Stranne S K, Callaghan J J, Cocks F H, Weinerth J L, Seaber A V, Myers B S
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Clin Orthop Relat Res. 1993 Feb(287):252-8.
Extracorporeal shock-wave lithotripsy has been proposed as a modality to facilitate the removal of bone cement during revision arthroplasty; however, concomitant cortical microfractures have been reported. The current study examines the effect on whole bone strength of extracorporeal shock-wave lithotripsy directed at the cement-bone complex. Canine femora were subjected to manual cement extraction or lithotripsy followed by manual cement extraction. Contralateral femora served as controls. Torsional fractures were created, and maximum torque, maximum angular displacement, and energy capacity to failure were determined. Although cement extraction alone reduced mean torque by 6.6% and failed to reduce mean torque angle or mean energy capacity, the combination of lithotripsy and cement extraction reduced mean torque by 7.3%, mean torque angle by 14.3%, and mean energy capacity by 18.3%. No statistical significance was demonstrated between the two groups in torque, angle, or energy capacity. At magnitudes and numbers of shock waves previously shown to significantly reduce cement-bone interface mechanical strength, lithotripsy exposure had a minimal and insignificant effect on whole bone strength.
体外冲击波碎石术已被提议作为一种在翻修关节成形术中促进骨水泥清除的方法；然而，有报道称会伴随出现皮质微骨折。本研究考察了针对骨水泥 - 骨复合体的体外冲击波碎石术对全骨强度的影响。对犬股骨进行手动取出骨水泥或先进行碎石术再手动取出骨水泥操作。对侧股骨作为对照。制造扭转骨折，并测定最大扭矩、最大角位移和破坏能量容量。尽管单独取出骨水泥使平均扭矩降低了6.6%，但未能降低平均扭矩角度或平均能量容量，而碎石术与取出骨水泥相结合则使平均扭矩降低了7.3%，平均扭矩角度降低了14.3%，平均能量容量降低了18.3%。两组在扭矩、角度或能量容量方面未显示出统计学差异。在先前已表明能显著降低骨水泥 - 骨界面机械强度的冲击波强度和数量下，碎石术暴露对全骨强度的影响极小且无统计学意义。
