Zhang Chun-Lin, Shen Guo-Qi, Zhu Kun-Peng, Liu Dong-Xu
Department of Orthopaedic Surgery, the Tenth People's Hospital Affiliated to Tongji University, #301 Yan-chang Middle Road, Shanghai, 200072, China.
Department of Orthopaedic Surgery, Changshu Second People's Hospital, Changshu, 215500, China.
J Orthop Surg Res. 2016 Jul 1;11(1):72. doi: 10.1186/s13018-016-0405-y.
The integrity of bone-cement interface is very important for the stabilization and long-term sustain of cemented prosthesis. Variations in the bone-cement interface morphology may affect the mechanical response of the shape-closed interlock.
Self-developed new reamer was used to process fresh pig reamed femoral canal, creating cortical grooves in the canal wall of experimental group. The biomechanical effects of varying the morphology with grooves of the bone-cement interface were investigated using finite element analysis (FEA) and validated using companion experimental data. Micro-CT scans were used to document interlock morphology.
The contact area of the bone-cement interface was greater (P < 0.05) for the experimental group (5470 ± 265 mm(2)) when compared to the specimens of control group (5289 ± 299 mm(2)). The mechanical responses to tensile loading and anti-torsion showed that the specimens with grooves were stronger (P < 0.05) at the bone-cement interface than the specimens without grooves. There were positively significant correlation between the contact area and the tensile force (r (2) = 0.85) and the maximal torsion (r (2) = 0.77) at the bone-cement interface. The volume of cement of the experimental group (7688 ± 278 mm(3)) was greater (P < 0.05) than of the control group (5764 ± 186 mm(3)). There were positively significant correlations between the volume of cement and the tensile force (r (2) = 0.90) and the maximal torsion (r (2) = 0.97) at the bone-cement interface. The FEA results compared favorably to the tensile and torsion relationships determined experimentally. More cracks occurred in the cement than in the bone.
Converting the standard reaming process from a smooth bore cortical tube to the one with grooves permits the cement to interlock with the reamed bony wall. This would increase the strength of the bone-cement interface.
骨水泥界面的完整性对于骨水泥型假体的稳定性和长期维持非常重要。骨水泥界面形态的变化可能会影响形状闭合互锁的力学响应。
使用自行研制的新型扩孔钻对新鲜猪股骨扩髓,在实验组的髓管壁上制造皮质沟。采用有限元分析(FEA)研究骨水泥界面形态变化带沟的生物力学效应,并使用配套实验数据进行验证。使用微型计算机断层扫描(Micro-CT)扫描记录互锁形态。
与对照组标本(5289±299mm²)相比,实验组(5470±265mm²)的骨水泥界面接触面积更大(P<0.05)。对拉伸载荷和抗扭转的力学响应表明,带沟的标本在骨水泥界面处比无沟的标本更强(P<0.05)。骨水泥界面的接触面积与拉力(r² = 0.85)和最大扭转力(r² = 0.77)之间存在正显著相关性。实验组的骨水泥体积(7688±278mm³)大于对照组(5764±186mm³)(P<0.05)。骨水泥体积与骨水泥界面的拉力(r² = 0.90)和最大扭转力(r² = 0.97)之间存在正显著相关性。有限元分析结果与实验确定的拉伸和扭转关系相比具有优势。骨水泥中出现的裂纹比骨中更多。
将标准扩髓过程从光滑的皮质管转变为带沟的皮质管可使骨水泥与扩髓后的骨壁互锁。这将增加骨水泥界面的强度。