人体髋臼前后柱骨硬度分布特征研究

doi:10.3877/cma.j.issn.1674-134X.2020.01.010

目的

研究人体髋臼前柱和后柱的硬度分布特征，探索骨硬度分布的科研价值及临床应用前景。

方法

本研究所用两男一女3具标本均由河北医科大学解剖教研室提供，选取3对髋臼前后柱样本，取出全部髋骨后剔除软组织，运用微型台锯将髋骨分割为髋臼前柱和后柱，后用高精慢速锯将髋臼前后柱切割成若干厚3 mm的骨组织切片，固定在载玻片后用砂纸打磨。使用维氏硬度仪测试骨组织切片不同解剖区域皮质骨和松质骨的硬度值。本研究采用50 g力加载50 s、维持12 s标准操作方法测定，组间数据比较采用配对t检验。

结果

本研究在人体髋臼前柱和髋臼后柱随机切取骨片，代表了髋臼前后柱纵向的不同位置，测量共计450个有效值，3个样本髋臼前柱总体硬度范围在18.9～33.8 HV，均值(25.2±3.1)HV；髋臼后柱硬度范围在23.1～39.1 HV，均值(31.9±3.8) HV。男性捐献者髋臼前、后柱总体硬度范围分别为18.8～33.8 HV及23.1～39.1 HV；女性捐献者髋臼前、后柱总体硬度范围分别为19.4～33.8 HV及24.6～38.9 HV，所有标本中后柱平均骨硬度值均大于前柱，且差异有统计学意义(t＝7.502、4.724、5.487，P<0.01)，研究数据表明男性和女性髋臼前柱与后柱均存在硬度分布差异。

结论

人体髋臼前后柱骨硬度值个体间存在差异，但均为后柱骨硬度大于前柱。骨硬度值的研究可为髋臼骨折内植物的置入位置、置钉长度及方向等提供参考，同时为研发符合人体梯度弹性模量的内植物及骨盆髋臼假体提供可靠的数据支撑。

关键词: 髋臼, 硬度, 骨骼, 成像, 三维

Objective

To analysis the hardness distribution characteristics of the anterior and posterior column of the acetabulum, and to explore the value of bone hardness distribution in scientific research and clinical application.

Methods

The metatarsal bones in this study were collected from three healthy donors (two males, one female, Hebei Medical University). Three pairs of anterior and posterior acetabular column were selected, all the soft tissue was removed. Bone specimens with a thickness of 3 mm were taken from anterior and posterior acetabular column with a low-speed saw. The microhardness of the bone tissue was measured using a Vickers microhardness tester after polish. The indentation load and dwell time was set to 50 g and 12 s in this study. The paired t test was used for data comparison between groups.

Results

Bone specimens, which were randomly cut from the anterior acetabular column and the posterior acetabular column in human body, representing different longitudinal positions of the anterior and posterior acetabular columns. Totally, 450 valid values at different bones and anatomic sites were involved in our result. The total hardness of the acetabular anterior column ranged from 18.9 to 33.8 HV with a mean of (25.2±3.1) HV and that of the acetabular posterior column ranged from 23.1 to 39.1 HV with a mean value of (31.9±3.8) HV. Bone hardness of acetabular anterior column and posterior column of male donor ranged from 18.8 to 33.8 HV and 23.1 to 39.1 HV respectively. For the female donor, the total hardness of acetabular anterior column and posterior column were 19.4-33.8 HV and 24.6-38.9 HV, the average bone hardness of posterior column of the acetabulum was larger than that of the anterior column, and the difference was statistically significant (t=7.502、4.724、5.487, all P<0.01). The data showed that there was a difference in hardness distribution between the anterior and posterior column of the acetabulum in both men and women.

Conclusions

There are individual differences for the hardness of acetabular, and the hardness of posterior column is higher than that of anterior column. This study can provide a reference for the position of implants, length and direction of screw, as well as provide reliable data support for the development of implants and acetabular prostheses in line with the gradient elastic modulus of human body.

Key words: Acetabulum, Hardness, Bone, Imaging, three-dimensional

图2 髋臼前柱(左)及后柱(右)骨组织切片大体图

图4 KB-5显微硬度测试仪测试骨骼试样

图6 髋臼前、后柱取样示意图。黑色阴影区域为髋臼后柱；点状灰色区域为髋臼前柱；红色线条为髋臼后柱取材位置；蓝色线条为髋臼前柱取材位置

图7 人体髋臼前后柱不同部位显微骨硬度值分布

表2 3具标本髋臼骨硬度值分布及差异显著性[HV，(±s)]

部位	试样数	标本A	标本B	标本C
髋臼前柱	12	23.8±2.5	26.3±3.4	25.6±2.9
髋臼后柱	12	31.4±3.9	31.3±3.7	32.9±3.7
t值	－	－7.502	－4.724	－5.487
P值	－	<0.01	<0.01	<0.01

表2 3具标本髋臼骨硬度值分布及差异显著性[HV，(±s)]

部位	试样数	标本A	标本B	标本C
髋臼前柱	12	23.8±2.5	26.3±3.4	25.6±2.9
髋臼后柱	12	31.4±3.9	31.3±3.7	32.9±3.7
t值	－	－7.502	－4.724	－5.487
P值	－	<0.01	<0.01	<0.01

[1]	Rho JY, Kuhn-Spearing L, Zioupos P. Mechanical properties and the hierarchical structure of bone[J]. Med Eng Phys, 1998, 20(2): 92-102.
[2]	Rivadeneira F, Zillikens MC, De Laet CE, et al. Femoral neck BMD is a strong predictor of hip fracture susceptibility in elderly men and women because it detects cortical bone instability: the Rotterdam Study[J]. J Bone Miner Res, 2007, 22(11): 1781-1790.
[3]	Yang L, Peel N, Clowes JA, et al. Use of DXA-based structure engineering models of the proximal femur to discriminate hip fracture[J]. J Bone Miner Res, 2009, 24(1)：33-42.
[4]	Zysset PK. Indentation of bone tissue: a short review[J]. Osteoporos Int, 2009, 20(6): 1049-1055.
[5]	Blackburn J, Hodgskinson R, Currey JD, et al. Mechanical properties of microcallus in human cancellous bone[J]. J Orthop Res, 1992, 10(2): 237-246.
[6]	Coats AM, Zioupos P, Aspden RM. Material properties of subchondral bone from patients with osteoporosis or osteoarthritis by microindentation testing and electron probe microanalysis[J]. Calcif Tissue Int, 2003, 73(1): 66-71.
[7]	Riches PE, Everitt NM, Heggie AR, et al. Microhardness anisotropy of lamellar bone[J]. J Biomech, 1997, 30(10): 1059-1061.
[8]	Ziv V, Wagner HD, Weiner S. Microstructure-microhardness relations in parallel-fibered and lamellar bone[J]. Bone, 1996, 18(5): 417-428.
[9]	Evans GP, Behiri JC, Currey JD，et al. Microhardness and Young′s modulus in cortical bone exhibiting a wide range of mineral volume fractions, and in a bone analogue[J]. J Mater Sci-Mater M, 1990, 1(1): 38-43.
[10]	Evans FG: Mechanical properties of bone [M]. 1973, Thomas.
[11]	Huja SS, Katona TR, Moore BK, et al. Microhardness and anisotropy of the vital osseous interface and endosseous implant supporting bone[J]. J Orthop Res, 1998, 16(1)：54-60.
[12]	胡祖圣，李升，刘国彬，等．人体骨骼显微硬度及其相关因素初步研究[J]．河北医科大学学报，2016，37(1)：102-104.
[13]	殷兵，胡祖圣，李升，等．人体骨骼显微硬度研究[J]．河北医科大学学报，2016，37(12)：1472-1474.
[14]	Johnson WM, Rapoff AJ. Microindentation in bone: hardness variation with five independent variables[J]. J Mater Sci Mater Med, 2007, 18(4): 591-597.
[15]	Designation A. Standard test method for microindentation hardness of materials[J]. ASTM, Philadelphia, 1999: 384-399.
[16]	Hodgskinson R, Currey JD, Evans GP. Hardness, an indicator of the mechanical competence of cancellous bone[J]. J Orthop Res, 1989, 7(5): 754-758.
[17]	Harnroongroj T. The role of the anterior column of the acetabulum on pelvic stability: a biomechanical study[J]. Injury, 1998, 29(4): 293-296.
[18]	Shazar N, Brumback RJ, Novak VP, et al. Biomechanical evaluation of transverse acetabular fracture fixation[J]. Clin Orthop Relat Res, 1998, Jul(352): 215-222.
[19]	王庆贤，张英泽，潘进社，等．髋臼横断骨折不同内固定方式的生物力学研究[J]．中华物理医学与康复杂志，2001，23(5)：279-281.
[20]	Sawaguchi T, Brown TD, Rubash HE, et al. Stability of acetabular fractures after internal fixation[J]. Acta Orthop Scand, 1984, 55(6): 601-605.
[21]	周华，高仕长，周程鹏，等．三维重建模拟经皮拉力螺钉固定髋臼前柱骨折的解剖学研究[J]．中国临床解剖学杂志，2015，33(2)：148-154.
[22]	孟庆兵，刘璠．髋臼骨折诊治的进展[J/CD]．中华关节外科杂志(电子版)，2008，2(2)：61-64.
[23]	Boudissa M, Francony F, Kerschbaumer G, et al. Epidemiology and treatment of acetabular fractures in a level-1 trauma centre: retrospective study of 414 patients over 10 years[J]. Orthop Traumatol Surg Res, 2017, 103(3): 335-339.
[24]	王红强，高延征，刘继军，等．重建钛板及记忆合金内固定系统治疗髋臼骨折的疗效分析[J/CD]．中华关节外科杂志(电子版)，2010，04(3)：357-361.

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Research on human bone microhardness distribution characteristics of acetabulum anterior and posterior columns

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Research on human bone microhardness distribution characteristics of acetabulum anterior and posterior columns