Wadia F, Malik M H A, Leonard D, Porter M L
Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, UK.
Int Orthop. 2006 Aug;30(4):237-42. doi: 10.1007/s00264-006-0101-3. Epub 2006 Apr 26.
Cement pressurisation is an important step in total hip arthroplasty that determines the long-term integration at the cement-bone interface. Our aim was to evaluate the performance of a new pressuriser designed by us against the standard existing pressurisers in an in vitro experimental set-up using two parameters: cement penetration and cement pressurisation. A polypropylene cup model was designed to represent the acetabulum. DePuy's T-handle, Exeter and our own plunger type pressuriser were each tested for cement pressurisation in this acetabular model. Cement penetration and pressures were measured. The cement intrusion into the capillaries with the DePuy pressuriser was found to vary between 2 and 8 mm (mean: 5 mm at the pole and 4.6 mm at the rim), with the Exeter pressuriser it varied between 3 and 9 mm (mean: 5.8 mm at the pole and 7.8 mm at the rim) and with the plunger type pressuriser it varied between 4 and 6 mm (mean 5.2 mm at the pole and 4.8 mm at the rim). The peak pressure achieved with the DePuy pressuriser was 60 kPa whereas it was 70 kPa with the plunger type pressuriser. The mean penetration with the plunger type pressuriser was found to be better than the other types. The penetration was found to be more uniform with equal penetration at the rim as well as at the pole.
骨水泥加压是全髋关节置换术中的一个重要步骤,它决定了骨水泥与骨界面的长期融合情况。我们的目的是在体外实验装置中,使用骨水泥渗透和骨水泥加压这两个参数,评估我们设计的一种新型加压装置相对于现有标准加压装置的性能。设计了一个聚丙烯杯模型来代表髋臼。分别在这个髋臼模型中测试了DePuy的T型手柄、埃克塞特加压装置和我们自己的柱塞式加压装置的骨水泥加压情况。测量了骨水泥的渗透情况和压力。发现使用DePuy加压装置时,骨水泥侵入毛细血管的深度在2至8毫米之间(平均:极点处为5毫米,边缘处为4.6毫米);使用埃克塞特加压装置时,其深度在3至9毫米之间(平均:极点处为5.8毫米,边缘处为7.8毫米);使用柱塞式加压装置时,其深度在4至6毫米之间(平均:极点处为5.2毫米,边缘处为4.8毫米)。DePuy加压装置达到的峰值压力为60千帕,而柱塞式加压装置为70千帕。发现柱塞式加压装置的平均渗透情况优于其他类型。发现在边缘和极点处渗透较为均匀,渗透深度相等。