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用于概念性肩胛盂部件设计的骨长入模拟

Bone ingrowth simulation for a concept glenoid component design.

作者信息

Andreykiv A, Prendergast P J, van Keulen F, Swieszkowski W, Rozing P M

机构信息

Faculty of Design, Engineering and Production, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands.

出版信息

J Biomech. 2005 May;38(5):1023-33. doi: 10.1016/j.jbiomech.2004.05.044.

Abstract

Glenoid component loosening is the major problem of total shoulder arthroplasty. It is possible that uncemented component may be able to achieve superior fixation relative to cemented component. One option for uncemented glenoid is to use porous tantalum backing. Bone ingrowth into the porous backing requires a degree of stability to be achieved directly post-operatively. This paper investigates the feasibility of bone ingrowth with respect to the influence of primary fixation, elastic properties of the backing and friction at the bone prosthesis interface. Finite element models of three glenoid components with different primary fixation configurations are created. Bone ingrowth into the porous backing is modelled based on the magnitude of the relative interface micromotions and mechanoregulation of the mesenchymal stem cells that migrated via the bonded part of the interface. Primary fixation had the most influence on bone ingrowth. The simulation showed that its major role was not to firmly interlock the prosthesis, but rather provide such a distribution of load, that would result in reduction of the peak interface micromotions. Should primary fixation be provided, friction has a secondary importance with respect to bone ingrowth while the influence of stiffness was counter intuitive: a less stiff backing material inhibits bone ingrowth by higher interface micromotions and stimulation of fibrous tissue formation within the backing.

摘要

肩胛盂部件松动是全肩关节置换术的主要问题。与骨水泥固定部件相比,非骨水泥固定部件有可能实现更好的固定效果。非骨水泥肩胛盂的一种选择是使用多孔钽背衬。骨长入多孔背衬需要在术后直接实现一定程度的稳定性。本文就初次固定、背衬的弹性特性以及骨假体界面处的摩擦对骨长入的影响进行了可行性研究。创建了具有不同初次固定构型的三种肩胛盂部件的有限元模型。基于相对界面微动的大小以及通过界面结合部分迁移的间充质干细胞的机械调节,对骨长入多孔背衬进行建模。初次固定对骨长入的影响最大。模拟表明,其主要作用不是将假体牢固地联锁,而是提供这样一种载荷分布,从而导致界面微动峰值降低。如果提供初次固定,摩擦对骨长入的重要性居其次,而刚度的影响则与直觉相反:刚度较小的背衬材料会通过更高的界面微动和刺激背衬内纤维组织形成来抑制骨长入。

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