Schreurs B W, Huiskes R, Buma P, Slooff T J
Department of Orthopaedics, University of Nijmegen, The Netherlands.
Biomaterials. 1996 Jun;17(12):1177-86. doi: 10.1016/0142-9612(96)84938-6.
To reconstruct femoral intramedullary bone-stock loss in revision surgery of failed total hip arthro-plasties, morsellized trabecular bone grafts can be used. In 14 goats a noncemented hydroxyapatite-coated titanium stem was fixed within a circumferential construction of bone allografts. After 6 or 12 wk, four goats were used for mechanical tests and three for histology. The stability of the stems relative to the bone was determined in a loading experiment with Roentgenstereo-Photogrammatic Analysis (RSA). Owing to two loosenings and two fractures, only one 6-wk specimen and three 12-wk specimens were available for mechanical testing. The prostheses were very stable at 12 wk. The most important movements were axial rotation (maximal 0.17 degrees at 800 N) and subsidence (maximal 0.036 mm at 800 N). After unloading, there was 40-60% elastic recovery. Histological examination showed revascularization and remodelling of the graft in all the specimens investigated. At the graft site, bone apposition and bone resorption had resulted in a mixture of graft and new bone. Bone incorporation was mainly seen in the proximal areas. Graft lysis was evident in the midshaft region and at distal levels around the prostheses.
在失败的全髋关节置换翻修手术中，为重建股骨骨髓腔内骨量丢失，可使用颗粒状松质骨移植。在14只山羊中，将非骨水泥型羟基磷灰石涂层钛柄固定在异体骨的环形结构内。6周或12周后，4只山羊用于力学测试，3只用于组织学检查。通过X射线立体摄影测量分析（RSA）加载实验确定柄与骨之间的稳定性。由于出现2例松动和2例骨折，仅1个6周标本和3个12周标本可用于力学测试。假体在12周时非常稳定。最重要的运动是轴向旋转（800 N时最大0.17度）和下沉（800 N时最大0.036 mm）。卸载后，有40% - 60%的弹性恢复。组织学检查显示，在所有研究的标本中移植骨均有血管化和重塑。在移植部位，骨附着和骨吸收导致移植骨与新骨混合。骨融合主要见于近端区域。在假体周围的中轴区域和远端水平可见移植骨溶解。
