Richter Martinus, Zech Stefan, Westphal Ralf, Klimesch Yvone, Gosling Thomas
Klinik Für Unfallchirurgie, Orthopädie und Fusschirurgie, Klinikum Coburg, Ketschendorfer Strasse 33, 96450 Coburg, Germany.
Foot Ankle Int. 2007 Dec;28(12):1276-86. doi: 10.3113/FAI.2007.1276.
An investigation was carried out into possible increased forces, torques, and altered motions during load-bearing ankle motion after implantation of two different total ankle prostheses. We hypothesized that the parameters investigated would not differ in relation to the two implants compared.
We included two different ankle prostheses (Hintegra, Newdeal, Vienne, France; German Ankle System, R-Innovation, Coburg, Germany). The prostheses were implanted in seven paired cadaver specimens. The specimens were mounted on an industrial robot that enables complex motion under predefined conditions (RX 90, Stäubli, Bayreuth, Germany). The robot detected the load-bearing (30 kg) motion of the 100(th) cycle of the specimens without prostheses as the baseline for the later testing, and mimicked that exact motion during 100 cycles after the prostheses were implanted. The resulting forces, torques, and bone motions were recorded and the differences between the prostheses compared.
The Hintegra and German Ankle System, significantly increased the forces and torques in relation to the specimen without a prosthesis with one exception (one-sample-t-test, each p < or = 0.01; exception, parameter lateral force measured with the German Ankle System, p = 0.34). The force, torque, and motion differences between the specimens before and after implantation of the prostheses were lower with the German Ankle System than with the Hintegra (unpaired t-test, each p < or = 0.05).
The German Ankle System prosthesis had less of an effect on resulting forces and torques during partial weightbearing passive ankle motion than the Hintegra prosthesis. This might improve function and minimize loosening during the clinical use.
对植入两种不同全踝关节假体后负重时踝关节运动过程中可能增加的力、扭矩及改变的运动进行了研究。我们假设所研究的参数在两种比较的植入物之间没有差异。
我们纳入了两种不同的踝关节假体（Hintegra，Newdeal，法国维也纳；德国踝关节系统，R-Innovation，德国科堡）。将假体植入七个配对的尸体标本中。标本安装在一台工业机器人上，该机器人能够在预定条件下进行复杂运动（RX 90，史陶比尔，德国拜罗伊特）。机器人将无假体标本第100个周期的负重（30千克）运动检测为后续测试的基线，并在植入假体后的100个周期内模拟该精确运动。记录产生的力、扭矩和骨运动，并比较假体之间的差异。
Hintegra和德国踝关节系统与无假体的标本相比，力和扭矩显著增加，但有一个例外（单样本t检验，各p≤0.01；例外情况是，用德国踝关节系统测量的侧向力参数，p = 0.34）。德国踝关节系统植入假体前后标本之间的力、扭矩和运动差异低于Hintegra（非配对t检验，各p≤0.05）。
在部分负重被动踝关节运动过程中，德国踝关节系统假体对产生的力和扭矩的影响小于Hintegra假体。这可能会改善功能并使临床使用期间的松动最小化。
