Comparison of periprosthetic femoral fracture torque and strain pattern of three types of femoral components in experimental model.
Comparison of periprosthetic femoral fracture torque and strain pattern of three types of femoral components in experimental model.
复制标题
实验模型中三种类型的股骨成分的股骨周围骨折扭矩和应变模式的比较。
DOI：
10.1302/2046-3758.115.bjr-2021-0375.r2
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发表时间：
2022-05
影响因子：
4.6
通讯作者：
Imagama, S.
中科院分区：
文献类型：
--
作者：
Takegami, Y.;Seki, T.;Osawa, Y.;Imagama, S.
全髋关节置换术后假体周围骨折（PPF）治疗困难，因此，识别可改变的风险因素（如股骨柄选择）以减少PPF的发生非常重要。本研究旨在阐明三种不同类型骨水泥型股骨柄在断裂扭矩、表面应变和断裂类型分析方面的差异。我们使用三种不同类型的六个骨水泥型股骨柄进行了骨模拟物的生物力学测试：无领抛光锥形（CPT）股骨柄、Versys Advocate（Versys）股骨柄和Charnley-Marcel-Kerboull（CMK）股骨柄。经验丰富的外科医生将每种类型的股骨柄植入到6个骨替代物中，并对替代物进行压缩和内旋转，直至失效。记录断裂扭矩和断裂类型。我们还用三轴旋转法测量了表面应变分布。三种股骨柄类型之间的断裂扭矩存在显著差异（p = 0.036）。特别是，CPT股骨柄的中位断裂扭矩显著低于CMK股骨柄（CPT vs CMK：164.5 Nm vs 200.5 Nm; p = 0.046）。在最近端部位，CPT股骨柄的应变值高于其他两个股骨柄。CPT和Versys股骨柄的断裂模式为温哥华B型，而CMK股骨柄的断裂模式为C型。我们的研究表明，钴铬合金材料、抛光表面光洁度、锐角方形近端形状和无颈领可能与较低的断裂扭矩相关，这可能与PPF有关。引用这篇文章：骨关节研究2022;11（5）：270-277。
Periprosthetic hip fractures (PPFs) after total hip arthroplasty are difficult to treat. Therefore, it is important to identify modifiable risk factors such as stem selection to reduce the occurrence of PPFs. This study aimed to clarify differences in fracture torque, surface strain, and fracture type analysis between three different types of cemented stems. We conducted biomechanical testing of bone analogues using six cemented stems of three different types: collarless polished tapered (CPT) stem, Versys Advocate (Versys) stem, and Charnley-Marcel-Kerboull (CMK) stem. Experienced surgeons implanted each of these types of stems into six bone analogues, and the analogues were compressed and internally rotated until failure. Torque to fracture and fracture type were recorded. We also measured surface strain distribution using triaxial rosettes. There was a significant difference in fracture torque between the three stem types (p = 0.036). Particularly, the median fracture torque for the CPT stem was significantly lower than that for the CMK stem (CPT vs CMK: 164.5 Nm vs 200.5 Nm; p = 0.046). The strain values for the CPT stem were higher than those for the other two stems at the most proximal site. The fracture pattern of the CPT and Versys stems was Vancouver type B, whereas that of the CMK stem was type C. Our study suggested that the cobalt-chromium alloy material, polished surface finish, acute-square proximal form, and the absence of a collar may be associated with lower fracture torque, which may be related to PPF. Cite this article: Bone Joint Res 2022;11(5):270–277.