肱骨组件尺寸对 Souter-Strathclyde 全肘假体扭转刚度的影响较小。

Minor influence of humeral component size on torsional stiffness of the Souter-Strathclyde total elbow prosthesis.

机构信息

Department of Orthopaedic Surgery, Leiden University Medical Center, The Netherlands.

出版信息

Int Orthop. 2010 Dec;34(8):1213-8. doi: 10.1007/s00264-009-0910-2. Epub 2009 Dec 1.

Abstract

The use of Souter-Strathclyde total elbow prostheses is a well-studied replacement therapy for reconstruction of the elbow, but loosening of the humeral component is still of concern at long-term follow-up. In this study we looked at the effect of humeral component size and bone mineral density with respect to the bone size, torsional stiffness and torque to failure in cadaveric bones. Fourteen cadaveric humeri were available for testing purposes and four different humeral component size categories were used. First, we calculated the bone quality using dual-energy X-ray absorptiometry (DEXA). The torsional stiffness of the prosthetic humeri was measured during two mechanical tests: Firstly, the applied torque was recorded during a torsion fatigue test. The change of torsional stiffness between the tenth and last cycle was calculated. Secondly, a simple torsion test was performed and the torque to failure was recorded. No significant differences in outcome were seen between sizes of humeral components, even after correction for the bone size. Torsional stiffness and torque to failure were significantly correlated with bone mineral density and not with component size. In conclusion, bone quality seems to be a major eminent factor in the fixation of the humeral component in elbow replacement surgery.

摘要

使用 Souter-Strathclyde 全肘假体是一种经过充分研究的肘部重建替代疗法,但在长期随访中,肱骨组件的松动仍然令人关注。在这项研究中,我们研究了肱骨组件大小和骨密度对骨骼大小、扭转刚度和失效扭矩的影响,使用了四种不同的肱骨组件尺寸类别。共有 14 个尸体肱骨可供测试,首先,我们使用双能 X 射线吸收法(DEXA)计算骨质量。在两个机械测试中测量了假体肱骨的扭转刚度:首先,在扭转疲劳测试中记录施加的扭矩。计算第十次和最后一次循环之间扭转刚度的变化。其次,进行了简单的扭转测试并记录失效扭矩。即使在考虑骨骼大小的情况下,肱骨组件的尺寸之间也没有明显的结果差异。扭转刚度和失效扭矩与骨密度显著相关,而与组件尺寸无关。总之,骨质量似乎是肘部置换手术中肱骨组件固定的一个主要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/150d/2989074/1cfd05103a53/264_2009_910_Fig1_HTML.jpg

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