Ducheyne P, Ellis L Y, Pollack S R, Pienkowski D, Cuckler J M
Department of Bioengineering, University of Pennsylvania, Philadelphia 19104.
IEEE Trans Biomed Eng. 1992 Nov;39(11):1168-78. doi: 10.1109/10.168683.
Expeditious post-operative ingrowth of bone is necessary for clinically successful fixation of porous joint prostheses. Electrical or electromagnetic fields to stimulate bone growth into porous implants have been used; however, they produced nonconvincing data. This was partially attributable to the lack of quantification of the localized electric fields produced in the pores of the implants. Therefore, this study set out: i) to quantify the local electric field values induced into the surface pores of nonconducting implants by "capacitive" coupling and to determine the magnitude of the macroscopically applied capacitively coupled electrical currents to induce specific electric field amplitudes in the pores, ii) to identify the important dielectric properties of the implant-tissue interface, and iii) to create the basis for successfully applying electrical fields in an animal model to stimulate bone ingrowth. A finite element method was used to calculate the electric field gradients and current densities present in a rat tibia modeled with a porous intramedullary implant when capacitively stimulated. Results indicated that while the current density in the pores are reduced in comparison to the region just outside the pore by about one order of magnitude, a significant current density still exists in the pore region. Furthermore, the presence of the implant increases the current densities in the trabecular bone while decreasing these values in the cortical bone. Replacing the trabecular bone in the pore by saline increases the current density in the pore by three-fold, but decreases the voltage gradient by a similar factor.
对于多孔关节假体的临床成功固定而言,术后骨骼迅速向内生长是必要的。人们曾使用电场或电磁场来刺激骨骼向多孔植入物内生长;然而,他们得到的数据并不令人信服。这部分归因于缺乏对植入物孔隙中产生的局部电场的量化。因此,本研究旨在:i)通过“电容性”耦合量化非导电植入物表面孔隙中感应的局部电场值,并确定为在孔隙中感应特定电场幅度而宏观施加的电容性耦合电流的大小,ii)识别植入物 - 组织界面的重要介电特性,以及iii)为在动物模型中成功应用电场刺激骨向内生长奠定基础。当进行电容性刺激时,使用有限元方法计算用多孔髓内植入物建模的大鼠胫骨中存在的电场梯度和电流密度。结果表明,虽然孔隙中的电流密度与孔隙外区域相比降低了约一个数量级,但孔隙区域中仍存在显著的电流密度。此外,植入物的存在增加了松质骨中的电流密度,同时降低了皮质骨中的电流密度。用盐水替代孔隙中的松质骨会使孔隙中的电流密度增加三倍,但会使电压梯度降低类似的倍数。