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近端和全多孔涂层犬髋关节柄设计对骨重塑的影响。

The effect of proximally and fully porous-coated canine hip stem design on bone modeling.

作者信息

Bobyn J D, Pilliar R M, Binnington A G, Szivek J A

出版信息

J Orthop Res. 1987;5(3):393-408. doi: 10.1002/jor.1100050312.

Abstract

Porous coated canine femoral hip replacement implants were evaluated for biological fixation by bone ingrowth and the effect of the extent of porous coating on bone modeling. The Co-Cr alloy implants were either fully porous coated or coated only on the proximal 40% of the stem. Two implants of each type were studied 9, 16, and 36 months after surgery. Implant fixation and bone modeling were assessed radiographically throughout the implant periods and histologically after the test animals were killed. All 12 implants appeared stably fixed within the femur and were bone-ingrown in the porous region. Radiographic features such as proximal medial and anterior cortical thinning, proximal cancellous bone hypertrophy, and new endosteal bone formation near the stem tip were noted within the first postoperative year, with no appreciable change thereafter. The extent of proximal cortical thinning varied from virtually none to as much as 40%, being more prominent with the proximally coated implants at 16 months and with the fully coated implants at 36 months. Of consistent note was cancellous hypertrophy at the junction of porous and smooth implant surfaces with proximally coated implants and new endosteal bone formation and ingrowth at the stem tip of fully coated implants. These results indicate that the proximally porous-coated implant design causes increased proximal stress transfer, but this does not necessarily preclude proximal cortical resorption.

摘要

对多孔涂层犬股骨髋关节置换植入物进行了评估,以研究骨长入实现的生物固定情况以及多孔涂层范围对骨塑形的影响。钴铬合金植入物要么完全多孔涂层,要么仅在柄的近端40%进行涂层。每种类型的两个植入物在术后9个月、16个月和36个月进行研究。在整个植入期间通过放射学评估植入物固定和骨塑形情况,在处死实验动物后进行组织学评估。所有12个植入物在股骨内均表现为稳定固定,且在多孔区域有骨长入。术后第一年内观察到近端内侧和前部皮质变薄、近端松质骨肥大以及柄尖附近新的骨内膜骨形成等放射学特征,此后无明显变化。近端皮质变薄的程度从几乎没有到高达40%不等,在16个月时近端涂层植入物更明显,在36个月时完全涂层植入物更明显。一致值得注意的是,近端涂层植入物在多孔与光滑植入物表面交界处有松质骨肥大,完全涂层植入物在柄尖有新的骨内膜骨形成和长入。这些结果表明,近端多孔涂层植入物设计会导致近端应力传递增加,但这不一定会阻止近端皮质吸收。

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