Virtual implantation technique to estimate endoprosthetic contact of percutaneous osseointegrated devices in the tibia.
Virtual implantation technique to estimate endoprosthetic contact of percutaneous osseointegrated devices in the tibia.
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DOI：
10.1016/j.medengphy.2021.05.011
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发表时间：
2021-07
影响因子：
2.2
通讯作者：
Bachus KN
中科院分区：
文献类型：
--
作者：
Taylor CE;Henninger HB;Bachus KN
经皮骨整合（OI）器械具有连接到截肢残骨的内假体，然后永久穿过皮肤连接到体外的远端假体部件。无论当前OI内假体的骨锚定区域是圆柱形和/或圆锥形，它们都需要紧密的骨-内假体接触以促进稳定的骨附着。然而，去除过多的皮质骨以实现更多的接触会导致皮质壁变薄，随后变弱。内假体的设计需要平衡这些因素，即最大限度地增加接触，同时最大限度地减少切除的骨体积。在这项研究中，27人胫骨被用来开发和验证虚拟植入方法。然后，在7个残肢长度处虚拟植入40个额外的胫骨，模拟圆柱形和圆锥形骨锚定区域，以测量所得的骨-内假体接触和骨去除。骨-内假体接触与截骨体积的比值显示，对于所有截肢节段，圆锥形几何结构的接触面积/截骨体积更大（p≤0.001）。在两种模拟器械中，在74%的评价病例中，内假体在20%剩余长度时发生皮质穿透，表明可能需要替代内假体几何形状以在该骨区域获得临床成功。
Percutaneous osseointegrated (OI) devices have an endoprosthesis attached to the residual bone of an amputated limb, then pass permanently through the skin to be connected to the distal prosthetic componentry outside of the body. Whether the bone-anchoring region of current OI endoprostheses are cylindrical, and/or conical, they require intimate bone-endoprosthesis contact to promote stabilizing bone attachment. However, removing too much cortical bone to achieve more contact leads to thinner and, subsequently, weaker cortical walls. Endoprostheses need to be designed to balance these factors, namely maximizing the contact, while minimizing the volume of bone removed. In this study, 27 human tibias were used to develop and validate a virtual implantation method. Then, 40 additional tibias were virtually implanted with mock cylindrical and conical bone-anchoring regions at seven residual limb lengths to measure resultant bone-endoprosthesis contact and bone removal. The ratio of bone-endoprosthesis contact to bone volume removed showed the conical geometry had more contact area per volume bone removed for all amputation levels (p≤0.001). In both mock devices, cortical penetration of the endoprosthesis at 20% residual length occurred in 74% of cases evaluated, indicating that alternative endoprosthesis geometries may be needed for clinical success in that region of bone.
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影响因子：
2.9
作者：
Haque R;Al-Jawazneh S;Hoellwarth J;Akhtar MA;Doshi K;Tan YC;Lu WY;Roberts C;Al Muderis M
通讯作者：
Al Muderis M
影响因子：
--
作者：
McGough, R. L.;Goodman, M. A.;Lindsey, B.
通讯作者：
Lindsey, B.
DOI：
10.1002/ar.24479
发表时间：
2021-03
期刊：
Anatomical record (Hoboken, N.J. : 2007)
影响因子：
--
作者：
Taylor CE;Henninger HB;Bachus KN
通讯作者：
Bachus KN
影响因子：
3.7
作者：
Zampelis V;Flivik G
通讯作者：
Flivik G
DOI：
10.1002/jbm.820280503
发表时间：
1994-05-01
期刊：
JOURNAL OF BIOMEDICAL MATERIALS RESEARCH
影响因子：
--
作者：
BLOEBAUM, RD;BACHUS, KN;HOFMANN, AA
通讯作者：
HOFMANN, AA