Department of Orthopedics, China-Japan Union Hospital of Jilin University, 126 Xiantai Avenue, Changchun, Jilin, China.
Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Road, Changchun, Jilin, China.
Sci Rep. 2021 May 10;11(1):9836. doi: 10.1038/s41598-021-89292-3.
We aimed to evaluate whether there are differences in the rotation center, cup coverage, and biomechanical effects between conventional and anatomical technique. Computed tomography scans of 26 normal hips were used to simulate implantation of acetabular component. The hip rotation center and acetabular component coverage rate were calculated. Moreover, a finite element model of the hip joint was generated to simulate and evaluate the acetabular cup insertion. Micromotion and the peak stress distribution were used to quantify the biomechanical properties. The medial and superior shifts of the rotation center were 5.2 ± 1.8 mm and 1.6 ± 0.7 mm for the conventional reaming technique and 1.1 ± 1.5 mm and 0.8 ± 0.5 mm for anatomical technique, respectively. The acetabular component coverage rates for conventional reaming technique and anatomical technique were 86.8 ± 4% and 70.0 ± 7%, respectively. The micromotion of the cup with conventional reaming technique was greater than that with anatomical technique. The peak stress concentration was highest in the superior portion with conventional reaming technique, whereas with anatomical technique, there was no stress concentration. Paradoxically although the acetabular component coverage rate is larger with conventional reaming technique, anatomical technique provides less micromotion and stress concentration for initial cup stability. Thus, anatomical technique may be more suitable for acetabulum reaming during primary total hip arthroplasty.
我们旨在评估传统技术与解剖技术在旋转中心、杯覆盖度和生物力学效应方面是否存在差异。使用 26 个正常髋关节的 CT 扫描来模拟髋臼部件的植入。计算了髋关节旋转中心和髋臼部件覆盖率。此外，还生成了髋关节的有限元模型，以模拟和评估髋臼杯插入。微动和峰值应力分布用于量化生物力学特性。旋转中心的内侧和上方移位，对于传统扩孔技术分别为 5.2±1.8mm 和 1.6±0.7mm，对于解剖技术分别为 1.1±1.5mm 和 0.8±0.5mm。传统扩孔技术和解剖技术的髋臼部件覆盖率分别为 86.8±4%和 70.0±7%。使用传统扩孔技术的杯的微动大于使用解剖技术的杯。在传统扩孔技术中，峰值应力集中在上方，而在解剖技术中，没有应力集中。矛盾的是，尽管传统扩孔技术的髋臼部件覆盖率更大，但解剖技术为初始杯稳定性提供的微动和应力集中更小。因此，解剖技术在初次全髋关节置换术中可能更适合髋臼扩孔。
