Sumner D R, Galante J O
Rush-Presbyterian-St. Luke's Medical Center, Department of Orthopedic Surgery, Chicago, IL 60612.
Clin Orthop Relat Res. 1992 Jan(274):202-12.
Experimental studies of cementless porous-coated total hip arthroplasty indicate that a critical design variable for femoral remodeling is stem stiffness. In the long term (two years) in the canine model, other variables, including the presence, type, and placement of the porous coating, did not significantly affect the pattern of bone remodeling when tested with metallic stems. The basic pattern of bone remodeling was characterized by proximal cortical atrophy, and distal cortical and medullary bone hypertrophy. In the short term (six months), the use of low-stiffness stems altered this pattern, leading to reduced proximal bone loss, increased proximal medullary bone hypertrophy, and no distal cortical hypertrophy, suggesting that stem stiffness had a profound effect on stress shielding.
非骨水泥型多孔涂层全髋关节置换术的实验研究表明，股骨重塑的一个关键设计变量是柄的刚度。在犬类模型的长期（两年）研究中，当使用金属柄进行测试时，其他变量，包括多孔涂层的存在、类型和放置位置，对骨重塑模式没有显著影响。骨重塑的基本模式表现为近端皮质萎缩，远端皮质和髓质骨肥大。在短期（六个月）研究中，使用低刚度柄改变了这种模式，导致近端骨丢失减少，近端髓质骨肥大增加，且无远端皮质肥大，这表明柄的刚度对应力遮挡有深远影响。
