Cemented Femoral Stem Performance: Effects of Proximal Bonding, Geometry, and Neck Length
Cemented Femoral Stem Performance: Effects of Proximal Bonding, Geometry, and Neck Length
复制标题
骨水泥股骨柄性能：近端粘合、几何形状和颈长度的影响
DOI：
--
复制
发表时间：
1998
影响因子：
4.2
通讯作者：
D. Bartel
中科院分区：
文献类型：
--
作者：
P. B. Chang;K. Mann;D. Bartel
确定了近端粘合、远端股骨柄几何形状和股骨颈长度对骨水泥和界面应力的影响，以更好地了解其在临床性能中的作用。将股骨柄设计的影响与环境变量、患者体重和患者活动的影响进行比较。使用有限元模型来确定峰值水泥和界面应力，并使用实验布局来区分设计和环境影响。粘合将骨水泥鞘应力降低了35%-60%，达到低于骨水泥疲劳强度的水平。平面植入物提供了更大的抗扭转性，相对于远端圆形植入物，近端骨水泥-假体界面处的剪切应力降低了22%至73%。与粘合或植入物几何形状相比，股骨颈长度对应力的影响最小。骨水泥界面应力对患者活动比设计变量更敏感。因此，基于这些结果，关于骨水泥和假体牢固结合可能对骨水泥界面有害的说法是不合理的。设计变量的最佳组合是近端粘合的平面植入物，颈部长度由外科医生决定。这种组合在保护骨水泥鞘和假体界面方面最有效，可能通过最大限度地减少与骨水泥碎屑生成相关的应力来保护骨水泥-骨界面。
The effects of proximal bonding, distal stem geometry, and femoral neck length on cement and interface stresses were determined to understand better their role in clinical performance. The effects of stem design were compared with the effects of environmental variables, patient weight, and patient activity. Finite element models were used to determine peak cement and interface stresses, and an experimental layout was used to separate design and environmental effects. Bonding reduced cement mantle stresses by 35% to 60%, to levels below the cement fatigue strength. A flat sided implant provided more torsional resistance, reducing shear stresses at the proximal cement-prosthesis interface by 22% to 73% with respect to a distal round implant. Neck length had minimal effects on stresses compared with bonding or implant geometry. Cement-bone interface stresses were more sensitive to patient activity than to the design variables. Therefore, claims that a strong cement and prosthesis bond may be harmful to the bone-cement interface are unjustified based on these results. The best combination of design variables was a proximally bonded, flat sided implant with neck length left to the surgeon's discretion. This combination was most effective at protecting the cement mantle and prosthesis interface and perhaps the cement-bone interface by minimizing stresses associated with cement debris generation.
影响因子：
2.4
作者：
Kenneth A. Mann;Donald L. Bartel;Timothy M. Wright;A. H. Burstein
通讯作者：
Kenneth A. Mann;Donald L. Bartel;Timothy M. Wright;A. H. Burstein