Jasty M, Krushell R, Zalenski E, O'Connor D, Sedlacek R, Harris W
Orthopaedics Department, Massachusetts General Hospital, Boston 02114.
J Arthroplasty. 1993 Feb;8(1):33-41. doi: 10.1016/s0883-5403(06)80105-1.
The contribution of the distal nonporous-coated stem to the stability of the uncemented femoral components, which were porous coated only proximally, was investigated under two conditions: (1) immediately after insertion and (2) at 6 months, 1 year, and 2 years after surgery in a canine model. The relative motion of the femoral components at the bone porous-coating interface under loads simulating the canine midstance was measured at these time periods using displacement transducers. The measurements were repeated after severing the connection between the porous-coated proximal body and the nonporous-coated distal stem through a small hole in the anterior cortex. The results showed that while the distal nonporous-coated stem enhanced the immediate stability of the proximally porous-coated uncemented femoral components, it contributed little to the long-term stability of the femoral components after bony ingrowth had occurred in vivo. The mean relative motion between the body of the prosthesis and the cortical bone increased from 12 microns (+/- 7 microns) to 31 microns (+/- 34 microns) in the posterior transverse direction when the stem was immediately severed after the surgery. However, at 6 months, 1 year, and 2 years after surgery, extensive bone ingrowth had occurred into the proximal porous-coated regions of the body and provided excellent stability to the femoral components. With bone ingrowth, the mean relative motion was less than 5 microns at any site. Under these conditions, severing the stem did not increase the relative motion of the prostheses significantly.(ABSTRACT TRUNCATED AT 250 WORDS)
在犬类模型中,研究了远端无孔涂层柄对仅近端有孔涂层的非骨水泥型股骨部件稳定性的贡献,研究条件如下:(1)植入后即刻;(2)术后6个月、1年和2年。在这些时间段,使用位移传感器测量模拟犬类中期站立负荷时股骨部件在骨孔涂层界面处的相对运动。通过在前皮质上的一个小孔切断有孔涂层近端主体与无孔涂层远端柄之间的连接后,重复进行测量。结果表明,虽然远端无孔涂层柄增强了近端有孔涂层非骨水泥型股骨部件的即刻稳定性,但在体内发生骨长入后,它对股骨部件的长期稳定性贡献不大。术后立即切断柄时,假体主体与皮质骨之间在后横向方向的平均相对运动从12微米(±7微米)增加到31微米(±34微米)。然而,在术后6个月、1年和2年,大量骨长入假体主体的近端有孔涂层区域,并为股骨部件提供了出色的稳定性。有了骨长入,任何部位的平均相对运动均小于5微米。在这些条件下,切断柄不会显著增加假体的相对运动。(摘要截选至250字)