Faizan Ahmad, Davignon Rob, Stamp Robin, Murray Sandra, Raja Lokesh
Stryker, Mahwah, New Jersey.
Surg Technol Int. 2019 May 15;34:462-468.
Porous surface acetabular shells have been successfully used in cementless total hip arthroplasty. Recent advances in additive manufacturing have provided opportunities to optimize the shell designs. The current study describes the design and verification of a new acetabular shell design.
Additive manufacturing technology was used to fabricate acetabular shells using Ti6Al4V powder. A large computed tomography (CT) database was used to verify the screw hole location to ensure the screw trajectories were directed in the safe zone. Benchtop stability tests were conducted to compare the fixation stability of the new shell design to a clinically successful design.
Shells were designed with an average pore size of 434 microns, surface porosity of 76%, and a coefficient of friction of 1.2. The CT analysis of various shell orientations demonstrated that at least two useful screws were typically directed toward the acetabular safe zone. The sawbone testing showed that the fixation stability of the new shell was either better or equivalent to the clinically successful design under two different bone preparation conditions.
Using additive manufacturing technology, thin walled acetabular shells were fabricated which allowed for at least two ancillary fixation screws in the safe zone. The thin walls enable the use of a 36mm femoral head with a 48mm diameter shell which may enhance the joint stability in small stature patients. The equivalent or better fixation stability of the new design indicates that good initial fixation may be expected in vivo.
多孔表面髋臼杯已成功应用于非骨水泥型全髋关节置换术。增材制造技术的最新进展为优化髋臼杯设计提供了契机。本研究描述了一种新型髋臼杯设计的设计与验证。
采用增材制造技术,使用Ti6Al4V粉末制造髋臼杯。利用一个大型计算机断层扫描(CT)数据库来验证螺钉孔位置,以确保螺钉轨迹指向安全区域。进行了台架稳定性测试,以比较新髋臼杯设计与一种临床成功设计的固定稳定性。
设计的髋臼杯平均孔径为434微米,表面孔隙率为76%,摩擦系数为1.2。对不同髋臼杯方向的CT分析表明,通常至少有两枚有用的螺钉指向髋臼安全区域。人工骨测试表明,在两种不同的骨准备条件下,新髋臼杯的固定稳定性要么优于要么等同于临床成功设计。
采用增材制造技术制造出了薄壁髋臼杯,其在安全区域至少允许使用两枚辅助固定螺钉。薄壁使得能够使用直径48毫米的髋臼杯搭配36毫米的股骨头,这可能会增强小个子患者的关节稳定性。新设计的固定稳定性相当或更好,表明在体内可能会有良好的初始固定效果。