Direct evidence of "damage accumulation" in cement mantles surrounding femoral hip stems retrieved at autopsy: cement damage correlates with duration of use and BMI.
Direct evidence of "damage accumulation" in cement mantles surrounding femoral hip stems retrieved at autopsy: cement damage correlates with duration of use and BMI.
复制标题
尸检时发现的股骨髋关节周围水泥套中“损伤累积”的直接证据：水泥损伤与使用时间和体重指数相关。
DOI：
10.1016/j.jbiomech.2011.07.013
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发表时间：
2011
影响因子：
2.4
通讯作者：
Mann,KA
中科院分区：
文献类型：
--
作者：
Race,A;Miller,MA;Izant,TH;Mann,KA
“损伤累积”现象尚未在股骨髋关节周围的临床水泥套中得到定量证明。我们使用荧光染料渗透剂对 11 个死后回收的用水泥固定的股骨髋关节组件的横截面进行了染色，并在落射荧光和白光显微照片中量化了水泥损伤、空隙和水泥-骨界面间隙。计算裂缝密度 (Cr.Dn)、裂缝长度密度 (Cr.Ln.Dn)、孔隙率和水泥-骨界面间隙分数 (c/b-gap%)，并通过地幔面积标准化。多元回归检验表明，水泥损伤（Cr.Ln.Dn. & Cr.Dn.）与“使用时间”和体重指数（“BMI”）显着正相关（r2=0.98，p<0.001），但与水泥地幔“孔隙率”无关。存在显着的交互作用：“使用持续时间”⁎“BMI”对 Cr.Dn. 有很强的预测性（p<0.005）； “使用时间”⁎“孔隙率”可预测 Cr.Ln.Dn（p=0.04）。与茎相关的裂纹约占 Cr.Dn 的五分之一和 Cr.Ln.Dn 的三分之一。平均 c/b-gap% 为 13.8%，但与使用持续时间不相关（r2=0.01，p=0.8）。我们得出的结论是，在体内使用过程中会发生与持续时间相关的疲劳损伤累积。随着时间的推移，BMI 强烈影响水泥裂缝长度和新裂缝形成率。空隙不会增加裂纹萌生的速度，但随着时间的推移似乎会促进裂纹的扩展。虽然不是进行性的，但水泥-骨界面处的大量骨吸收似乎很常见。
The “damage accumulation” phenomenon has not been quantitatively demonstrated in clinical cement mantles surrounding femoral hip stems. We stained transverse sections of 11 postmortem retrieved femoral hip components fixed with cement using fluorescent dye-penetrant and quantified cement damage, voids, and cement–bone interface gaps in epifluorescence and white light micrographs. Crack density (Cr.Dn), crack length-density (Cr.Ln.Dn), porosity, and cement–bone interface gap fraction (c/b-gap%) were calculated, normalized by mantle area. Multiple regression tests showed that cement damage (Cr.Ln.Dn. & Cr.Dn.) was significantly positively correlated (r2=0.98, p<0.001) with “duration of use” and body mass index (“BMI”) but not cement mantle “porosity”. There were significant interactions: “duration of use”⁎“BMI” was strongly predictive (p<0.005) of Cr.Dn.; and “duration of use”⁎“porosity” was predictive (p=0.04) of Cr.Ln.Dn. Stem related cracks accounted for approximately one fifth of Cr.Dn and one third of Cr.Ln.Dn. The mean c/b-gap% was 13.8% but it did not correlate (r2=0.01, p=0.8) with duration of use. We concluded that duration-dependent fatigue damage accumulation occurred during in vivo use. BMI strongly influenced cement crack length and the rate of new crack formation over time. Voids did not increase the rate of crack initiation but appeared to have promoted crack growth over time. Although not progressive, substantial bone resorption at the cement–bone interface appeared to be common.