Stability of fused versus nonfused THA femoral impaction grafts.
Stability of fused versus nonfused THA femoral impaction grafts.
复制标题
融合与非融合 THA 股骨撞击移植物的稳定性。
DOI：
10.1002/jor.20316
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Brown,ThomasD
中科院分区：
文献类型：
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作者：
Heiner,AnnelieseD;Callaghan,JohnJ;Brown,ThomasD
全髋关节置换术的打入移植包括将颗粒松质骨（MCB）压实到空腔缺损中以建立骨量。理想情况下，MCB随后重塑为新的连续松质骨网格。MCB融合的最新实验室模型允许在这种理想的最终临床状态下模拟撞击移植物结构。本研究的目的是确定MCB融合的股骨打入移植物结构与新鲜打入非融合条件下MCB的相对稳定性。在复合股骨中创建骨水泥型股骨打入移植物结构。对于融合结构，MCB与胺环氧树脂混合，使MCB形成连续结构，在生物力学上与压缩的完整松质骨相当。结构加载500，000次生理步态循环。测量股骨和股骨柄之间的三维运动。在股骨柄近端位置，融合的股骨撞击移植物比未融合的移植物稳定得多，但MCB融合对股骨柄远端稳定性的影响较小。这些结果表明，减少股骨柄微动和移位的大部分机会位于近端，并且增强打入移植物重塑和融合的步骤最有效地集中在近端。© 2006骨科研究学会。出版社：Wiley Periodicals，Inc.骨科研究杂志2007
Impaction grafting for THA involves compacting morselized cancellous bone (MCB) into a cavitary defect to build up bone stock. Ideally, the MCB subsequently remodels into a new contiguous cancellous lattice. A recent laboratory model of MCB fusion allows simulating an impaction graft construct in this ideal eventual clinical state. The purpose of the present study was to determine the relative stability of femoral impaction graft constructs in which the MCB has fused versus that for MCB in the freshly impacted nonfused condition. Cemented femoral impaction graft constructs were created in composite femurs. For fused constructs, the MCB was mixed with an amine epoxy that causes the MCB to set up into a contiguous structure biomechanically comparable to intact cancellous bone in compression. The constructs were loaded with 500,000 physiologic gait cycles. Three‐dimensional motion was measured between the femur and the stem. The fused femoral impaction grafts were much more stable than the nonfused grafts at the proximal stem location, but MCB fusion had only a modest effect on distal stem stability. These results indicate that most of the opportunity to reduce femoral stem micromotion and migration lies proximal, and that steps to enhance impaction graft remodeling and fusion are most effectively focused proximally. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 2007