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翻修全膝关节置换假体的表面形貌对比分析:氧化锆与钴铬合金股骨部件

A comparative surface topographical analysis of explanted total knee replacement prostheses: Oxidised zirconium vs cobalt chromium femoral components.

作者信息

Kennard Emma, Scholes Susan C, Sidaginamale Raghavendra, Gangadharan Rajkumar, Weir David J, Holland James, Deehan David, Joyce Thomas J

机构信息

Bioengineering Group, School of Engineering, Newcastle University, Stephenson Building, NE1 7RU Newcastle upon Tyne, England, United Kingdom.

Bioengineering Group, School of Engineering, Newcastle University, Stephenson Building, NE1 7RU Newcastle upon Tyne, England, United Kingdom.

出版信息

Med Eng Phys. 2017 Dec;50:59-64. doi: 10.1016/j.medengphy.2017.10.003. Epub 2017 Oct 15.

Abstract

It has been proposed that an increased surface roughness of the femoral components of Total Knee Replacements (TKRs) may be a contributing factor to the accelerated wear of the polyethylene (PE) bearing and ultimately prosthesis failure. Oxidised Zirconium was introduced to the orthopaedic market in an attempt to reduce PE wear associated failures and increase the longevity of the prosthesis. In this study, non-contacting profilometry was used to measure the surface roughness of the femoral components of 6 retrieved TKRs (3 Oxidised Zirconium (OxZr) and 3 Cobalt Chromium alloy (CoCr) femoral components) and 2 as-manufactured femoral components (1 OxZr and 1 CoCr). A semi-quantitative method was used to analyse the damage on the retrieved PE components. The S values for the retrieved OxZr femoral components (S = 0.093 µm ± 0.014) and for the retrieved CoCr femoral components (S = 0.065 µm ± 0.005) were significantly greater (p < .05) than the roughness values for the as-manufactured femoral components (OxZr S = 0.061 µm ± 0.004 and CoCr S = 0.042 µm ± 0.003). No significant difference was seen between the surface roughness parameters of the retrieved OxZr and retrieved CoCr femoral components. There was no difference between the PE component damage scores for the retrieved OxZr TKRs compared to the retrieved CoCr TKRs. These results agree with other studies that both OxZr and CoCr femoral components roughen during time in vivo but the lack of difference between the surface roughness measurements of the two materials is in contrast to previous topographical reports. Further analysis of retrieved OxZr TKRs is recommended so that a fuller appreciation of their benefits and limitations be obtained.

摘要

有人提出,全膝关节置换术(TKR)中股骨部件表面粗糙度增加可能是导致聚乙烯(PE)轴承加速磨损并最终导致假体失效的一个因素。氧化锆被引入骨科市场,旨在减少与PE磨损相关的故障并提高假体的使用寿命。在本研究中,采用非接触轮廓仪测量了6个回收的TKR股骨部件(3个氧化锆(OxZr)和3个钴铬合金(CoCr)股骨部件)以及2个制造时的股骨部件(1个OxZr和1个CoCr)的表面粗糙度。使用半定量方法分析回收的PE部件上的损伤。回收的OxZr股骨部件的S值(S = 0.093 µm ± 0.014)和回收的CoCr股骨部件的S值(S = 0.065 µm ± 0.005)显著高于(p <.05)制造时的股骨部件的粗糙度值(OxZr S = 0.061 µm ± 0.004和CoCr S = 0.042 µm ± 0.003)。回收的OxZr和回收的CoCr股骨部件的表面粗糙度参数之间没有显著差异。回收的OxZr TKRs与回收的CoCr TKRs的PE部件损伤评分之间没有差异。这些结果与其他研究一致,即OxZr和CoCr股骨部件在体内都会随着时间而变得粗糙,但两种材料表面粗糙度测量结果缺乏差异与之前的形貌报告形成对比。建议对回收的OxZr TKRs进行进一步分析,以便更全面地了解其益处和局限性。

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