Department of Orthopaedic Surgery, First Clinical Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China.
Chin Med J (Engl). 2010 May 5;123(9):1163-9.
Non-cement femoral stems are recognized in clinical use, but there are still some problems. The aim of this research was to make non-cement femoral stems to be press-fit with the medullary cavity.
Twenty-four healthy adult mongrel dogs were randomly divided into experimental and control groups. In the right hip joint, an artificial femoral bone replacement surgery was conducted. For the experimental group, the replacement surgery of hydroxyapatite (HA)-coated femoral stems was done, while autogeneous morselized bone was implanted into the medullary cavity. For the control group, morselized bone was not implanted. At postoperative 1, 3, 6 months, a test for interfacial shear characteristics was conducted in the MTS810 Tester. The comparison between the two groups' bone-prostheses in shear strength for their interface from shearing destruction was made. A histological observation to check prosthesis-bone interface contact ratios and bone growth was carried out.
For the experimental group, shear strength was 0.317 MPa in 1 month, 1.447 MPa in 3 months, and 1.621 MPa in 6 months. For the control group, shear strength was 0.195 MPa in 1 month, 1.023 MPa in 3 months, and 1.483 MPa in 6 months. The difference was statistically significant. Stereomicroscope-based observation showed that the number of trabecular bones in the experimental group was larger than that of the control group, and bone growth of the former group was better than that of the latter group. Inverted microscopic observation showed that the binding degree between the prosthesis and trabecular bone of the experimental group was higher than that of the control group. Comparatively, the experimental group's trabecular bone had more stromal cells.
The morselized bones can effectively improve the biological bonding strength and bone-contact ratios in the short term for the HA-coated femoral stem and accelerate the bonding process. The use of morselized autogenous bones played a good role in bone in-growth of the femoral bone stem surface.
非骨水泥股骨柄已在临床应用中得到认可，但仍存在一些问题。本研究旨在使非骨水泥股骨柄与髓腔紧密贴合。
将 24 只健康成年杂种犬随机分为实验组和对照组。在右侧髋关节进行人工股骨置换手术。实验组行羟基磷灰石（HA）涂层股骨柄置换术，并将自体碎骨植入髓腔；对照组则不植入碎骨。术后 1、3、6 个月，在 MTS810 试验机上进行界面剪切特性测试，比较两组骨-假体界面的剪切强度。进行组织学观察以检查假体-骨界面的接触率和骨生长情况。
实验组 1 个月时剪切强度为 0.317 MPa，3 个月时为 1.447 MPa，6 个月时为 1.621 MPa；对照组 1 个月时为 0.195 MPa，3 个月时为 1.023 MPa，6 个月时为 1.483 MPa。差异有统计学意义。体视显微镜观察显示实验组的小梁骨数量多于对照组，骨生长情况也优于对照组。倒置显微镜观察显示实验组假体与小梁骨的结合程度高于对照组，实验组小梁骨中的基质细胞也较多。
短期内自体碎骨可有效提高 HA 涂层股骨柄的生物结合强度和骨接触率，加快结合过程。使用自体碎骨对股骨柄表面的骨长入起到了良好的作用。
