Subject-specific planning of femoroplasty: An experimental verification study
Subject-specific planning of femoroplasty: An experimental verification study
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DOI：
10.1016/j.jbiomech.2014.11.002
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发表时间：
2015-01-02
影响因子：
2.4
通讯作者：
Armand, Mehran
中科院分区：
文献类型：
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作者：
Basafa, Ehsan;Murphy, Ryan J.;Armand, Mehran
通过使用丙烯酸聚甲基丙烯酸甲酯（PMMA）骨水泥强化易受损的股骨，可能会降低骨质疏松性髋部骨折的风险。用PMMA大量填充股骨近端已显示出前景，但强化后的骨骼可能会出现热坏死或骨水泥渗漏等副作用。我们假设，通过特定对象的规划和计算机辅助强化，我们能够在增加骨强度和降低骨折风险的同时，使骨水泥用量最小化。我们对8对骨质疏松性股骨进行了力学测试，此前按照之前报道的针对患者的特定规划对每对中的一根股骨进行了强化，该规划优化了骨水泥的分布和强度增加。在强化组中，平均注入了9.5（±1.7）毫升的骨水泥。与未强化的对照组相比，强化显著（P < 0.05）使屈服载荷增加了33%，最大载荷增加了30%，屈服能量增加了118%，最大能量增加了94%。此外，预测的屈服载荷与实验结果相关性良好（R² = 0.74），对于强化样本，骨水泥轮廓的预测平均表面误差为……
The risk of osteoporotic hip fractures may be reduced by augmenting susceptible femora with acrylic polymethylmethacrylate (PMMA) bone cement. Grossly filling the proximal femur with PMMA has shown promise, but the augmented bones can suffer from thermal necrosis or cement leakage, among other side effects. We hypothesized that, using subject-specific planning and computer-assisted augmentation, we can minimize cement volume while increasing bone strength and reducing the risk of fracture. We mechanically tested eight pairs of osteoporotic femora, after augmenting one from each pair following patient-specific planning reported earlier, which optimized cement distribution and strength increase. An average of 9.5( +/- 1.7) ml of cement was injected in the augmented set. Augmentation significantly (P < 0.05) increased the yield load by 33%, maximum load by 30%, yield energy by 118%, and maximum energy by 94% relative to the non-augmented controls. Also predicted yield loads correlated well (R-2=0.74) with the experiments and, for augmented specimens, cement profiles were predicted with an average surface error of