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非骨水泥型金属和陶瓷髋臼部件周围的骨重塑

Bone remodelling around uncemented metallic and ceramic acetabular components.

作者信息

Ghosh Rajesh, Mukherjee Kaushik, Gupta Sanjay

机构信息

Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India.

出版信息

Proc Inst Mech Eng H. 2013 May;227(5):490-502. doi: 10.1177/0954411913478703. Epub 2013 Mar 6.

Abstract

Stress shielding-induced bone resorption around cementless acetabular components has been indicated as a potential failure mechanism that may threaten long-term fixation. Using a bone remodelling algorithm in combination with three-dimensional finite element models of intact and implanted pelvises and musculoskeletal loading during normal walking, the objectives of the study were to investigate the deviations in load transfer due to implantation and bone adaptation around cementless metallic and ceramic acetabular components. Variations in implant-bone interfacial condition affected strain shielding and bone remodelling; strain shielding was higher for the bonded condition as compared to the debonded condition. For bonded interfacial condition, severe bone resorption, 20%-50% bone density reduction, was observed within the acetabulum. Considering debonded implant-bone interface, bone density increase of 50%-60% was observed around the supero-posterior part of acetabulum, whereas bone density reductions were low (2%-15%) in other locations. The implant-bone interface appeared less likely to fail, post-operatively and after bone remodelling. Moreover, the implant-bone micromotion was found to be low, less than 100 µm. Strain shielding and bone remodelling were almost similar for the metallic and ceramic components. Based on the results of this study, the ceramic acetabular component appeared to be a viable alternative to metal.

摘要

无水泥髋臼假体周围应力屏蔽诱导的骨吸收已被指出是一种可能威胁长期固定的潜在失效机制。本研究利用骨重塑算法,结合完整骨盆和植入骨盆的三维有限元模型以及正常行走时的肌肉骨骼负荷,旨在研究无水泥金属和陶瓷髋臼假体植入导致的负荷传递偏差以及周围骨适应性。植入物与骨界面条件的变化影响应变屏蔽和骨重塑;与脱粘状态相比,粘结状态下的应变屏蔽更高。对于粘结界面条件,髋臼内观察到严重的骨吸收,骨密度降低20%-50%。考虑到植入物与骨界面脱粘,髋臼后上部周围骨密度增加50%-60%,而其他部位骨密度降低幅度较小(2%-15%)。植入物与骨界面在术后和骨重塑后似乎不太可能失效。此外,发现植入物与骨的微动较低,小于100微米。金属和陶瓷部件的应变屏蔽和骨重塑几乎相似。基于本研究结果,陶瓷髋臼假体似乎是金属假体的可行替代方案。

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