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Article(id=1244321223832879159, tenantId=1146029695717560320, journalId=1244284848500682798, issueId=1244321215637209904, articleNumber=null, orderNo=null, doi=10.16156/j.1004-7220.2025.05.005, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1733760000000, receivedDateStr=2024-12-10, revisedDate=1737129600000, revisedDateStr=2025-01-18, acceptedDate=null, acceptedDateStr=null, onlineDate=1774598898131, onlineDateStr=2026-03-27, pubDate=1759248000000, pubDateStr=2025-10-01, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1774598898131, onlineIssueDateStr=2026-03-27, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1774598898131, creator=13701087609, updateTime=1774598898131, updator=13701087609, issue=Issue{id=1244321215637209904, tenantId=1146029695717560320, journalId=1244284848500682798, year='2025', volume='40', issue='5', pageStart='1079', pageEnd='1366', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1774598896178, creator=13701087609, updateTime=1774599509568, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1244323788452639476, tenantId=1146029695717560320, journalId=1244284848500682798, issueId=1244321215637209904, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1244323788452639477, tenantId=1146029695717560320, journalId=1244284848500682798, issueId=1244321215637209904, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1122, endPage=1128, ext={EN=ArticleExt(id=1244321224793374805, articleId=1244321223832879159, tenantId=1146029695717560320, journalId=1244284848500682798, language=EN, title=Biomechanical Effects of Bone Quality Differences on Stability of Unicondylar Knee Replacement Prostheses, columnId=1244321216404767539, journalTitle=Journal of Medical Biomechanics, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effects of patient bone mass differences on the stability of unicondylar knee arthroplasty (UKA) prostheses.

Methods

A UKA finite element model was established to quantify the effects of five different bone quality conditions on the proximal tibial von Mises stress, bone-prosthesis fixation interface contact stress, and bone-prosthesis fixation interface micromotion, using the medial knee force and joint motion predicted by the individualized UKA musculoskeletal multibody dynamics model as boundary conditions.

Results

The influences of bone strength on the proximal tibia von Mises stress and bone-prosthesis fixation interface contact stress were not obvious, and the difference in peak values of the proximal tibia von Mises stress between two groups of models with the largest difference in bone strength was not more than 5%, and the difference in peak values of the bone-prosthesis fixation interface contact stress was only 2.37 MPa. However, the influence of bone strength on the bone-prosthesis fixation interface micromotion was significant, and the weaker bones were more prone to cause the bone-prosthesis fixation interface micromotion. However, bone strength had a significant effect on the bone-prosthesis fixation interface micromotion, and weak bone was more likely to cause changes in the bone-prosthesis fixation interface micromotion. Compared to patients with the neutral bone quality, the prosthesis fixation interface micromotion increased by 84.67% at 20% gait cycles for patients with the weakest bone quality.

Conclusions

UKA patients with a weaker bone quality have a higher risk of prosthesis loosening. It is recommended that surgeons should carefully choose their surgical strategy in order to reduce the rate of postoperative revision in UKA.

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目的

研究患者骨质量差异对单髁膝关节置换（unicondylar knee arthroplasty，UKA）假体稳定性的影响。

方法

建立UKA有限元模型，以个体化UKA骨肌多体动力学模型预测的膝关节内侧力和关节运动作为边界条件，量化研究5种不同骨质量情况对胫骨近端von Mises应力、骨-假体固定界面接触应力以及骨-假体固定界面微动的影响。

结果

骨质量差异对胫骨近端von Mises应力和骨-假体固定界面接触应力的影响并不明显，骨质量强度相差最大的两组模型间胫骨近端von Mises应力峰值相差不超过5%，骨-假体固定界面接触应力峰值相差仅2.37 MPa。但是骨质量强弱对骨-假体固定界面微动的影响显著，弱骨质量更容易引起骨-假体固定界面微动的变化。相比中性骨质量患者，弱骨质量患者在20%步态周期时假体固定界面微动增加了84.67%。

结论

骨质量较弱的UKA患者假体松动风险更高。建议医生应谨慎选择手术策略，以降低UKA术后翻修率。

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陈瑱贤，高级工程师，E-mail：
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作者贡献声明：

马张稳、张静和陈瑱贤构思并设计研究方案；许敬亭和樊一鸣进行模型仿真；许敬亭和马张稳进行论文撰写；张静和陈瑱贤修改论文。

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articleId=1244321223832879159, language=CN, label=图6, caption=20%步态周期不同骨质量条件下UKA骨-假体固定界面微动云图, figureFileSmall=ioVIkyT6CahW9Wi/zkgSww==, figureFileBig=sHT+4zgemnfLzuatWOIiGw==, tableContent=null), ArticleFig(id=1244321235618874192, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321223832879159, language=EN, label=Tab. 1, caption=

Material properties of the UKA finite element model

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部件/材料 E/MPa ν
聚乙烯衬垫-UHMWPE4630.46
股骨部件-CoCrMo210 0000.30
胫骨部件-CoCrMo210 0000.30
胫骨（弱骨质量）138.1~7 413.10.30
胫骨（较弱骨质量）184.1~9 884.20.30
胫骨（中性骨质量）230.1~12 355.20.30
胫骨（较强骨质量）276.1~14 826.20.30
胫骨（强骨质量）322.1~17 297.30.30
), ArticleFig(id=1244321235744703318, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321223832879159, language=CN, label=表1, caption=

UKA有限元模型材料属性

, figureFileSmall=null, figureFileBig=null, tableContent=
部件/材料 E/MPa ν
聚乙烯衬垫-UHMWPE4630.46
股骨部件-CoCrMo210 0000.30
胫骨部件-CoCrMo210 0000.30
胫骨（弱骨质量）138.1~7 413.10.30
胫骨（较弱骨质量）184.1~9 884.20.30
胫骨（中性骨质量）230.1~12 355.20.30
胫骨（较强骨质量）276.1~14 826.20.30
胫骨（强骨质量）322.1~17 297.30.30
), ArticleFig(id=1244321235820200796, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321223832879159, language=EN, label=Tab. 2, caption=

Comparison of the maximum von Mises stress between model predictions in this study and literature reports

, figureFileSmall=null, figureFileBig=null, tableContent=
文献衬垫胫骨近端
本模型29.4527.22
[29]25.64±1.33—
[30]23.83±1.39—
[32]—25.91±4.73
[31]—27.39±14.95
), ArticleFig(id=1244321235929252708, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321223832879159, language=CN, label=表2, caption=

本文模型预测的最大von Mises应力与文献报道对比

, figureFileSmall=null, figureFileBig=null, tableContent=
文献衬垫胫骨近端
本模型29.4527.22
[29]25.64±1.33—
[30]23.83±1.39—
[32]—25.91±4.73
[31]—27.39±14.95
), ArticleFig(id=1244321236029916010, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321223832879159, language=EN, label=Tab. 3, caption=

Comparison of peak micromotion between model predictions in this study and literature reports

, figureFileSmall=null, figureFileBig=null, tableContent=
文献出处骨-假体固定界面
本模型24.70
[33]22.63±10.44
[34]21.96±12.31
), ArticleFig(id=1244321236126385009, tenantId=1146029695717560320, journalId=1244284848500682798, articleId=1244321223832879159, language=CN, label=表3, caption=

本文模型预测的峰值微动与文献报道对比

, figureFileSmall=null, figureFileBig=null, tableContent=
文献出处骨-假体固定界面
本模型24.70
[33]22.63±10.44
[34]21.96±12.31
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骨质量差异对单髁膝关节置换假体稳定性的生物力学影响
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马张稳 1 , 许敬亭 2 , 樊一鸣 2 , 张静 2 , 陈瑱贤 2
医用生物力学 | 论著 2025,40(5): 1122-1128
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医用生物力学 | 论著 2025, 40(5): 1122-1128
骨质量差异对单髁膝关节置换假体稳定性的生物力学影响
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马张稳1, 许敬亭2, 樊一鸣2, 张静2, 陈瑱贤2
作者信息
  • 1.延安大学附属医院　骨外科，陕西　延安　716000
  • 2.长安大学　工程机械学院，西安　710064

通讯作者:

陈瑱贤，高级工程师，E-mail：
Biomechanical Effects of Bone Quality Differences on Stability of Unicondylar Knee Replacement Prostheses
Zhangwen MA1, Jingting XU2, Yiming FAN2, Jing ZHANG2, Zhenxian CHEN2
Affiliations
  • 1.Department of Bone Surgery, Affiliated Hospital of Yan'an University, Yan'an 716000, Shaanxi, China
  • 2.School of Construction Machinery, Chang'an University, Xi'an 710064, China
出版时间: 2025-10-01 doi: 10.16156/j.1004-7220.2025.05.005
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摘要
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目的

研究患者骨质量差异对单髁膝关节置换（unicondylar knee arthroplasty，UKA）假体稳定性的影响。

方法

建立UKA有限元模型，以个体化UKA骨肌多体动力学模型预测的膝关节内侧力和关节运动作为边界条件，量化研究5种不同骨质量情况对胫骨近端von Mises应力、骨-假体固定界面接触应力以及骨-假体固定界面微动的影响。

结果

骨质量差异对胫骨近端von Mises应力和骨-假体固定界面接触应力的影响并不明显，骨质量强度相差最大的两组模型间胫骨近端von Mises应力峰值相差不超过5%，骨-假体固定界面接触应力峰值相差仅2.37 MPa。但是骨质量强弱对骨-假体固定界面微动的影响显著，弱骨质量更容易引起骨-假体固定界面微动的变化。相比中性骨质量患者，弱骨质量患者在20%步态周期时假体固定界面微动增加了84.67%。

结论

骨质量较弱的UKA患者假体松动风险更高。建议医生应谨慎选择手术策略，以降低UKA术后翻修率。

单髁膝关节置换术  /  骨质量  /  假体松动  /  微动  /  接触应力
Objective

To investigate the effects of patient bone mass differences on the stability of unicondylar knee arthroplasty (UKA) prostheses.

Methods

A UKA finite element model was established to quantify the effects of five different bone quality conditions on the proximal tibial von Mises stress, bone-prosthesis fixation interface contact stress, and bone-prosthesis fixation interface micromotion, using the medial knee force and joint motion predicted by the individualized UKA musculoskeletal multibody dynamics model as boundary conditions.

Results

The influences of bone strength on the proximal tibia von Mises stress and bone-prosthesis fixation interface contact stress were not obvious, and the difference in peak values of the proximal tibia von Mises stress between two groups of models with the largest difference in bone strength was not more than 5%, and the difference in peak values of the bone-prosthesis fixation interface contact stress was only 2.37 MPa. However, the influence of bone strength on the bone-prosthesis fixation interface micromotion was significant, and the weaker bones were more prone to cause the bone-prosthesis fixation interface micromotion. However, bone strength had a significant effect on the bone-prosthesis fixation interface micromotion, and weak bone was more likely to cause changes in the bone-prosthesis fixation interface micromotion. Compared to patients with the neutral bone quality, the prosthesis fixation interface micromotion increased by 84.67% at 20% gait cycles for patients with the weakest bone quality.

Conclusions

UKA patients with a weaker bone quality have a higher risk of prosthesis loosening. It is recommended that surgeons should carefully choose their surgical strategy in order to reduce the rate of postoperative revision in UKA.

unicondylar knee arthroplasty  /  bony quality  /  prosthesis loosening  /  micromotion  /  contact stress
马张稳, 许敬亭, 樊一鸣, 张静, 陈瑱贤. 骨质量差异对单髁膝关节置换假体稳定性的生物力学影响. 医用生物力学, 2025 , 40 (5) : 1122 -1128 . DOI: 10.16156/j.1004-7220.2025.05.005
Zhangwen MA, Jingting XU, Yiming FAN, Jing ZHANG, Zhenxian CHEN. Biomechanical Effects of Bone Quality Differences on Stability of Unicondylar Knee Replacement Prostheses[J]. Journal of Medical Biomechanics, 2025 , 40 (5) : 1122 -1128 . DOI: 10.16156/j.1004-7220.2025.05.005
正文
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单髁膝关节置换（unicondylar knee arthroplasty，UKA）已广泛应用于治疗终末期膝关节单髁骨性关节炎。然而，假体松动造成的UKA术后翻修高达45%[1]。假体固定界面设计、安装精度和患者自身因素是影响假体松动的重要方面，其中患者骨质量特征是影响UKA骨-假体固定界面稳定性的重要因素。由于老龄化或患病等因素会造成骨密度和骨质量下降，骨质量下降会影响骨的弹性模量下降，进而增加骨折[2-3]、假体沉降[4]和骨-假体界面松动[5-6]等风险，因此，研究患者骨质量差异与UKA假体松动风险间的内在关系，对降低UKA术后翻修率具有重要的临床意义。
国内学者主要对UKA术后因骨质疏松产生的并发症[7]、骨质量较弱术后易引起假体周围骨折[8]以及UKA术后假体周围骨密度变化情况[9]进行研究。Jyoti等[2]研究发现，弱骨质量患者进行全膝关节置换后体内会引起较高的骨应力和较大的骨-假体固定界面微动。Scheele等[10]通过动态压缩-剪切试验发现，UKA胫骨的失效载荷与骨密度显著正相关。目前有关UKA术后患者行走步态下骨质量差异对UKA假体固定的生物力学影响研究较少，患者骨质量强弱与假体松动失效风险间的关系尚不明确。
前人进行UKA有限元仿真时多采用标准步态[11]或静态分析[10]，并未考虑患者实际膝关节受力状态。Zhang等[12]研究发现，标准步态条件无法复现体内膝关节内侧和外侧关节的载荷分布。个体化UKA骨肌多体动力学模型可以预测膝关节内侧力和关节运动，能够为UKA有限元仿真提供更合理的边界条件[13]。因此，亟待采用更合理的加载方式，研究步态条件下骨质量差异对UKA假体固定的生物力学影响。
本文考虑了弱骨质量、较弱骨质量、中性骨质量、较强骨质量、强骨质量5种骨质量情况，基于有限元方法分别建立UKA假体固定的有限元模型，采用行走步态下膝关节内侧力和关节运动为边界条件，探究患者不同骨质量情况对UKA假体固定的生物力学影响，为理解UKA假体松动失效机制提供理论参考。
1　材料和方法
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1.1　三维模型建立
采用的医学影像数据来源于1名健康男性志愿者（年龄26岁，身高187 cm，体重84.9 kg），在获得西安红会医院伦理审查（201903001）和患者知情同意后，志愿者位于仰卧位，膝关节屈曲0°进行CT扫描，扫描层厚1mm，分辨率512×512。将CT数据导入Mimics 21.0（Materialise公司，比利时）中对左腿胫骨进行建模，然后在骨科医生的指导下对胫骨近端模拟胫骨内侧UKA手术截骨[14]，截骨面在冠状面上垂直于胫骨机械轴[15-16]（0°内外翻）并低于内侧胫骨平台最低点8 mm，在矢状面上具有5°后倾角[17]。将截骨后的胫骨近端与股骨部件、聚乙烯衬垫和胫骨托盘在SolidWorks 2016（Dassault Systemes公司，法国）中模拟装配，建立内侧UKA三维实体模型。
1.2　有限元模型
将UKA三维实体模型导入HyperMesh 2019（Altair公司，美国）中进行网格划分。股骨髁假体和聚乙烯衬垫的网格类型为C3D8I八节点六面体网格，胫骨托盘和胫骨的网格类型为C3D10M十节点四面体网格。UKA有限元模型单元网格尺寸分别采用1、2、4 mm进行网格敏感性分析，网格数量分别为397 533、193 766、150 169，2、4 mm网格的胫骨von Mises应力和骨-假体固定界面微动相比1 mm变化分别为2.8%、0.6%和4.4%、2.8%。
基于网格敏感性分析，假体部件和胫骨整体平均网格尺寸设为2 mm，UKA骨-假体固定界面接触区域采用细化网格1 mm。将构建好的网格模型分别导入ABAQUS 2021（Dassault Systemes公司，法国）中建立有限元模型（见图1）。
骨密度是最常用的骨质量指标，而骨密度、强度和应力分布之间存在密切的关系[18-19]。本文通过Mimics软件获得胫骨灰度值范围为0~1 543 GV。于CT灰度值（GV）与骨密度（ρ）关系[20]为：
计算得到骨密度范围为0.04~1.49 g/cm3。为了研究不同骨质量情况对UKA假体固定的生物力学影响，将此骨质量下的骨密度作为基准值，以基准值两侧偏差20%的变化增量表征更广泛人群所代表的骨质量情况[21]。将基准值下的骨密度模型定义为中性骨质量模型，而骨密度与基准值相比为60%（0.024~0.984 g/cm3）、80%（0.032~1.192 g/cm3）、120%（0.048~1.788 g/cm3）、140%（0.56~ 2.086 g/cm3）的情况分别定义为弱、较弱、较强、强骨质量模型。最后，根据骨密度与弹性模量（E）之间的关系
分别计算得到不同质骨模型下的弹性模量。最终针对弱、较弱、中性、较强、强骨质量模型，以UKA术后行走活动下的膝关节内侧力和运动参数[13]作为边界条件，建立5种不同骨质量的UKA有限元模型。
股骨部件和胫骨托盘均采用钴铬钼（CoCrMo）合金[22]，衬垫材料为超高分子量聚乙烯（UHMWPE）[23]，所有部件均被设置为各向同性线弹性材料[20,24]。UKA模型材料属性如表1所示。
有限元模型中，将股骨部件与聚乙烯衬垫之间定义为接触，摩擦系数为0.04[25]；胫骨托盘为非骨水泥安装固定，将托盘背部结构与胫骨定义为接触，摩擦系数为0.2[26]；接触面之间设置0.7 mm过盈配合[27]。设置股骨部件为刚体，股骨部件参考点与股骨部件之间采用刚性耦合，胫骨远端参考点与胫骨之间采用运动学耦合，聚乙烯衬垫背部与胫骨托盘之间为绑定约束[28]。
参考点位置以及膝关节运动加载如图2所示，股骨参考点过屈曲伸展轴，位于股骨假体宽度中心位置；胫骨参考点过胫骨髓腔中心，位于胫骨远端。轴向载荷及屈曲伸展运动施加于股骨参考点，其他自由度约束。前后平移及内旋外旋运动施加于胫骨参考点，其他自由度约束。
以个体化UKA骨肌多体动力学模型预测的患者行走步态下的膝关节内侧力和关节运动为边界条件[13]，膝关节内侧力范围为29.25~1 779.31 N，屈曲角度范围为-4.11°~64.94°，分别加载到有限元模型参考点上。
2　结果
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2.1　有限元模型验证
文献报道的固定式UKA衬垫von Mises应力范围为22~27 MPa[29-30]；胫骨近端von Mises应力范围为12~43 MPa[31-32]。本文预测所得衬垫和胫骨近端最大von Mises应力与上述文献报道范围相近（见表2）。
文献报道的行走步态下骨-假体固定界面微动范围为9.65~34.27 μm，本文预测所得骨-假体固定界面的峰值微动在上述文献报道范围内（见表3）。
2.2　胫骨近端von Mises应力
分析行走活动下UKA患者不同骨质量情况对胫骨近端von Mises应力分布的影响，结果显示，患者骨质量变化对胫骨von Mises应力的影响不显著。在膝关节内侧力达到第1个峰值时刻（20%步态周期）、第2个峰值时刻（50%步态周期）和膝关节屈曲角度最大时刻（72%步态周期），膝关节内侧力分别为1 737.36、1 766.19、71.28 N；和中性骨质量强度相比，胫骨近端von Mises应力在弱骨质量下分别减小了1.58%、1.95%、1.41%，在强骨质量下分别增加了0.81%、0.55%和0.42%（见图3）。
2.3　骨-假体固定界面接触应力
分析行走活动下UKA患者不同骨质量情况对骨-假体固定界面接触应力分布的影响，结果显示，随着骨质量的增强，骨-假体固定界面接触应力呈现减小的趋势。在膝关节内侧力达到第1个峰值时刻（20%步态周期），和中性骨质量强度相比，骨-假体固定界面接触应力在弱骨质量下增大了9.63%，在强骨质量下减小了8.77%；在膝关节内侧力达到第2个峰值时刻（50%步态周期），和中性骨质量强度相比，骨-假体固定界面接触应力在弱骨质量下增大了10.81%，在强骨质量下减小了9.52%；在膝关节屈曲角度最大时刻（72%步态周期），和中性骨质量强度相比，骨-假体固定界面接触应力在弱骨质量下减小了3.09%，在强骨质量下增大了2.32%（见图4）。
2.4　骨-假体固定界面微动
分析行走步态下不同骨质量情况对UKA骨-假体固定界面微动的影响，结果显示，随着骨质量的增强，UKA骨-假体固定界面微动减小，并在20%步态周期附近呈现最大（见图5）。
分析20%步态周期下不同骨质量对UKA骨-假体固定界面最大微动分布的影响，结果显示，与中性骨质量强度相比，UKA骨-假体固定界面微动在弱骨质量和较弱骨质量下分别增大了84.67%和28.62%（分别增大了20.38、6.89 μm），在较强骨质量和强骨质量下分别减小了17.52%和29.37%（分别减小了4.22、7.07 μm），见图6。
3　讨论
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本文发现，骨质量强度对UKA术后胫骨近端von Mises应力影响不明显，变化不超过2%。Liu等[11]研究发现，骨质量强度对胫骨近端von Mises应力的影响不超过7%，该结果与本文结论相近。但是Seeger等[35]研究认为，接受非骨水泥型UKA治疗的骨质量较差患者，发生假体周围胫骨骨折的风险更高，并且最大胫骨von Mises应力位于胫骨内侧平台下方的皮质骨上[36]，这与本文的研究结果一致。
UKA骨-假体固定界面最大接触应力出现在截骨面拐角处，这与马振等[37]研究结论相同，侧面证明了本文有限元模型的准确性。随着骨质量的增强，UKA骨-假体固定界面接触应力在步态周期站立相随之减小，而在步态周期摆动相随之增大。但是，在接触应力较大的20%、50%步态周期下，虽然在强骨质量下比在弱骨质量下骨-假体固定界面接触应力相差接近20%，但最大相差仅2.37 MPa。由此可见，骨质量强度对UKA骨-假体固定界面接触应力的影响不明显。
Jyoti等[2]和本文均发现，随着骨质量的增强，骨-假体固定界面微动随之减小，并且弱的骨质量更容易引起骨-假体固定界面微动的变化。本文结果显示，弱骨质量相比中性骨质量在20%步态周期峰值微动处增加了84.67%。随着骨质量的减弱，胫骨就会变得像海绵状和多孔状，表现出弹性模量较小的柔软材料特性；同时，在UKA胫骨托盘材料不变的情况下，弱骨质量就容易发生更大的微动，增加假体松动的可能性。这一发现强调了在UKA术前评估患者骨质量状况的重要性，并提示医生在面对骨质量较弱的患者时采取相应的预防措施。
本研究存在以下局限性：①基于中性骨密度情况，通过定量增减讨论了5种不同骨质量情况，并未采用不同患者真实骨密度情况，在后续研究中应统计并采用更合理的骨密度情况。②只进行了行走步态模拟，未考虑日常活动中其他高频活动，如上下楼梯、起立坐下、慢跑。③为了节省计算时间，未建立包括股骨、腓骨、关节软骨、对侧半月板和韧带在内的完整UKA膝关节模型。④应扩大骨质疏松的骨密度变化范围进行研究。尽管本文存在上述局限性，但不影响讨论患者骨质量与UKA假体固定稳定性的生物力学关系，研究结果为理解UKA假体松动失效提供了理论参考。
4　结论
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本文通过有限元方法量化研究了行走步态下不同骨质量情况对UKA假体固定稳定性的生物力学影响。行走时UKA骨-假体固定界面微动对患者骨质量变化较为敏感。患者骨质量越弱，UKA骨-假体固定界面微动越显著，假体松动风险越高。因此，对于骨质量较弱的患者，医生应谨慎选择手术策略以降低UKA术后翻修率。
基金
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  • 榆林市科技计划项目(CXY-2022-187)
  • 国家自然科学基金项目(11902048; 12202074)
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2025年第40卷第5期
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doi: 10.16156/j.1004-7220.2025.05.005
  • 接收时间：2024-12-10
  • 首发时间：2026-03-27
  • 出版时间：2025-10-01
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  • 收稿日期：2024-12-10
  • 修回日期：2025-01-18
基金
榆林市科技计划项目(CXY-2022-187)
国家自然科学基金项目(11902048; 12202074)
作者信息
    1.延安大学附属医院　骨外科，陕西　延安　716000
    2.长安大学　工程机械学院，西安　710064

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2种不同金属材料的力学参数
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species		 占总种数比例
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total species (%)		 属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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