Hemiarthroplasty in young patients.

IF 4.9 1区 医学 Q1 ORTHOPEDICS Bone & Joint Journal Pub Date : 2024-11-01 DOI:10.1302/0301-620X.106B11.BJJ-2024-0432.R2
Hazimah Mahmud, Dong Wang, Andra Topan-Rat, Anthony M J Bull, Christian H Heinrichs, Peter Reilly, Roger Emery, Andrew A Amis, Ulrich N Hansen
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Abstract

Aims: The survival of humeral hemiarthroplasties in patients with relatively intact glenoid cartilage could theoretically be extended by minimizing the associated postoperative glenoid erosion. Ceramic has gained attention as an alternative to metal as a material for hemiarthroplasties because of its superior tribological properties. The aim of this study was to assess the in vitro wear performance of ceramic and metal humeral hemiarthroplasties on natural glenoids.

Methods: Intact right cadaveric shoulders from donors aged between 50 and 65 years were assigned to a ceramic group (n = 8, four male cadavers) and a metal group (n = 9, four male cadavers). A dedicated shoulder wear simulator was used to simulate daily activity by replicating the relevant joint motion and loading profiles. During testing, the joint was kept lubricated with diluted calf serum at room temperature. Each test of wear was performed for 500,000 cycles at 1.2 Hz. At intervals of 125,000 cycles, micro-CT scans of each glenoid were taken to characterize and quantify glenoid wear by calculating the change in the thickness of its articular cartilage.

Results: At the completion of the wear test, the total thickness of the cartilage had significantly decreased in both the ceramic and metal groups, by 27% (p = 0.019) and 29% (p = 0.008), respectively. However, the differences between the two were not significant (p = 0.606) and the patterns of wear in the specimens were unpredictable. No significant correlation was found between cartilage wear and various factors, including age, sex, the size of the humeral head, joint mismatch, the thickness of the native cartilage, and the surface roughness (all p > 0.05).

Conclusion: Although ceramic has better tribological properties than metal, we did not find evidence that its use in hemiarthroplasty of the shoulder in patients with healthy cartilage is a better alternative than conventional metal humeral heads.

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年轻患者的半关节成形术
目的:盂软骨相对完整的患者进行肱骨半关节置换时,理论上可以通过最大限度地减少相关的术后盂软骨侵蚀来延长其存活时间。陶瓷因其优越的摩擦学特性而备受关注,可替代金属作为半关节假体的材料。本研究旨在评估陶瓷和金属肱骨半关节假体在天然盂上的体外磨损性能:方法:将来自 50 至 65 岁供体的完整右肩尸体分配到陶瓷组(n = 8,4 名男性尸体)和金属组(n = 9,4 名男性尸体)。使用专用的肩关节磨损模拟器,通过复制相关的关节运动和负载曲线来模拟日常活动。测试期间,关节在室温下用稀释的小牛血清保持润滑。每次磨损测试都以 1.2 Hz 的频率进行 500,000 次循环。每隔 125,000 次循环,对每个盂状关节进行显微 CT 扫描,通过计算关节软骨厚度的变化来描述和量化盂状关节的磨损情况:磨损测试结束时,陶瓷组和金属组的软骨总厚度均显著下降,分别为 27% (p = 0.019) 和 29% (p = 0.008)。然而,两者之间的差异并不明显(p = 0.606),而且试样的磨损模式也无法预测。软骨磨损与各种因素,包括年龄、性别、肱骨头大小、关节错位、原生软骨厚度和表面粗糙度之间没有发现明显的相关性(均 p > 0.05):结论:虽然陶瓷的摩擦学特性优于金属,但我们没有发现证据表明,在软骨健康的患者肩关节半关节成形术中使用陶瓷比使用传统金属肱骨头更好。
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来源期刊
Bone & Joint Journal
Bone & Joint Journal ORTHOPEDICS-SURGERY
CiteScore
9.40
自引率
10.90%
发文量
318
期刊介绍: We welcome original articles from any part of the world. The papers are assessed by members of the Editorial Board and our international panel of expert reviewers, then either accepted for publication or rejected by the Editor. We receive over 2000 submissions each year and accept about 250 for publication, many after revisions recommended by the reviewers, editors or statistical advisers. A decision usually takes between six and eight weeks. Each paper is assessed by two reviewers with a special interest in the subject covered by the paper, and also by members of the editorial team. Controversial papers will be discussed at a full meeting of the Editorial Board. Publication is between four and six months after acceptance.
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