Wagner Moritz, Brunner Alexander, Kaufmann Gerhard, Dammerer Dietmar, Nardelli Paul, Schwaighofer Erwin
Department of Orthopedic Surgery, District Hospital St. Johann, St. Johann, Austria.
OFZ Innsbruck, Innsbruck, Austria.
Arthroplast Today. 2022 Jul 19;16:203-206. doi: 10.1016/j.artd.2022.06.004. eCollection 2022 Aug.
Primary total hip arthroplasty with cementless stems has numerous advantages over cemented total hip arthroplasty in patients with good bone quality. To enhance osseointegration with ingrowth into the implant, various surface treatments have been proposed. Multiple biomechanical studies in animals have shown that bioactive coatings enhance osseointegration and increase construct stability. Bony ingrowth in humans can only be assessed in rare instances of periprosthetic femoral fractures. In this case report, we describe the findings after a periprosthetic fracture mandating stem exchange in a patient who experienced a fall 8 weeks after implantation. The retrieved proximal Bonit (DOT GmbH, Rostock, Germany) coated stem showed substantial macroscopically visible trabecular bone. This finding supports results from animal studies that showed enhanced metaphyseal bone ingrowth with Bonit coating of implants.
对于骨质良好的患者,采用非骨水泥型柄的初次全髋关节置换术相比骨水泥型全髋关节置换术具有诸多优势。为增强骨向内生长与植入物的骨整合,人们提出了各种表面处理方法。多项动物生物力学研究表明,生物活性涂层可增强骨整合并提高结构稳定性。人类的骨向内生长仅在极少数假体周围股骨骨折的情况下才能评估。在本病例报告中,我们描述了一名患者在植入后8周因跌倒导致假体周围骨折而必须更换柄后的情况。取出的近端涂有Bonit(德国罗斯托克DOT有限公司)涂层的柄在宏观上可见大量小梁骨。这一发现支持了动物研究的结果,即植入物涂有Bonit涂层可增强干骺端骨向内生长。