与单击技术相比,振动插入压配髋臼组件所需的力量更小。

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Bone & Joint Research Pub Date : 2024-06-05 DOI:10.1302/2046-3758.136.BJR-2023-0263.R1
Yasaman Niki, Gerd Huber, Kambiz Behzadi, Michael M Morlock
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引用次数: 0

摘要

目的:假体周围骨折和假体松动是无骨水泥假体翻修手术的两个主要原因。在这种手术中,以最小的骨损伤实现最佳的植入物固定具有挑战性。本试验研究探讨了在代用聚氨酯(PU)模型中进行髋臼组件植入时,振动植入是否比连续单次打击更温和:使用振动植入装置和自动撞击装置进行单次撞击,将髋臼组件(髋臼杯)植入聚氨酯泡沫(每立方英尺 15 和 30 个)中标称尺寸不足 1 毫米的空腔中。测量了植入力、剩余极性间隙和杠杆力矩,并对两种植入方法进行了比较:结果:在 15 PCF 和 30 PCF 泡沫中,振动植入法的撞击力分别降低了 89% 和 53%。在 15 PCF 泡沫中,两种方法都能将部件定位在极间隙小于 2 毫米的位置。但在 30 PCF 泡沫中,振动插入导致极间隙超过 2 毫米,这在临床上是不可取的。在 15 PCF 泡沫中,连续单吹植入的杠杆力矩高出 42%,而在 30 PCF 泡沫中则高出 2.7 倍:结论:振动种植体植入可通过降低撞击力来降低假体周围骨折的风险,尤其是在低质量骨质中。使用振动植入法实现种植体就位需要调整名义压入配合,尤其是在骨质较致密的情况下。有必要对真实骨组织进行进一步的临床前测试,以评估其粘弹性与调整后的压入配合是否能弥补本研究中观察到的振动植入后初级稳定性降低的问题。
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Vibratory insertion of press-fit acetabular components requires less force than a single blow technique.

Aims: Periprosthetic fracture and implant loosening are two of the major reasons for revision surgery of cementless implants. Optimal implant fixation with minimal bone damage is challenging in this procedure. This pilot study investigates whether vibratory implant insertion is gentler compared to consecutive single blows for acetabular component implantation in a surrogate polyurethane (PU) model.

Methods: Acetabular components (cups) were implanted into 1 mm nominal under-sized cavities in PU foams (15 and 30 per cubic foot (PCF)) using a vibratory implant insertion device and an automated impaction device for single blows. The impaction force, remaining polar gap, and lever-out moment were measured and compared between the impaction methods.

Results: Impaction force was reduced by 89% and 53% for vibratory insertion in 15 and 30 PCF foams, respectively. Both methods positioned the component with polar gaps under 2 mm in 15 PCF foam. However, in 30 PCF foam, the vibratory insertion resulted in a clinically undesirable polar gap of over 2 mm. A higher lever-out moment was achieved with the consecutive single blow insertion by 42% in 15 PCF and 2.7 times higher in 30 PCF foam.

Conclusion: Vibratory implant insertion may lower periprosthetic fracture risk by reducing impaction forces, particularly in low-quality bone. Achieving implant seating using vibratory insertion requires adjustment of the nominal press-fit, especially in denser bone. Further preclinical testing on real bone tissue is necessary to assess whether its viscoelasticity in combination with an adjusted press-fit can compensate for the reduced primary stability after vibratory insertion observed in this study.

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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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