Gluek Cooper, Zdero Radovan, Quenneville Cheryl E
Department of Mechanical Engineering, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada.
Department of Mechanical and Materials Engineering, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada; Department of Surgery (Division of Orthopaedic Surgery), Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada.
J Biomech. 2020 Oct 9;111:110018. doi: 10.1016/j.jbiomech.2020.110018. Epub 2020 Aug 28.
Osteoporosis is a disease prevalent in older adults, characterized by high porosity in bone and subsequent decrease in fracture resistance. This demographic is also the population that most frequently receives devices such as hip implants. However, high porosity complicates surgery and reduces the fixation and effectiveness of orthopaedic devices, which are typically designed using cadaveric specimens from the general population. Synthetic bones are also used in the design of such devices but need to represent the properties of the patient population. Thus, the mechanical response of two iterations of novel synthetic femurs were evaluated for their ability to represent osteoporotic cadaveric specimens and were tested and compared against cadaveric specimens across four loading modes. The first iteration had reduced density and wall thickness compared to standard models and was typically too rigid or too stiff to be a feasible alternative to cadaveric specimens. The second iteration, with similarly reduced wall thickness and further reduced density, was quite representative, with no statistical differences identified against the cadaveric specimens in any loading mode, except in screw pullout. Such a model can provide a foundation for the development of orthopaedic devices better suited to osteoporotic bone, potentially improving surgical outcomes, reducing medical expense, and improving quality of life for patients.
骨质疏松症是一种在老年人中普遍存在的疾病，其特征是骨孔隙率高，随后抗骨折能力下降。这一人群也是最常接受髋关节植入物等器械的群体。然而，高孔隙率使手术复杂化，并降低了骨科器械的固定效果和有效性，这些器械通常是根据普通人群的尸体标本设计的。合成骨也用于此类器械的设计，但需要体现患者群体的特性。因此，对新型合成股骨的两个迭代版本的力学响应进行了评估，以确定它们代表骨质疏松症尸体标本的能力，并在四种加载模式下与尸体标本进行了测试和比较。与标准模型相比，第一个迭代版本的密度和壁厚降低，通常过于坚硬或刚硬，无法成为尸体标本的可行替代品。第二个迭代版本的壁厚同样降低，密度进一步降低，具有很强的代表性，除了螺钉拔出试验外，在任何加载模式下与尸体标本相比均未发现统计学差异。这样的模型可以为开发更适合骨质疏松性骨的骨科器械提供基础，有可能改善手术效果、降低医疗费用并提高患者的生活质量。
