硫酸钙骨缺损填充材料对全膝关节置换术第三体损伤及聚乙烯磨损的影响。
The influence of a calcium sulphate bone void filler on the third-body damage and polyethylene wear of total knee arthroplasty.
作者信息
Cowie R M, Aiken S S, Cooper J J, Jennings L M
机构信息
Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.
Biocomposites Ltd, Keele, UK.
出版信息
Bone Joint Res. 2019 Mar 2;8(2):65-72. doi: 10.1302/2046-3758.82.BJR-2018-0146.R1. eCollection 2019 Feb.
OBJECTIVES
Bone void fillers are increasingly being used for dead space management in arthroplasty revision surgery. The aim of this study was to investigate the influence of calcium sulphate bone void filler (CS-BVF) on the damage and wear of total knee arthroplasty using experimental wear simulation.
METHODS
A total of 18 fixed-bearing U2 total knee arthroplasty system implants (United Orthopedic Corp., Hsinchu, Taiwan) were used. Implants challenged with CS-BVF were compared with new implants (negative controls) and those intentionally scratched with a diamond stylus (positive controls) representative of severe surface damage (n = 6 for each experimental group). Three million cycles (MC) of experimental simulation were carried out to simulate a walking gait cycle. Wear of the ultra-high-molecular-weight polyethylene (UHMWPE) tibial inserts was measured gravimetrically, and damage to articulating surfaces was assessed using profilometry.
RESULTS
There was no significant difference (p > 0.05) between the wear rate of implants challenged with CS-BVF (3.3 mm/MC (95% confidence interval (CI) 1.8 to 4.8)) and the wear rate of those not challenged (2.8 mm/MC (95% CI 1.3 to 4.3)). However, scratching the cobalt-chrome (CoCr) significantly (p < 0.001) increased the wear rate (20.6 mm/MC (95% CI 15.5 to 25.7)). The mean surface roughness of implants challenged with CS-BVF was equivalent to negative controls both after damage simulation (p = 0.98) and at the conclusion of the study (p = 0.28).
CONCLUSION
When used close to articulating surfaces, a low-hardness, high-purity CS-BVF had no influence on wear. When trapped between the articulating surfaces of a total knee arthroplasty, CS-BVF did not scratch the surface of CoCr femoral components, nor did it increase the wear of UHMWPE tibial inserts compared with undamaged negative controls.: R. M. Cowie, S. S. Aiken, J. J. Cooper, L. M. Jennings. The influence of a calcium sulphate bone void filler on the third-body damage and polyethylene wear of total knee arthroplasty. 2019;8:65-72. DOI: 10.1302/2046-3758.82.BJR-2018-0146.R1.
目的
骨缺损填充材料越来越多地用于关节置换翻修手术中的死腔处理。本研究旨在通过实验性磨损模拟，探讨硫酸钙骨缺损填充材料（CS-BVF）对全膝关节置换术损伤和磨损的影响。
方法
总共使用了18个固定平台U2全膝关节置换系统植入物（联合骨科公司，中国台湾新竹）。将使用CS-BVF的植入物与新植入物（阴性对照）以及用代表严重表面损伤的金刚石探针故意刮擦的植入物（阳性对照）进行比较（每个实验组n = 6）。进行三百万次循环（MC）的实验模拟，以模拟步行步态周期。通过重量法测量超高分子量聚乙烯（UHMWPE）胫骨衬垫的磨损，并使用轮廓仪评估关节表面的损伤情况。
结果
使用CS-BVF的植入物的磨损率（3.3毫米/百万次循环（95%置信区间（CI）1.8至4.8））与未使用的植入物的磨损率（2.8毫米/百万次循环（95%CI 1.3至4.3））之间无显著差异（p＞0.05）。然而，刮擦钴铬合金（CoCr）显著（p＜0.001）增加了磨损率（20.6毫米/百万次循环（95%CI 15.5至25.7））。在损伤模拟后（p = 0.98）以及研究结束时（p = 0.28），使用CS-BVF的植入物的平均表面粗糙度与阴性对照相当。
结论
当在关节表面附近使用时，低硬度、高纯度的CS-BVF对磨损没有影响。当夹在全膝关节置换术的关节表面之间时，与未受损的阴性对照相比，CS-BVF不会刮伤CoCr股骨部件的表面，也不会增加UHMWPE胫骨衬垫的磨损。：R.M.考伊、S.S.艾肯、J.J.库珀、L.M.詹宁斯。硫酸钙骨缺损填充材料对全膝关节置换术第三体损伤和聚乙烯磨损的影响。2019年；8：65 - 72。DOI：10.1302/2046 - 3758.82.BJR - 2018 - 0146.R1。
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