Beckmann Nicholas A, Bitsch Rudi G, Schonhoff Mareike, Siebenrock Klaus-Arno, Schwarze Martin, Jaeger Sebastian
Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69118 Heidelberg, Germany.
Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland.
Materials (Basel). 2020 Apr 10;13(7):1783. doi: 10.3390/ma13071783.
Adequate primary stability of the acetabular revision construct is necessary for long-term implant survival. The difference in primary stability between tantalum and titanium components is unclear. Six composite hemipelvises with an acetabular defect were implanted with a tantalum augment and cup, using cement fixation between cup and augment. Relative motion was measured at cup/bone, cup/augment and bone/augment interfaces at three load levels; the results were compared to the relative motion measured at the same interfaces of a titanium cup/augment construct of identical dimensions, also implanted into composite bone. The implants showed little relative motion at all load levels between the augment and cup. At the bone/augment and bone/cup interfaces the titanium implants showed less relative motion than tantalum at 30% load ( < 0.001), but more relative motion at 50% ( = n.s.) and 100% ( < 0001) load. The load did not have a significant effect at the augment/cup interface ( = 0.086); it did have a significant effect on relative motion of both implant materials at bone/cup and bone/augment interfaces ( < 0.001). All interfaces of both constructs displayed relative motion that should permit osseointegration. Tantalum, however, may provide a greater degree of primary stability at higher loads than titanium. The clinical implication is yet to be seen.
髋臼翻修结构具备足够的初始稳定性对于植入物的长期存活至关重要。钽和钛组件之间初始稳定性的差异尚不清楚。对六个存在髋臼缺损的复合半骨盆植入钽增强物和髋臼杯，在髋臼杯和增强物之间使用骨水泥固定。在三个负荷水平下测量髋臼杯/骨、髋臼杯/增强物和骨/增强物界面的相对运动；将结果与同样植入复合骨的相同尺寸的钛髋臼杯/增强物结构在相同界面处测量的相对运动进行比较。在所有负荷水平下，增强物与髋臼杯之间的植入物显示出很少的相对运动。在30%负荷时，在骨/增强物和骨/髋臼杯界面处，钛植入物的相对运动比钽植入物少（<0.001），但在50%（无显著差异）和100%（<0.001）负荷时，钛植入物的相对运动更多。负荷在增强物/髋臼杯界面没有显著影响（P = 0.086）；但对两种植入材料在骨/髋臼杯和骨/增强物界面的相对运动有显著影响（<0.001）。两种结构的所有界面均显示出应允许骨整合的相对运动。然而，在较高负荷下，钽可能比钛提供更高程度的初始稳定性。其临床意义尚待观察。
