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柄部微槽会影响全髋关节置换术中的柄部腐蚀吗?一项配对队列翻修研究。

Do Stem Taper Microgrooves Influence Taper Corrosion in Total Hip Arthroplasty? A Matched Cohort Retrieval Study.

作者信息

Arnholt Christina M, MacDonald Daniel W, Underwood Richard J, Guyer Eric P, Rimnac Clare M, Kurtz Steven M, Mont Michael A, Klein Gregg R, Lee Gwo-Chin, Chen Antonia F, Hamlin Brian R, Cates Harold E, Malkani Arthur L, Kraay Matthew J

机构信息

Implant Research Center, Drexel University, Philadelphia, Pennsylvania.

Exponent, Inc, Philadelphia, Pennsylvania.

出版信息

J Arthroplasty. 2017 Apr;32(4):1363-1373. doi: 10.1016/j.arth.2016.11.018. Epub 2016 Nov 17.

Abstract

BACKGROUND

Previous studies identified imprinting of the stem morphology onto the interior head bore, leading researchers to hypothesize an influence of taper topography on mechanically assisted crevice corrosion. The purpose of this study was to analyze whether microgrooved stem tapers result in greater fretting corrosion damage than smooth stem tapers.

METHODS

A matched cohort of 120 retrieved head-stem pairs from metal-on-polyethylene bearings was created controlling for implantation time, flexural rigidity, apparent length of engagement, and head size. There were 2 groups of 60 heads each, mated with either smooth or microgrooved stem tapers. A high-precision roundness machine was used to measure and categorize the surface morphology. Fretting corrosion damage at the head-neck junction was characterized using the Higgs-Goldberg scoring method. Fourteen of the most damaged heads were analyzed for the maximum depth of material loss and focused ion beam cross-sectioned to view oxide and base metal.

RESULTS

Fretting corrosion damage was not different between the 2 cohorts at the femoral head (P = .14, Mann-Whitney) or stem tapers (P = .35). There was no difference in the maximum depths of material loss between the cohorts (P = .71). Cross-sectioning revealed contact damage, signs of micro-motion, and chromium-rich oxide layers in both cohorts. Microgroove imprinting did not appear to have a different effect on the fretting corrosion behavior.

CONCLUSION

The results of this matched cohort retrieval study do not support the hypothesis that taper surfaces with microgrooved stems exhibit increased in vivo fretting corrosion damage or material release.

摘要

背景

先前的研究发现柄部形态会印刻在股骨头内孔上,这使得研究人员推测锥度形貌对机械辅助缝隙腐蚀有影响。本研究的目的是分析带有微槽柄部锥度的假体是否比光滑柄部锥度的假体产生更大的微动腐蚀损伤。

方法

从金属对聚乙烯关节假体中选取120对取出的股骨头-柄组合,组成匹配队列,控制植入时间、抗弯刚度、明显的结合长度和股骨头尺寸。每组60个股骨头,分别与光滑或带有微槽的柄部锥度相匹配。使用高精度圆度仪测量并分类表面形态。采用希格斯-戈德堡评分法对股骨头-颈交界处的微动腐蚀损伤进行表征。对14个损伤最严重的股骨头分析材料损失的最大深度,并进行聚焦离子束截面分析以观察氧化物和母材。

结果

两组在股骨头处(P = 0.14,曼-惠特尼检验)或柄部锥度处(P = 0.35)的微动腐蚀损伤无差异。两组之间材料损失的最大深度无差异(P = 0.71)。截面分析显示两组均有接触损伤、微动迹象和富铬氧化层。微槽印记似乎对微动腐蚀行为没有不同影响。

结论

这项匹配队列取出研究的结果不支持以下假设:带有微槽柄部的锥面在体内表现出更大的微动腐蚀损伤或材料释放。

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