Gluteal muscle attachment during proximal femoral reconstruction in a canine model.
Gluteal muscle attachment during proximal femoral reconstruction in a canine model.
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犬模型近端股骨重建期间的臀肌附着。
DOI：
10.1002/jor.20283
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Markel,MarkD
中科院分区：
文献类型：
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作者：
Pluhar,GElizabeth;Manley,PaulA;Heiner,JohnP;VanderbyJr,Ray;Markel,MarkD
在这项18个月的活体犬研究中，我们比较了三种方法，在髋关节重建期间使用同种异体移植物-假体复合材料(APC)将臀肌连接到股骨近端。这三种方法都是人类髋关节翻修手术中常用的方法，关于它们在狗身上的有效性的数据与人类的治疗直接相关。比较的方法是将宿主臀肌腱缝合到同种异体肌腱上，用缆索夹持系统固定移植物的大转子，用环扎钢丝固定移植物周围的宿主皮质骨。对于每种方法，我们通过定性放射学、步态分析、组织学和生物力学测试来评估异体骨-宿主骨融合、负重、臀肌质量和结构特性的变化。髋关节重建术后18个月臀肌萎缩完全消失，肢体使用率最高。这种方法产生了一个更强壮、更稳定的髋关节，允许更正常的肢体功能。这些髋关节在宿主骨-同种异体骨连接处的骨愈合速度更快，移植骨的吸收很少。肢体使用量的增加和随之而来的更大的臀肌质量赋予了WARP髋关节复合材料在重建18个月后进行测试时最大的抗拉强度和硬度。在骨膜表面有大量的新骨形成，包裹式重建覆盖了活骨，导致截骨水平更快的愈合和皮质宽度的增加。包裹组在距截骨处较远的位置，新骨也穿透到同种异体移植物中。©2006矫形外科研究会。由Wiley期刊出版公司出版，J Orthop Res 25：208-220,2007
In this 18 month in vivo canine study we compared three methods of attaching the gluteal muscles to the proximal femur during hip reconstruction with an allograft‐prosthesis composite (APC). All three methods are commonly practiced in human hip revision surgery and data on their effectiveness in dogs is directly relevant to human treatment. The methods compared were host gluteal tendon sutured to allograft tendon, host greater trochanter apposed to allograft using a cable grip system, and host cortical bone shells around the allograft secured with cerclage wires. For each method, we assessed changes in allograft‐host bone fusion, weight bearing, gluteal muscle mass, and structural properties through qualitative radiography, gait analysis, histology, and biomechanical testing. Hip reconstruction using the WRAP method resulted in the greatest limb use with complete resolution of gluteal muscle atrophy 18 months after surgery. This method yielded a stronger, more stable hip joint that allowed for more normal limb function. These hips had the more rapid rate of bony union at the host bone‐allograft junction and little resorption of the graft. The increased limb use and resultant larger gluteal muscle mass conferred to the WRAP hip composites the greatest tensile strength and stiffness when tested 18 months after reconstruction. There was a large amount of new bone formation on the periosteal surface where the WRAP reconstructions had an overlay of live bone that resulted in a more rapid union and increased cortical width at the level of the osteotomy. New bone also penetrated into the allograft a greater distance from the osteotomy in the WRAP group. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:208–220, 2007