Orfanos Georgios, Zderic Ivan, Gueorguiev Boyko, Nylund Pamela, D'Este Matteo, Varga Peter, Okoro Tosan
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, UK.
AO Foundation, Davos, Graubünden, Switzerland.
BMJ Surg Interv Health Technol. 2024 Oct 18;6(1):e000307. doi: 10.1136/bmjsit-2024-000307. eCollection 2024.
To assess the effect of adjuvant antibiotic-loaded hydrogel application on the primary stability of implanted uncemented hip stems.
Biomechanical study.
An electro-mechanic material test system (#5866, Instron, Norwood, MA, USA) equipped with a 10-kN load cell was used. A staircase loading protocol was applied via quasi-static ramped compression loading at 0.005 mm/s and six different load levels between 500 N and 3000 N in 500 N intermittent load increase steps.
12 artificial femora were prepared and received a collarless uncemented standard offset stem (Corail; DePuy Synthes, Zuchwil, Switzerland).
The two groups were prepared with or without the antibiotic-loaded hydrogel.
Construct stiffness was determined from the recorded load-displacement curves and stem subsidence was measured via motion tracking.
Construct stiffness (control: 4176±240 N/mm; intervention: 4588±448 N/mm) was not significantly different between the groups (p=0.076). Stem subsidence increased significantly over the increasing load levels in each separate group (p≤0.002) and remained not significantly different between the groups (p=0.609).
The application of antibiotic-loaded hydrogel was associated with non-inferior performance in terms of primary uncemented hip stem stability. This finding makes the prospect of adjuvant antibiotic-loaded hydrogel application potentially feasible; however, it requires further investigations prior to translation in the clinical practice.
评估辅助应用载抗生素水凝胶对非骨水泥型髋关节柄植入初期稳定性的影响。
生物力学研究。
使用配备10 kN 测力传感器的机电材料测试系统（#5866，英斯特朗公司，美国马萨诸塞州诺伍德）。通过以0.005 mm/s 的准静态斜坡压缩加载以及在500 N至3000 N之间的六个不同载荷水平（以500 N的间歇载荷增加步长）应用阶梯加载方案。
制备了12根人工股骨，并植入无领非骨水泥标准偏移柄（Corail；德普伊辛迪斯公司，瑞士祖赫维尔）。
两组分别在有或无载抗生素水凝胶的情况下制备。
根据记录的载荷-位移曲线确定结构刚度，并通过运动跟踪测量柄的下沉情况。
两组之间的结构刚度（对照组：4176±240 N/mm；干预组：4588±448 N/mm）无显著差异（p = 0.076）。在每个单独的组中，随着载荷水平的增加，柄的下沉显著增加（p≤0.002），且两组之间仍无显著差异（p = 0.609）。
在非骨水泥型髋关节柄植入初期稳定性方面，载抗生素水凝胶的应用表现不差。这一发现使得辅助应用载抗生素水凝胶具有潜在可行性；然而，在临床实践中应用之前还需要进一步研究。
