DiResta Gene R, Brown Holly, Aiken Sean, Doty Steven, Schneider Robert, Wright Timothy, Healey John H
Orthopaedics Research Laboratory, Memorial Sloan Kettering Cancer Center, RRL 409, 430 E67th St., New York, NY 10021, USA.
J Biomech. 2006;39(5):833-43. doi: 10.1016/j.jbiomech.2005.02.004.
A device is presented that positions ultrahigh molecular weight polyethylene (UHMWPE) debris against periprosthetic bone surfaces. This can facilitate the study of aseptic loosening associated with cemented joint prostheses by speeding the appearance of this debris within the periprosthetic space. The device, composed of a 100 microm thick bioabsorbable membrane impregnated with 1.4 x 10(9) sub-micron particles of UHMWPE debris, is positioned on the endosteum of the bone prior to the insertion of the cemented orthopedic implant. An in vitro pullout study and an in vivo canine pilot study were performed to investigate its potential to accelerate "time to aseptic loosening" of cemented prosthetic joints. Pullout studies characterized the influence of the membrane on initial implant fixation. The tensile stresses (mean+/-std.dev.) required to withdraw a prosthesis cemented into canine femurs with and without the membrane were 1.15+/-0.3 and 1.54+/-0.01 MPa, respectively; these findings were not significantly different (p > 0.4). The in vivo pilot study, involving five dogs, was performed to evaluate the efficacy of the debris to accelerate loosening in a canine cemented hip arthroplasty. Aseptic loosening and lameness occurred within 12 months, quicker than the 30 months reported in a retrospective clinical review of canine hip arthroplasty.
本文介绍了一种将超高分子量聚乙烯（UHMWPE）碎片置于假体周围骨表面的装置。通过加快假体周围空间内这种碎片的出现，这有助于研究与骨水泥型关节假体相关的无菌性松动。该装置由一张100微米厚的可生物吸收膜组成，膜中浸渍有1.4×10⁹个超高分子量聚乙烯碎片的亚微米颗粒，在植入骨水泥型骨科植入物之前，将其放置在骨内膜上。进行了一项体外拔出研究和一项体内犬类初步研究，以调查其加速骨水泥型假体关节“无菌性松动时间”的潜力。拔出研究表征了该膜对初始植入物固定的影响。将假体植入有膜和无膜的犬股骨中，拔出假体所需的拉应力（平均值±标准差）分别为1.15±0.3和1.54±0.01MPa；这些结果无显著差异（p>0.4）。体内初步研究涉及五只犬，以评估碎片在犬骨水泥型髋关节置换术中加速松动的效果。无菌性松动和跛行在12个月内出现，比犬髋关节置换术回顾性临床研究报告的30个月更快。
