Sumner D R, Turner T M, Dawson D, Rosenberg A G, Urban R M, Galante J O
Department of Orthopedic Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612.
Clin Orthop Relat Res. 1994 Dec(309):150-5.
The purpose of the present study was to assess the effects of pegs and screws on bone ingrowth into the tibial component in cementless total knee replacement. Left total knee replacements were performed in 21 mature male dogs with 3 cementless porous-coated tibial tray configurations (7 animals per group): (1) 4-peg design implanted with cortical screws passing through the pegs; (2) 4-peg design implanted without screws; and (3) pegless design secured by 4 cortical screws. The animals were allowed unrestricted activity and were euthanized 6 months postoperatively. The pegless components (Group 3) had the highest extent of bone ingrowth into the tray (90.3% +/- 9.4%), followed by the components with 4 pegs only (Group 2, 82.8% +/- 9.2%), and the components with 4 pegs and 4 screws (Group 1, 75.9% +/- 11.8%). The difference between Groups 1 and 3 was statistically significant (p < 0.05). The volume fraction of bone ingrowth in the tray did not differ among the 3 groups, with an overall mean of 22.5% (+/- 4.6%). At the posterolateral quadrant, Group 1 had significantly less bone ingrowth than Group 3 within the tray whether measured as the extent (63.6% +/- 20.5% versus 91.0% +/- 10.6%, p < 0.05) or volume fraction (19.1% +/- 8.8% versus 32.9% +/- 10.5%, p < 0.05). There were no between-group differences at the other quadrants. This study indicated that pegs provided no added benefit in a circumstance where sufficient initial fixation was obtained with screws.
本研究的目的是评估在非骨水泥全膝关节置换术中，骨栓和螺钉对胫骨部件骨长入的影响。对21只成年雄性犬进行左全膝关节置换术，采用3种非骨水泥多孔涂层胫骨托构型（每组7只动物）：（1）4骨栓设计，植入穿过骨栓的皮质骨螺钉；（2）4骨栓设计，不植入螺钉；（3）无骨栓设计，用4枚皮质骨螺钉固定。允许动物自由活动，术后6个月实施安乐死。无骨栓部件（第3组）的骨长入托内程度最高（90.3%±9.4%），其次是仅带有4个骨栓的部件（第2组，82.8%±9.2%），以及带有4个骨栓和4枚螺钉的部件（第1组，75.9%±11.8%）。第1组和第3组之间的差异具有统计学意义（p<0.05）。3组之间托内骨长入的体积分数无差异，总体平均值为22.5%（±4.6%）。在外侧后象限，无论以程度（63.6%±20.5%对91.0%±10.6%，p<0.05）还是体积分数（19.1%±8.8%对32.9%±10.5%，p<0.05）衡量，第1组托内的骨长入均显著少于第3组。在其他象限，组间无差异。本研究表明，在通过螺钉获得足够初始固定的情况下，骨栓没有额外益处。
