Plank Gordon R, Estok Daniel M, Muratoglu Orhun K, O'Connor Daniel O, Burroughs Brian R, Harris William H
Harris Orthopaedic Biomechanics and Biomaterials Laboratory, Massachusetts General Hospital, 55 Fruit Street, Jackson 1126, Boston, Massachusetts 02114, USA.
J Biomed Mater Res B Appl Biomater. 2007 Jan;80(1):1-10. doi: 10.1002/jbm.b.30560.
Stress magnitude and distribution of both conventional polyethylene versus a crosslinked polyethylene in the liner of a total hip replacement (THR) were examined using finite element analysis and pressure sensitive film. Both types of polyethylene were assessed against head sizes of 22 and 28 mm with 5-mm thick polyethylene liners and head sizes of 28, 38, and 46 mm with 3-mm thick polyethylene liners. Liners with 5-mm conventional polyethylene represented successful combinations with long track records. Our hypothesis was that although the combination of the large head and the lower modulus of the highly crosslinked polyethylene would lead to lower stresses, the stresses would be excessive if the liner was extremely thin at 3 mm. Von Mises stresses at the articulating surface of the highly crosslinked liners were lower, when compared to conventional polyethylene, in every THR size examined. Specifically, however, the 38- and 46-mm inner diameter (ID) highly crosslinked polyethylene even at the extreme of only 3-mm thick had lower stresses than the 22-mm ID conventional liner of 5-mm thickness. These data indicate that the use of a large head against highly crosslinked material even at 3-mm thickness results in lower stresses than in an existing conventional 22-mm head and 5-mm thick combination. Obviously, other considerations will influence the minimum thickness to be recommended.
使用有限元分析和压敏膜检查了全髋关节置换术(THR)髋臼衬垫中传统聚乙烯与交联聚乙烯的应力大小和分布。针对22毫米和28毫米的股骨头尺寸,使用5毫米厚的聚乙烯衬垫;针对28毫米、38毫米和46毫米的股骨头尺寸,使用3毫米厚的聚乙烯衬垫,对这两种类型的聚乙烯进行了评估。5毫米厚的传统聚乙烯衬垫代表了具有长期成功记录的组合。我们的假设是,尽管大头与高交联聚乙烯较低模量的组合会导致应力降低,但如果衬垫仅有3毫米厚则应力会过高。在所检查的每种THR尺寸中,与传统聚乙烯相比,高交联衬垫关节表面的冯·米塞斯应力更低。然而,具体而言,内径为38毫米和46毫米的高交联聚乙烯即使在仅3毫米厚的极端情况下,其应力也低于内径为22毫米、厚度为5毫米的传统衬垫。这些数据表明,即使在3毫米厚的情况下,使用大头与高交联材料相结合所产生的应力低于现有的22毫米头和5毫米厚的传统组合。显然,其他因素将影响推荐的最小厚度。