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站立!对于全髋关节置换术的 12/14Morse 锥度锁定,正常负重是否足够?

Stand up! Are normal weight-bearing forces sufficient for a 12/14 Morse taper locking in total hip arthroplasty?

机构信息

Surgical & Orthopaedic Research Laboratories, Prince of Wales Clinical School University of New South Wales, Sydney, NSW, Australia.

The Hip & Knee Clinic at Harbour City Orthopaedics, Sydney, NSW, Australia.

出版信息

Hip Int. 2022 Mar;32(2):231-236. doi: 10.1177/1120700020967000. Epub 2020 Oct 20.

Abstract

BACKGROUND

The aim of this study was to investigate total hip arthroplasty (THA) Morse taper pull-off strengths after impaction prior to cyclical loading compared to cyclical loading alone. The practical relevance of the experiment is to provide a perspective on what may be clinically satisfactory taper assembly given the spectrum of head tapping patterns used by surgeons, as well as compare traditional impaction performed in standard THA with alternate methods of taper engagement such as ' assembly' used in micro-invasive techniques.

METHODS

36 taper constructs utilising a combination of cobalt-chrome alloy and ceramic-titanium alloy junctions were investigated in wet and dry conditions with cyclical loading of the constructs. Taper disengagement strengths with and without impaction were compared. Secondary investigation of the surface roughness of the heads and tapers was also assessed.

RESULTS

An impaction to a wet taper resulted in a greater pull off force compared to a dry taper with a CoCr head and taper combination. Impacting the head and dryness of the taper did not affect pull off forces of a ceramic femoral head on titanium taper. Pulling a head off a taper significantly alters the head surface roughness.

CONCLUSION

Impaction of a taper does not provide any benefit over cyclical loading of a taper assembly alone for pull-off strength.

摘要

背景

本研究旨在比较在循环加载之前进行压配与单独循环加载对全髋关节置换术(THA)莫氏锥度抗拔出强度的影响。该实验的实际意义在于,鉴于外科医生使用的各种头部敲击模式,为可能在临床上令人满意的锥度装配提供一个视角,同时将标准 THA 中的传统压配与替代方法进行比较,如微创伤技术中使用的“装配”。

方法

在湿、干条件下对 36 个利用钴铬合金和陶瓷-钛合金连接的锥度结构进行了循环加载研究。比较了有无压配的锥度脱离强度。还对头部和锥度的表面粗糙度进行了二次评估。

结果

与钴铬头和锥度组合的干锥度相比,湿锥度的压配会导致更大的拔出力。撞击头部和干燥的锥度不会影响陶瓷股骨头与钛合金锥度的拔出力。从锥度上拔出头部会显著改变头部表面粗糙度。

结论

对于拔出强度,压配不会提供任何优于单独循环加载锥度组件的好处。

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