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柄部锥度表面形貌的变化会影响全髋关节置换术中的腐蚀和微动程度。

Variability in stem taper surface topography affects the degree of corrosion and fretting in total hip arthroplasty.

机构信息

Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany.

Department of Mechanical Engineering, University of California, 6141 Etcheverry Hall, Berkeley, CA, USA.

出版信息

Sci Rep. 2021 Apr 30;11(1):9348. doi: 10.1038/s41598-021-88234-3.

DOI:10.1038/s41598-021-88234-3
PMID:33931680
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8087796/
Abstract

Degradation at the modular head-neck interface in total hip arthroplasty (THA) is predominately expressed in the form of corrosion and fretting, potentially causing peri-prosthetic failure by adverse reactions to metal debris. This retrieval study aimed to quantify variations in stem taper surface topographies and to assess the influence on the formation of corrosion and/or fretting in titanium alloy stem tapers combined with metal and ceramic heads. Four hip stem designs (Alloclassic, CLS, Bicontact and SL-Plus) were characterized using high-resolution 3D microscopy, and corrosion and fretting were rated using the Goldberg scoring scheme. Quantification of the taper surface topographies revealed a high variability in surface characteristics between threaded stem tapers: Alloclassic and CLS tapers feature deeply threaded trapezoid-shaped profiles with thread heights over 65 µm. The sawtooth-shaped Bicontact and triangular SL-Plus taper are characterized by low thread heights below 14 µm. Significantly lower corrosion and fretting scores were observed in lightly threaded compared to deeply threaded tapers in ceramic head combinations. No significant differences in corrosion or fretting scores with thread height were found in pairings with metal heads. Understanding the relationship between stem taper surface topography and the formation of corrosion and fretting could help to improve the performance of modern THAs and lead to longer-lasting clinical results.

摘要

髋关节置换术（THA）中模块化头颈部界面的降解主要表现为腐蚀和微动的形式，通过对金属碎片的不良反应，可能导致假体周围失效。这项研究旨在量化柄锥表面形貌的变化，并评估其对与金属和陶瓷头结合的钛合金柄锥腐蚀和/或微动形成的影响。使用高分辨率 3D 显微镜对四个髋关节柄设计（Alloclassic、CLS、Bicontact 和 SL-Plus）进行了特征描述，并使用 Goldberg 评分方案对腐蚀和微动进行了评估。柄锥表面形貌的量化表明，螺纹柄锥之间的表面特征存在高度的可变性：Alloclassic 和 CLS 柄锥具有深螺纹的梯形形状，螺纹高度超过 65 µm。锯齿形的 Bicontact 和三角形的 SL-Plus 柄锥的特点是螺纹高度低于 14 µm。在陶瓷头组合中，与深螺纹相比，轻螺纹的柄锥腐蚀和微动评分明显更低。在与金属头配对时，没有发现螺纹高度与腐蚀或微动评分之间存在显著差异。了解柄锥表面形貌与腐蚀和微动形成之间的关系有助于提高现代 THA 的性能，并带来更持久的临床效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/81145d5738b9/41598_2021_88234_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/8de80b7f1b84/41598_2021_88234_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/f0131adc08c5/41598_2021_88234_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/d50264715aab/41598_2021_88234_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/d2df08009e22/41598_2021_88234_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/81145d5738b9/41598_2021_88234_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/8de80b7f1b84/41598_2021_88234_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/f0131adc08c5/41598_2021_88234_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/d50264715aab/41598_2021_88234_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/d2df08009e22/41598_2021_88234_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/8087796/81145d5738b9/41598_2021_88234_Fig5_HTML.jpg

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本文引用的文献

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Taper corrosion: a complication of total hip arthroplasty.锥形腐蚀：全髋关节置换术的一种并发症。
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Contact conditions for total hip head-neck modular taper junctions with microgrooved stem tapers.
髋关节植入物锥形连接处微槽颈部的稳定性与微动腐蚀概述
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Micromotion at the head-stem taper junction of total hip prostheses is influenced by prosthesis design-, patient- and surgeon-related factors.髋关节假体柄-干连接部的微动受到假体设计、患者和外科医生相关因素的影响。
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