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增材制造的推入式植入物固定，具有螺钉强度的拔出力。

Additive manufactured push-fit implant fixation with screw-strength pull out.

作者信息

van Arkel Richard J, Ghouse Shaaz, Milner Piers E, Jeffers Jonathan R T

机构信息

Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom.

出版信息

J Orthop Res. 2018 May;36(5):1508-1518. doi: 10.1002/jor.23771. Epub 2017 Nov 22.

DOI:10.1002/jor.23771
PMID:29023901
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6175131/
Abstract

Additive manufacturing offers exciting new possibilities for improving long-term metallic implant fixation in bone through enabling open porous structures for bony ingrowth. The aim of this research was to investigate how the technology could also improve initial fixation, a precursor to successful long-term fixation. A new barbed fixation mechanism, relying on flexible struts was proposed and manufactured as a push-fit peg. The technology was optimized using a synthetic bone model and compared with conventional press-fit peg controls tested over a range of interference fits. Optimum designs, achieving maximum pull-out force, were subsequently tested in a cadaveric femoral condyle model. The barbed fixation surface provided more than double the pull-out force for less than a third of the insertion force compared to the best performing conventional press-fit peg (p < 0.001). Indeed, it provided screw-strength pull out from a push-fit device (1,124 ± 146 N). This step change in implant fixation potential offers new capabilities for low profile, minimally invasive implant design, while providing new options to simplify surgery, allowing for one-piece push-fit components with high levels of initial stability. © 2017 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 36:1508-1518, 2018.

摘要

增材制造为改善金属植入物在骨内的长期固定提供了令人兴奋的新可能性，因为它能够制造出有利于骨长入的开放多孔结构。本研究的目的是探讨该技术如何还能改善初始固定，而初始固定是成功实现长期固定的前提。一种基于柔性支柱的新型倒刺固定机制被提出并制造成一种压入配合栓钉。该技术通过使用合成骨模型进行了优化，并与在一系列干涉配合下测试的传统压入配合栓钉对照进行了比较。随后，在尸体股骨髁模型中对实现最大拔出力的最佳设计进行了测试。与性能最佳的传统压入配合栓钉相比，倒刺固定表面提供的拔出力增加了一倍多，而插入力不到其三分之一（p < 0.001）。事实上，它从一个压入配合装置中提供了螺丝强度的拔出力（1,124 ± 146 N）。植入物固定潜力的这一重大变化为低轮廓、微创植入物设计提供了新能力，同时为简化手术提供了新选择，允许使用具有高水平初始稳定性的一体式压入配合部件。© 2017作者。《骨科研究杂志》®由威利期刊公司代表骨科研究协会出版。《骨科研究杂志》36:1508 - 1518, 2018年。

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