Heiney Jake P, Battula Suneel, Vrabec Gregory A, Parikh Anand, Blice Rebecca, Schoenfeld Andrew J, Njus Glenn O
Department of Orthopaedics, ProMedica Health System, Harris McIntosh Tower, Toledo, OH 43606, USA.
Arch Orthop Trauma Surg. 2009 Jun;129(6):793-6. doi: 10.1007/s00402-008-0660-4. Epub 2008 Jul 4.
This study was designed to test whether the number of impacts, the experience of the surgeon or impact force made significant difference in pull off forces.
The forces applied by 10 orthopaedic surgeons (five residents and five attending staff) to impact the femoral head onto the trunnion of a femoral component were recorded. The resultant forces were then divided into four energy levels and compared to determine if the number of impacts would make a difference in pull off strength.
No significant differences existed between the resident versus attending groups in magnitude of force applied. Through ANOVA testing, it was found that at each of the energy levels, multiple blows demonstrated a significant pull off strength difference compared to a single blow. Increased pull off force was also noted when the magnitude of force of the applied blows was increased.
We recommend at least two firm, axially aligned blows to impact the femoral head onto the trunnion intra-operatively.
本研究旨在测试冲击次数、外科医生的经验或冲击力在拔出力方面是否存在显著差异。
记录了10位骨科医生（5名住院医生和5名主治医生）将股骨头冲击到股骨假体柄上所施加的力。然后将合力分为四个能量水平并进行比较，以确定冲击次数是否会对拔出强度产生影响。
住院医生组和主治医生组在所施加力的大小上没有显著差异。通过方差分析测试发现，在每个能量水平下，多次冲击与单次冲击相比，拔出强度存在显著差异。当所施加冲击的力的大小增加时，拔出力也会增加。
我们建议在手术中至少进行两次稳固、轴向对齐的冲击，将股骨头冲击到股骨假体柄上。
