Reiner Tobias, Schwarze Martin, Panzram Benjamin, Klotz Matthias C, Bitsch Rudi G, Jaeger Sebastian
Department of Orthopedics and Traumatology, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany.
Laboratory of Biomechanics and Implant Research, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany.
Clin Biomech (Bristol). 2018 Jun;55:23-27. doi: 10.1016/j.clinbiomech.2018.04.003. Epub 2018 Apr 5.
The twin peg femoral component was introduced for the cemented Oxford unicondylar knee to increase implant stability. The aim of this experimental study was to investigate the influence of the twin peg design on femoral interface temperature and maximum load to failure in comparison to the single peg design.
In this experimental study medial Oxford unicompartmental knee arthroplasty was performed in 12 pairs of fresh-frozen human knees. A cemented femoral single peg component was implanted on the one side (group A) and a cemented twin peg component on the other side (group B). Cement interface temperature was continuously monitored during the procedure. Maximum tensile forces of the femoral components were measured by pull-out tests.
Maximum femoral interface temperatures did not reach critical values for heat necrosis of the bone in group A (mean 28.4, SD 1.2 °C) or group B (mean 27.6, SD 0.5 °C). The maximum load to failure was significantly higher in the twin peg group (mean 3628.41, SD 650.92 N) compared to the single peg group (mean 2979, SD 781 N) (P = 0.016).
Our experiments showed higher load to failure for the twin peg design compared to the single peg design without raising the risk of heat necrosis at the interfacial bone. The twin peg component offers a save alternative to the single peg component in a cadaveric setting.
双柄股骨组件被引入用于骨水泥型牛津单髁膝关节置换术，以提高植入物的稳定性。本实验研究的目的是调查双柄设计与单柄设计相比，对股骨界面温度和最大破坏载荷的影响。
在本实验研究中，对12对新鲜冷冻的人膝关节进行内侧牛津单髁膝关节置换术。一侧植入骨水泥型股骨单柄组件（A组），另一侧植入骨水泥型双柄组件（B组）。手术过程中持续监测骨水泥界面温度。通过拔出试验测量股骨组件的最大拉力。
A组（平均28.4，标准差1.2℃）和B组（平均27.6，标准差0.5℃）的股骨界面最高温度均未达到骨热坏死的临界值。与单柄组（平均2979，标准差781N）相比，双柄组的最大破坏载荷显著更高（平均3628.41，标准差650.92N）（P = 0.016）。
我们的实验表明，与单柄设计相比，双柄设计具有更高的破坏载荷，且不会增加界面骨热坏死的风险。在尸体模型中，双柄组件为单柄组件提供了一种安全的替代方案。
