Wu Dengxian, Wang Qianjin, Tsai Hung-Kang, Zhou Sheng, Zheng Donggui, Jiang Qing, Xu Zhihong
Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, PR China.
State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, Jiangsu, PR China.
J Orthop Surg (Hong Kong). 2023 Sep-Dec;31(3):10225536231217537. doi: 10.1177/10225536231217537.
Total knee arthroplasty is the most effective treatment for advanced-stage knee arthritis, and the majority of knee prostheses are made of metal. Nevertheless, metal prostheses still have several problems. The objective of this study is to introduce new metal-free knee prostheses made of polyether-ether-ketone (PEEK) and to compare their cement bond strength with metal prostheses.
Twelve sets of knee prostheses were divided into four groups (unloaded PEEK, unloaded Metal, 10 million cycles (MC) PEEK, 10 MC Metal, = 3 each), and then attached to composite bones using bone cement. Both the 10 MC PEEK and 10 MC Metal groups were subjected to dynamic gait simulations of 10 MC, whereas the other two sets were not. Afterwards, a pull-off strength test was performed on the femoral prostheses and a shear strength test was performed on the tibial prostheses.
No apparent cracks were observed in the bone cement after subjecting the PEEK and Metal groups to 10 million cycles of dynamic simulation. No statistically significant differences were observed ( > .05) in the strength tests for unloaded PEEK vs. unloaded Metal, 10 MC PEEK vs.10 MC Metal in the femoral pull-off test, and for unloaded PEEK vs. unloaded Metal in the tibial shear test. The shear strength of 10 MC PEEK was significantly lower ( < .05) compared to that of 10 MC Metal.
By comparing the force analysis of previous investigations on knee prostheses with the failure pattern observed in the PEEK knee prosthesis of this study, which replicates that of the metal prosthesis. We believe that the combination of the peek knee prosthesis with bone cement is reliable. We anticipate that metal-free PEEK knee prostheses will find application in Total Knee Arthroplasty (TKA) in the future, thereby benefiting patients.
全膝关节置换术是治疗晚期膝关节炎最有效的方法，大多数膝关节假体由金属制成。然而，金属假体仍存在一些问题。本研究的目的是介绍由聚醚醚酮（PEEK）制成的新型无金属膝关节假体，并将其与金属假体的骨水泥粘结强度进行比较。
将12套膝关节假体分为四组（未加载的PEEK组、未加载的金属组、1000万次循环（MC）的PEEK组、10 MC金属组，每组n = 3），然后使用骨水泥将其附着在复合骨上。10 MC PEEK组和10 MC金属组均进行10 MC的动态步态模拟，而另外两组不进行。之后，对股骨假体进行拔出强度测试，对胫骨假体进行剪切强度测试。
对PEEK组和金属组进行1000万次动态模拟后，骨水泥中未观察到明显裂纹。在股骨拔出试验中，未加载的PEEK与未加载的金属、10 MC PEEK与10 MC金属的强度测试中，以及在胫骨剪切试验中，未加载的PEEK与未加载的金属之间，均未观察到统计学上的显著差异（P > 0.05）。与10 MC金属相比，10 MC PEEK的剪切强度显著较低（P < 0.05）。
通过将先前对膝关节假体的力分析与本研究中PEEK膝关节假体观察到的失效模式（该模式与金属假体的失效模式相似）进行比较。我们认为PEEK膝关节假体与骨水泥的结合是可靠的。我们预计，未来无金属的PEEK膝关节假体将在全膝关节置换术（TKA）中得到应用，从而使患者受益。
