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髋关节置换术中撞击的体外模型。

An in vitro model of impaction during hip arthroplasty.

作者信息

Doyle Ruben, Boughton Oliver, Plant Daniel, Desoutter George, Cobb Justin P, Jeffers Jonathan R T

机构信息

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

Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, UK; Sackler Centre for Musculoskeletal Research, Department of Surgery & Cancer, Imperial College London, London, W6 8RP, UK.

出版信息

J Biomech. 2019 Jan 3;82:220-227. doi: 10.1016/j.jbiomech.2018.10.030. Epub 2018 Nov 1.

Abstract

Impaction is required to properly seat press-fit implants and ensure initial implant stability and long term bone ingrowth, however excessive impaction or press-fit presents a high fracture risk in the acetabulum and femur. Current in-vitro impaction testing methods do not replicate the compliance of the soft tissues surrounding the hip, a factor that may be important in fracture and force prediction. This study presents the measurement of compliance of the soft tissues supporting the hip during impaction in operative conditions, and replicates these in vitro. Hip replacements were carried out on 4 full body cadavers while impact force traces and acetabular/femoral displacement were measured. Compliance was then simulated computationally using a Voigt model. These data were subsequently used to inform the design of a representative in-vitro drop rig. Effective masses of 19.7 kg and 12.7 kg, spring stiffnesses of 8.0 kN/m and 4.1 kN/m and dashpot coefficients of 595 N s/m and 322 N s/m were calculated for the acetabular and femoral soft tissues respectively. A good agreement between cadaveric and in-vitro peak displacement and rise time during impact is found. Such an in-vitro setup is of use during laboratory testing, simulation or even surgical training.

摘要

为了使压配式植入物正确就位并确保初始植入物稳定性和长期骨长入,需要进行撞击,然而过度撞击或压配会使髋臼和股骨出现较高的骨折风险。当前的体外撞击测试方法无法复制髋关节周围软组织的顺应性,而这一因素在骨折和力的预测中可能很重要。本研究介绍了在手术条件下撞击过程中支撑髋关节的软组织顺应性的测量,并在体外进行复制。对4具完整尸体进行了髋关节置换手术,同时测量了撞击力轨迹和髋臼/股骨位移。然后使用Voigt模型进行计算模拟顺应性。这些数据随后被用于指导设计一个具有代表性的体外落锤试验台。分别计算出髋臼和股骨软组织的有效质量为19.7千克和12.7千克,弹簧刚度为8.0千牛/米和4.1千牛/米,阻尼系数为595牛·秒/米和322牛·秒/米。发现在撞击过程中尸体和体外的峰值位移及上升时间之间有良好的一致性。这样的体外装置可用于实验室测试、模拟甚至手术训练。

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