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模块化髋关节置换中的锥形连接:哪些因素影响其稳定性?

Taper junctions in modular hip joint replacements: What affects their stability?

机构信息

Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.

出版信息

J Mech Behav Biomed Mater. 2021 Apr;116:104258. doi: 10.1016/j.jmbbm.2020.104258. Epub 2021 Jan 7.

Abstract

BACKGROUND

Although taper junctions are beneficial in the reconstruction of hip joints, some clinical concerns like the formation of adverse local tissue reactions have recently emerged. These reactions are associated with wear and corrosion products from the interface of insufficient taper connections regarding strength. Commonly used tapers vary in their geometric and topographical design parameter. Therefore, this study aims to evaluate interactions between design and surgical related parameters to the taper connection strength.

METHODS

In this study, the effect of the taper contact situation, surface roughness and head material in combination with assembly force on the taper connection strength were assessed using torque-off tests. Furthermore, the type of use in terms of single-use or re-use of the stem taper was investigated.

RESULTS

The study showed that the impaction force is the predominant factor that determines the taper strength followed by the type of use and the head material. The contact situation seems to slightly influence the determined torque-off moment, whereas the surface topography of the stem taper obviously plays a minor role for the taper connection strength.

CONCLUSION

Clinical users should be aware that an increased assembly force will strengthen the stability of the taper junction, whereas care should be taken when reusing hip stems with metal heads as this may decrease their connection strength.

摘要

背景

尽管锥形连接在髋关节重建中是有益的,但最近出现了一些临床关注问题,例如形成不良的局部组织反应。这些反应与强度不足的锥形连接界面的磨损和腐蚀产物有关。常用的锥形接头在几何和拓扑设计参数上有所不同。因此,本研究旨在评估设计和手术相关参数对锥形连接强度的相互作用。

方法

在这项研究中,使用扭矩分离试验评估了锥形接触情况、表面粗糙度和头部材料与装配力相结合对锥形连接强度的影响。此外,还研究了柄部锥形接头的单次使用或重复使用类型。

结果

研究表明,撞击力是决定锥形强度的主要因素,其次是使用类型和头部材料。接触情况似乎略微影响确定的扭矩分离瞬间,而柄部锥形的表面形貌显然对锥形连接强度的影响较小。

结论

临床使用者应该意识到,增加装配力将增强锥形连接的稳定性,而在重复使用带有金属头部的髋关节柄时应格外小心,因为这可能会降低其连接强度。

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