Hansen T B, Meier M, Møller M C M, Larsen K, Stilling M
Department of Orthopaedics, Section of Hand Surgery, and Orthopaedic Research Unit, Regional Hospital Holstebro, Denmark.
J Hand Surg Eur Vol. 2011 May;36(4):285-90. doi: 10.1177/1753193410394526. Epub 2011 Jan 31.
High loosening rates of the trapezium components of trapeziometacarpal total joint prostheses have been reported. The purpose of this study was to compare the primary press fit fixation of two different, uncemented cup designs (MOTEC and Elektra) with the primary fixation of a cemented polyethylene cup (DLC) in a pig bone model. We did a push out test to measure the maximal load strength of the implants and a low-pressure cyclic loading test combined with radiostereometric analysis to measure the micromotion of the implants. There was no significant difference in fixation strength between the two uncemented screw cup designs or between the two uncemented screw cups and the cemented polyethylene cup. However, we found that threading of the bone before insertion of the Electra screw cup weakens the primary fixation strength of the implant. The results indicate that focus should be on the insertion technique as well as on the cup design of uncemented trapezium cup implants. Further studies of trapezium implant migration in a clinical setting are needed.
据报道,大多角骨-掌骨全关节假体的大多角骨部件松动率较高。本研究的目的是在猪骨模型中比较两种不同的非骨水泥杯设计(MOTEC和Elektra)的初次压配固定与骨水泥聚乙烯杯(DLC)的初次固定情况。我们进行了推出试验以测量植入物的最大负载强度,并进行了低压循环加载试验结合放射立体测量分析以测量植入物的微动情况。两种非骨水泥螺钉杯设计之间,以及两种非骨水泥螺钉杯与骨水泥聚乙烯杯之间的固定强度均无显著差异。然而,我们发现,在插入Elektra螺钉杯之前对骨进行攻丝会削弱植入物的初次固定强度。结果表明,应关注非骨水泥大多角骨杯植入物的插入技术以及杯设计。需要在临床环境中对大多角骨植入物的迁移进行进一步研究。