Kashima Nobuhiro, Shiramizu Kei, Nakamura Yoshinari, Moriyama Shigeaki, Naito Masatoshi
1 Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka - Japan.
Hip Int. 2015 Mar-Apr;25(2):164-7. doi: 10.5301/hipint.5000214. Epub 2015 Jan 29.
We performed curved periacetabular osteotomy, a modification of the Bernese periacetabular osteotomy, to treat hip dysplasia. The purpose of our study was to compare the biomechanical stability of acetabular fragments fixed in place with 3 titanium screws, or with 2 or 3 bioabsorbable screws composed of particulate resorbable uncalcined hydroxyapatite (HA) and poly-L-lactic acid (PLLA) termed HA/PLLA screws.
Curved periacetabular osteotomy was performed on 24 composite model hemipelves. Three groups of 8 specimens were affixed with 1) 3 titanium screws, 2) 2 HA/PLLA screws, or 3) 3 HA/PLLA screws. After fixation, the hemipelves were biomechanically attested with simulated push-off phase of the gait cycle using a servohydraulic material testing system.
The average failure loads were not significantly different among the3 groups tested. However, the group repaired with 3 HA/PLLA screws showed significantly greater stiffness than the other groups.
All 3 fixation methods provided sufficient stability to allow for early partial weight-bearing after surgery. The use of 3 HA/PLLA screws provided significantly greater stiffness for acetabular fragment fixation.
我们实施了髋臼周围弧形截骨术，这是对伯尔尼髋臼周围截骨术的一种改良，用于治疗髋关节发育不良。本研究的目的是比较用3枚钛螺钉或由颗粒状可吸收未煅烧羟基磷灰石（HA）和聚-L-乳酸（PLLA）组成的2枚或3枚生物可吸收螺钉（称为HA/PLLA螺钉）固定髋臼碎片的生物力学稳定性。
对24个复合模型半骨盆实施髋臼周围弧形截骨术。将8个标本分为三组，分别用1）3枚钛螺钉、2）2枚HA/PLLA螺钉或3）3枚HA/PLLA螺钉固定。固定后，使用伺服液压材料测试系统对半骨盆在步态周期的模拟蹬离阶段进行生物力学验证。
在测试的三组中，平均失效载荷没有显著差异。然而，用3枚HA/PLLA螺钉修复的组显示出比其他组显著更高的刚度。
所有三种固定方法都提供了足够的稳定性，以允许术后早期部分负重。使用3枚HA/PLLA螺钉为髋臼碎片固定提供了显著更高的刚度。
