The effects of femoral canal geometries, stem shapes, cement thickness, and stem materials on the choice of femoral implant in cemented total hip replacement
The effects of femoral canal geometries, stem shapes, cement thickness, and stem materials on the choice of femoral implant in cemented total hip replacement
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DOI：
10.1080/02533839.2009.9671513
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发表时间：
2009-04
影响因子：
1.1
通讯作者：
Yu-Shu Lai;Hung-Wen Wei;Ting-Kuo Chang;Cheng-Kung Cheng-Cheng-Kung-Cheng-3453495
中科院分区：
文献类型：
--
作者：
Yu-Shu Lai;Hung-Wen Wei;Ting-Kuo Chang;Cheng-Kung Cheng-Cheng-Kung-Cheng-3453495
骨水泥失效是骨水泥全髋关节置换术中导致局部骨溶解，进而导致无菌性松动的主要因素。但是对于全髋关节置换术后骨水泥厚度、骨柄形状和材料对骨水泥失效的影响以及不同股骨管形状股骨假体选择的影响研究甚少。采用股骨近端有限元模型，包括正常股骨管和管状股骨管形状，预测不同水泥厚度、管状和材料的水泥套管失效。结果表明：在烟囱管模型中，水泥地幔远端区域存在较高的破坏概率和拉应力；采用厚水泥地幔（2mm）来模拟高耀斑杆，以减少水泥地幔远端区域的应力。此外，采用薄水泥地幔（0.5 mm）时，在水泥地幔中出现了超高的破坏概率和拉应力。在采用钛合金杆的模型中，水泥地幔的峰值拉应力和破坏概率与CoCrMo合金的结果相似。我们的结论是，高耀度的管杆，无论是钛还是CoCrMo合金，都可以减少管管患者的管杆松动率。
Abstract Cement failure is a main factor leading to localized bone lysis, and later to aseptic loosening in cemented total hip replacement. But the effects of the cement thickness, stem shapes and materials on the cement failure and the choice of femoral implant in different femoral canal shapes after total hip arthroplasty have rarely been investigated. Finite element models of proximal femurs including normal and stovepipe femoral canal shapes were used to predict the failure of cement mantles for different cement thicknesses, stem shapes and materials. The results showed that high failure probabilities and tensile stress occurred in the distal region of the cement mantle in the stovepipe canal model. A high flare stem, reducing the stress in the distal region of the cement mantle, was modeled by adopting a thick cement mantle (2 mm). In addition, extra high failure probabilities and tensile stress occurred in the cement mantle while adopting a thin cement mantle (0.5 mm). In the models with titanium alloy stems, the peak tensile stress and failure probabilities in the cement mantle presented similar results compared to CoCrMo alloys. We concluded that a high flare stem, either titanium or CoCrMo alloy, could decrease the rate of stem loosening for patients with stovepipe canals.