Effects of a contoured articular prosthetic device on tibiofemoral peak contact pressure: a biomechanical study.
Effects of a contoured articular prosthetic device on tibiofemoral peak contact pressure: a biomechanical study.
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DOI：
10.1007/s00167-007-0416-7
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发表时间：
2008-01
影响因子：
3.8
通讯作者：
Skrbensky, Gobert
中科院分区：
文献类型：
--
作者：
Becher, Christoph;Huber, Roland;Thermann, Hajo;Paessler, Hans H.;Skrbensky, Gobert
关键词：
许多中年患者受到局部软骨缺损的影响，这些缺损既不适合初次修复，也不适合重复生物修复方法，也不适合传统的关节成形术。该体外研究旨在确定使用部分股骨表面置换装置（HemiCAP®，Arthrosurface Inc.，美国马萨诸塞州富兰克林）。使用Tekscan传感器在8个新鲜冷冻尸体标本中测定峰值接触压力，该传感器放置在髂动脉上方的内侧室中。使用闭环机器人膝关节模拟器在静态站立位置（5°/15°/30°/45°）和体重地面反作用力（GRF）、30°屈曲和2倍体重（2 tBW）GRF以及动态膝关节弯曲循环中测试每个膝关节。根据尸体供体的活体重量调整地面反作用力，并在所有循环中保持。在四种不同条件下对每个样本进行测试：未处理、齐平HemiCAP®植入、1 mm凸起植入和20 mm缺损。采用配对抽样t检验比较平均值（显著性，P ≤ 0.05）进行统计分析。平均而言，在任何测试条件下，正常膝关节与冲洗器械植入相比均未发现统计学显著差异。与未处理条件相比，使用1 mm凸起植入物时，观察到峰值接触压力统计学显著增加217%（5°站立位）、99%（动态膝关节弯曲）和90%（30°站立位，2 tBW）。使用20 mm缺损，未评估峰值接触压力的显著增加。数据表明，使用HemiCAP®进行表面置换不会导致冲洗植入时的峰值接触压力增加。然而，升高的植入导致峰值接触压力增加，并且在体内应用中可能在生物力学上不利。
Many middle-aged patients are affected by localized cartilage defects that are neither appropriate for primary, nor repeat biological repair methods, nor for conventional arthroplasty. This in vitro study aims to determine the peak contact pressure in the tibiofemoral joint with a partial femoral resurfacing device (HemiCAP®, Arthrosurface Inc., Franklin, MA, USA). Peak contact pressure was determined in eight fresh-frozen cadaveric specimens using a Tekscan sensor placed in the medial compartment above the menisci. A closed loop robotic knee simulator was used to test each knee in static stance positions (5°/15°/30°/45°) with body weight ground reaction force (GRF), 30° flexion with twice the body weight (2tBW) GRF and dynamic knee-bending cycles with body weight GRF. The ground reaction force was adjusted to the living body weight of the cadaver donor and maintained throughout all cycles. Each specimen was tested under four different conditions: Untreated, flush HemiCAP® implantation, 1-mm proud implantation and 20-mm defect. A paired sampled t test to compare means (significance, P ≤ 0.05) was used for statistical analysis. On average, no statistically significant differences were found in any testing condition comparing the normal knee with flush device implantation. With the 1-mm proud implant, statistically significant increase of peak contact pressures of 217% (5° stance), 99% (dynamic knee bending) and 90% (30° stance with 2tBW) compared to the untreated condition was seen. No significant increase of peak contact pressure was evaluated with the 20-mm defect. The data suggests that resurfacing with the HemiCAP® does not lead to increased peak contact pressure with flush implantation. However, elevated implantation results in increased peak contact pressure and might be biomechanically disadvantageous in an in vivo application.
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DOI：
10.1053/jars.2002.32839
发表时间：
2002-09-01
影响因子：
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作者：
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10.2106/00004623-200300002-00004
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2003-01-01
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