Berahmani Sanaz, Janssen Dennis, Wolfson David, de Waal Malefijt Maarten, Fitzpatrick Clare K, Rullkoetter Paul J, Verdonschot Nico
Orthopaedic Research Laboratory, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
DePuy Synthes Joint Reconstruction, LS11 0BG, Leeds, United Kingdom.
J Orthop Res. 2016 May;34(5):812-9. doi: 10.1002/jor.23074. Epub 2015 Dec 18.
Experimental testing of orthopaedic implants requires simplifications concerning load application and activities being analyzed. This computational study investigated how these simplifications affect micromotions at the bone-implant interface of an uncemented femoral knee implant. As a basis, validated in vivo loads of the stance phase of gait and a deep knee bend were adopted. Eventually, three configurations were considered: (i) simulation of the complete loading cycle; (ii) inclusion of only tibiofemoral loads (ignoring patellofemoral loads); and (iii) applying only a single peak tibiofemoral force. For all loading conditions the largest micromotions found at the proximal anterior flange. Without the patellofemoral force, peak micromotions increased 6% and 22% for gait and deep knee bend, respectively. By applying a single peak tibiofemoral force micromotions were overestimated. However, the peak micromotions corresponded to the maximum tibiofemoral force, and strong micromotion correlations were found between a complete loading cycle and a single peak load (R(2) = 0.73 and R(2) = 0.89 for gait and deep knee bend, respectively). Deep knee bend resulted in larger micromotions than gait. Our study suggests that a simplified peak force can be used to assess the stability of cementless femoral components. For more robust testing, implants should be subjected to different loading modes. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:812-819, 2016.
骨科植入物的实验测试需要对载荷施加和所分析的活动进行简化。这项计算研究调查了这些简化如何影响非骨水泥型股骨膝关节植入物的骨-植入物界面处的微动。作为基础,采用了经过验证的步态站立期和深度屈膝的体内载荷。最终,考虑了三种配置:(i) 模拟完整加载周期;(ii) 仅包含胫股载荷(忽略髌股载荷);(iii) 仅施加单个胫股力峰值。对于所有加载条件,在近端前凸缘处发现的微动最大。如果不考虑髌股力,步态和深度屈膝时的微动峰值分别增加了6%和22%。通过施加单个胫股力峰值,微动被高估了。然而,微动峰值与最大胫股力相对应,并且在完整加载周期和单个峰值载荷之间发现了很强的微动相关性(步态和深度屈膝时的R(2)分别为0.73和0.89)。深度屈膝导致的微动比步态时更大。我们的研究表明,可以使用简化的峰值力来评估非骨水泥型股骨部件的稳定性。为了进行更可靠的测试,植入物应承受不同的加载模式。© 2015骨科研究协会。由威利期刊公司出版。《矫形外科学研究》34:812 - 819,2016年。