ZESBO - Centre for Research on Musculoskeletal Systems, Leipzig University, Leipzig, Germany; Institute of Anatomy, Leipzig University, Leipzig, Germany.
ZESBO - Centre for Research on Musculoskeletal Systems, Leipzig University, Leipzig, Germany; Department of Orthopaedic, Trauma and Plastic Surgery, Leipzig University, Leipzig, Germany.
Clin Biomech (Bristol). 2023 Aug;108:106057. doi: 10.1016/j.clinbiomech.2023.106057. Epub 2023 Jul 28.
Atraumatic femoral head necrosis is a rare pathological change of the femoral head. It is characterized by local necrosis of the cancellous bone as a result of reduced blood supply to the bone. Even today it remains unclear how to assess the hardness of the necrosis, whether it is soft tissue that is easily removed, or hard tissue that is difficult to resect.
Femoral heads with primary coxarthrosis were selected as a comparison group. For this purpose, 49 femoral heads obtained during total hip arthroplasty surgery with either condition (23 femoral head necrosis, 26 coxarthrosis) were transferred to the testing laboratory in fresh condition. Cylindrical specimens were obtained using a tenon cutter along the main trabecular load direction in the subchondral region of the femoral head. Additionally, thin bone slices were extracted proximal and distal to the specimens for density measurements. Brass plates were glued to the circular surfaces of the specimens. After curing of the adhesive, the specimens were mounted in the testing machine and destructive uniaxial compression tests were conducted.
The recorded mean compressive strengths and elastic moduli were almost identical for both groups, but the necrosis group showed significantly higher data scattering and range regarding the elastic modulus. The mean density of the coxarthrosis specimens was significantly higher than that of the necrotic specimens.
The mechanical properties of cancellous bone vary considerably in the presence of femoral head necrosis. The existence of hard necrosis implies a potential challenge regarding the clinical resection of these tissues.
非创伤性股骨头坏死是股骨头的一种罕见病理变化。其特征是由于骨血供减少导致松质骨局部坏死。即使在今天，如何评估坏死骨的硬度仍然不清楚，是软组织容易切除，还是硬组织难以切除。
选择原发性髋关节骨关节炎的股骨头作为对照组。为此，在全髋关节置换手术中，将 49 个股骨头（23 个股骨头坏死，26 个髋关节骨关节炎）作为新鲜标本转移到实验室。在股骨头软骨下区，沿着主要骨小梁负载方向，使用榫切刀获得圆柱形标本。此外，在标本的近端和远端提取薄骨片进行密度测量。黄铜板粘在标本的圆形表面上。在胶黏剂固化后，将标本安装在试验机上，并进行破坏性单轴压缩试验。
两组记录的平均抗压强度和弹性模量几乎相同，但坏死组的弹性模量数据离散度和范围明显更高。髋关节骨关节炎标本的平均密度明显高于坏死标本。
在股骨头坏死的情况下，松质骨的力学性能差异很大。硬坏死的存在意味着这些组织的临床切除存在潜在挑战。
