斜10度。结果：三种骨盆体位下，发育不良髋的平均接触面积比正常髋小0.6-0.7倍，平均最大接触压力高1.8-1.9倍，平均最大等效应力高1.3-2.8倍。随着骨盆由前10度向后10度倾斜，平均接触面积减小，平均最大接触压力和中位最大等效应力增大。后两种变化在发育不良髋中比在正常髋中更为显著（总增量分别为1.3 MPa比0.4 MPa, P = 0.001, 3.6 MPa比0.4 MPa, P < 0.001）。在发育不良髋和正常髋后骨盆倾斜时，髋前上髋臼的平均等效应力增加，而两组髋上髋臼和髋后上髋臼变化不显著。解释：矢状骨盆倾斜改变了髋关节的负荷环境和关节应力分布，并可能影响发育不良髋关节的退变过程。
Background: Physiologic pelvic tilt can change acetabular orientation and coverage in patients with hip dysplasia. In this study, we aimed to clarify the impact of change in sagittal pelvic tilt on joint stress distribution in dysplastic hips.Methods: We developed patient-specific finite element models of 21 dysplastic hips and 21 normal hips. The joint contact area, contact pressure, and equivalent stress of the acetabular cartilage were assessed at three pelvic tilt positions relative to the functional pelvic plane: 10 degrees anterior tilt, no tilt, and 10 degrees posterior tilt.Findings: The mean contact area was 0.6-0.7 times smaller, the mean maximum contact pressure was 1.8-1.9 times higher, and the mean maximum equivalent stress was 1.3-2.8 times higher in dysplastic hips than in normal hips at all three pelvic positions. As the pelvis tilted from 10 degrees anterior to 10 degrees posterior, the mean contact area decreased, and the mean maximum contact pressure and median maximum equivalent stress increased. The latter two changes were more significant in dysplastic hips than in normal hips (total increment was 1.3 MPa vs. 0.4 MPa, P = 0.001, and 3.6 MPa vs. 0.4 MPa, P < 0.001, respectively). The mean equivalent stress increased in the anterosuperior acetabulum during posterior pelvic tilt in dysplastic and normal hips, while the change was not significant in the superior and posterosuperior acetabulum in both groups.Interpretation: Sagittal pelvic tilt alters the loading environment and joint stress distribution of the hip joint and may impact the degeneration process in dysplastic hips.