Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Proc Inst Mech Eng H. 2024 Mar;238(3):324-331. doi: 10.1177/09544119231225172. Epub 2024 Jan 18.
This biomechanical study aimed to determine if variations in stem material, stem geometry, stem offset and cement viscosity affect mechanical resistance to postoperative periprosthetic fracture (PFF) after hip arthroplasty with a commonly used cemented polished taper-slip (PTS) stem (CPT, Zimmer Biomet) in a novel osteoporotic composite femoral bone model. Thirty-six osteoporotic composite femoral models were tested using a standardised in-vitro loading technique to simulate a typical PFF. Outcome measures were torque to failure (N), fracture energy (N/m) and rotation to failure (°). Comparisons were made by stem material (cobalt chrome vs stainless steel), stem geometry (CPT stem vs Exeter stem), stem offset (standard offset vs extra extended offset) and cement viscosity (high viscosity vs low viscosity). Statistical comparisons were carried out with significance set at < 0.05. All tested samples produced clinically representative fracture patterns with varying degrees of bone and cement comminution. There was no statistically significant difference in torque to failure, fracture energy or rotation to failure between any of the compared variables (all > 0.05). This is the first biomechanical study on mechanical resistance to PFF using osteoporotic composite bone models. For the CPT stem, it confirms that stem material, stem offset, stem geometry and cement viscosity do not affect mechanical resistance to PFF in an osteoporotic bone model.
这项生物力学研究旨在确定在骨质疏松复合股骨模型中，使用普遍使用的带涂层锥形滑动（CPT，捷迈邦美）骨水泥固定假体后，柄材料、柄几何形状、柄偏心距和骨水泥粘度的变化是否会影响术后假体周围骨折（PFF）的机械抵抗力。采用标准化的体外加载技术对 36 个骨质疏松复合股骨模型进行了测试，以模拟典型的 PFF。测量结果为失效扭矩（N）、断裂能（N/m）和失效旋转角度（°）。比较因素包括柄材料（钴铬对不锈钢）、柄几何形状（CPT 柄对 Exeter 柄）、柄偏心距（标准偏心距对额外延长偏心距）和骨水泥粘度（高粘度对低粘度）。统计学比较的显著性水平设为 < 0.05。所有测试样本均产生了具有不同程度骨水泥粉碎的临床代表性骨折模式。在任何比较变量之间，失效扭矩、断裂能或失效旋转角度均无统计学差异（均 > 0.05）。这是第一项使用骨质疏松复合骨模型研究机械抵抗 PFF 的生物力学研究。对于 CPT 柄，它证实了柄材料、柄偏心距、柄几何形状和骨水泥粘度不会影响骨质疏松骨模型中 PFF 的机械抵抗力。
