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在狗身上进行的关于全关节植入物骨整合方式的实验研究。

An experimental investigation in the dog into the mode of osseous integration of total joint implants.

作者信息

Schatzker J, Anderson G, Sumner-Smith G, Hearn T, Fornasier V

机构信息

University of Toronto, Division of Orthopaedic Surgery, Sunnybrook Medical Centre, Ontario, Canada.

出版信息

Arch Orthop Trauma Surg. 1989;108(3):132-40. doi: 10.1007/BF00934255.

Abstract

An uncemented scaled down version of the Mueller SLS femoral component was inserted into 30 dogs. The material (Protasul 100), geometry, and finish were identical to those designed for clinical use. Half of the prostheses inserted were fitted out with a modular collar to improve stability. Initial stability was achieved through press fit which was made possible by the special modification of the surface area and external configuration of the prosthesis. The function of the prosthesis was assessed through clinical assessment and force plate gait analysis. This was correlated with the degree of osseous integration which was evaluated on the basis of regular radiological examinations, and at post mortem by microradiography of the serially sectioned undecalcified femurs, and histological examination of selected sections under regular and ultraviolet light. The animals were sacrificed at 4, 8, and 12 months. Force plate gait analysis revealed that all animals walked with a normal gait by the 4th post-operative month. Evaluation revealed that 29/30 femoral prostheses became successfully integrated. The prostheses without the collar were less stable and most achieved stability only by incorporation of the distal tip of the prostheses in bone and the remainder in dense fibrous tissue. The prostheses with the collar were stable and achieved without fail full bony integration. The stability was provided by appositional growth of bone which came into direct contact with the implant over the proximal 1/3 and the distal 1/3 without an intervening fibrous membrane. Despite failure of full integration of the collarless prostheses clinically and by force plate analyses the two groups were indistinguishable.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

将穆勒 SLS 股骨部件的无骨水泥小型版本植入 30 只狗体内。其材料(Protasul 100)、几何形状和表面处理与临床使用设计的相同。植入的假体中有一半配备了模块化颈圈以提高稳定性。初始稳定性通过压配合实现,这得益于假体表面积和外部构型的特殊改进。通过临床评估和测力板步态分析来评估假体的功能。这与骨整合程度相关,骨整合程度通过定期放射学检查进行评估,死后通过对连续切片的未脱钙股骨进行显微放射照相以及在普通光和紫外光下对选定切片进行组织学检查来评估。在 4 个月、8 个月和 12 个月时对动物实施安乐死。测力板步态分析显示,所有动物在术后第 4 个月时步态正常。评估显示,30 个股骨假体中有 29 个成功实现整合。没有颈圈的假体稳定性较差,大多数仅通过将假体远端尖端纳入骨内而其余部分纳入致密纤维组织来实现稳定。有颈圈的假体很稳定,无一例外地实现了完全骨整合。稳定性由骨的贴壁生长提供,骨在近端 1/3 和远端 1/3 与植入物直接接触,中间没有纤维膜。尽管无颈圈假体在临床和测力板分析中未完全整合,但两组在这些方面并无差异。(摘要截选至 250 字)

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