Lerch Matthias, Weigel Nelly, Windhagen Henning, Ettinger Max, Thorey Fritz, Kurtz Agnes, Stukenborg-Colsman Christina, Bouguecha Anas
Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany.
Technol Health Care. 2013;21(5):493-500.
Numerous short stemmed total hip arthroplasty (THA) implants have been introduced over the last decades. It is questionable if little differences between the implant designs affect stress shielding and bone remodeling. The finite element analysis allows an evaluation of the design rationale of the implant without negative side effects for the patient.
We investigated a relatively new short stemmed implant designed from clustered CT datasets of proximal femurs. How does the implant affect femoral bone remodeling? Can we see a positive effect on bone remodeling from the CT based design?
We used a Finite Element Model that was validated by a prospective dual-energy-x-ray-absorptiometry study to calculate apparent bone density.
Apparent bone density (ABD) decreased by 2.3% in the entire femur. Bone mass loss was pronounced in the proximal calcar region. Little ABD increase was seen in the lateral aspect of the cortical ring, in the minor trochanter area and at the lateral aspect of the stem.
ABD reduction occurs in the proximal regions of the femur. The overall bone mass loss was little after THA with the investigated implant. The specific design seems to have no major effect on stress shielding or load distribution.
在过去几十年里,已经推出了众多短柄全髋关节置换(THA)植入物。植入物设计之间的微小差异是否会影响应力遮挡和骨重塑仍存在疑问。有限元分析能够在不对患者产生负面副作用的情况下评估植入物的设计原理。
我们研究了一种基于股骨近端聚类CT数据集设计的相对较新的短柄植入物。该植入物如何影响股骨骨重塑?基于CT的设计能否对骨重塑产生积极影响?
我们使用了一个通过前瞻性双能X线吸收法研究验证的有限元模型来计算表观骨密度。
整个股骨的表观骨密度(ABD)下降了2.3%。股骨近端骨皮质区骨量丢失明显。在皮质环外侧、小转子区域和柄的外侧可见ABD略有增加。
股骨近端区域出现ABD降低。使用所研究的植入物进行THA后,总体骨量丢失较少。具体设计似乎对应力遮挡或负荷分布没有重大影响。