Experimental study on initial stability of total hip arthroplasty and local osteolysis

全髋关节置换术初始稳定性与局部骨溶解的实验研究

• 批准号: 09671512
• 负责人: KAWATE Kenji
• 金额: $ 1.02万
• 依托单位: Nara Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671512/
• 关键词: Total hip arthroplasty; Initial stability; Direct insertion technique; Reaming; Polyethylene particle; Osteolysis; Micro motion; 人工骨頭; 人工関節; ラスピング; ポリエチレン紛

The purpose of this study was to clarify the advantages of direct insertion technique without any preparation of the femoral canal for the initial stability of femoral components and osteolysis.In the first and second studies, sand-blasted tapered titan alloy rods were implanted in 30 SAW BONE Foam Cortex TIBIA and 24 pig femora. Group LR1 (Line-to-line reaming technique) included 10 bone models which were inserted with the rod into the canal after reaming. Group UR1 (Underreaming technique) included 10 bone models which were inserted with the rod after 0.5 mm underreaming. Group DI1 (Direct insertion technique) included 10 bone models which were inserted with the rod without reaming. Group LR2 (Line-to-line reaming technique) included 8 pig femora which were inserted with the rod after reaming. Group UR2 (Underreaming technique) included 8 pig femora which were inserted with the rod after 0.5mm underreaming. Group DI2(Direct insertion technique)included 8 pig femora which were inserte … More d with the rod without reaming. A pullout test was performed on samples using a testing machine. In the third study, each sand-blasted titan alloy femoral stem was selected from one of 3 sizes and inserted in 20 femora of 10 beagles. Twenty femora were divided into 4 groups. Group R0 (Rasping insertion technique) included 5 femora which were inserted with the stem after reaming just after sacrifice. Group R2 (Rasping insertion technique) included 5 femora which were inserted with the stem after reaming and harvested 2 weeks after surgery. Group D0 (Direct insertion technique) included 5 femora which were inserted with the stem without reaming just after sacrifice. Group D2 (Direct insertion technique) included 5 femora which were inserted with the stem without reaming and harvested 2 weeks after surgery. The micro motion and displacement of the stem were measured after 40 kgf loading. Next, polyethylene particles (200mg) were injected into 4 hip joints of 4 other beagles after surgery with rasping insertion technique or direct insertion technique.In the first and second studies, there were significant differences between Group LR1 (21.2±5.5kgf) and Group UR1 (47±6.9kgf), and between Group LR1 and Group DI1 (39.9±19kgf). There was also a significant difference between Group LR2 (34±16.5kgf) and Group DI2 (56.3±1.6kgf). In the third study on micro motion, there was a significant difference between Group R2 (48.6±23.9μm) and Group D2 (20.0±4.8μm). In the third study on displacement, there was a significant difference between Group R0 (7.2±3.0μm) and Group D0 (2.6±1.0μm). The polyethylene particles did not generate osteolysis in all femora.The results of the third study suggested that the direct insertion technique generated good stability just after surgery and less soft tissue surrounding the stem 2 weeks after surgery. The results of the first and second studies suggested that meticulous study was needed to clarify the difference between direct insertion technique and underreaming technique. Less

本研究的目的是阐明直接插入技术的优点，无需任何股骨管准备，对股骨组成部分的初始稳定性和骨溶解。在第一和第二项研究中，将喷砂锥形泰坦合金棒植入30只SAW骨泡沫皮质胫骨和24只猪股骨。LR1组（线对线扩孔技术）包括10个骨模型，扩孔后用棒插入根管。UR1组（下扩孔技术）10只骨模型，下扩孔0.5 mm后插入骨棒。DI1组（直接插入技术）10只骨模型，不扩孔，用棒插入。LR2组（线对线扩孔技术）包括8只猪股骨，扩孔后插入杆。UR2组（下扩孔技术）8只猪股骨，下扩孔0.5mm后插入杆。DI2组（直接插入技术）共8只猪股骨，其余8只用不扩孔棒插入。用试验机对样品进行拉拔试验。在第三项研究中，每种喷砂泰坦合金股骨柄从3种尺寸中选择一种，插入10只小猎犬的20根股骨。20只股骨分为4组。R0组（拉丝插入技术）5根股骨，在牺牲后扩孔后与股骨茎一起插入。R2组（Rasping插入技术）包括5根股骨，扩孔后与股骨柄插入，术后2周切除。D0组（直接插入技术）包括5根股骨，在牺牲后不扩孔的情况下与股骨茎一起插入。D2组（直接插入技术）包括5根股骨，在不扩孔的情况下与股骨茎一起插入，术后2周切除。在加载40kgf后，测量了杆的微运动和位移。然后，将聚乙烯颗粒（200mg）注射到另外4只手术后的比格犬的4个髋关节内，分别采用研磨插入技术和直接插入技术。在第一、二项研究中，LR1组（21.2±5.5kgf）与UR1组（47±6.9kgf）、LR1组（39.9±19kgf）与DI1组（39.9±19kgf）比较差异均有统计学意义。LR2组（34±16.5kgf）与DI2组（56.3±1.6kgf）之间也有显著差异。在第三项微运动研究中，R2组（48.6±23.9μm）与D2组（20.0±4.8μm）差异有统计学意义。在第三项研究中，R0组（7.2±3.0μm）与D0组（2.6±1.0μm）之间存在显著差异。聚乙烯颗粒并未在所有股骨中产生骨溶解。第三项研究的结果表明，直接插入技术在术后产生了良好的稳定性，术后2周后茎周周围的软组织较少。第一和第二项研究的结果表明，需要进行细致的研究，以澄清直接插入技术与扩眼技术的区别。少

项目成果

川手健次: "セメントレスステムの術直後固定性に関する研究"Hip Joint. 25. 420-423 (1999)

Kenji Kawate：“非骨水泥柄术后立即固定的研究” 髋关节 25. 420-423 (1999)。

Kenji Kawate, Tetsuji Ohmura, Nobuyuki Hiyoshi, Yumiko Natsume, Tomohiro Teranishi, Susumu Tamai, Yutaka Ohneda: "Experimental study on initial stability of a cementless stem"Hip Joint. 25. 420-423 (1999)

Kenji Kawate、Tetsuji Ohmura、Nobuyuki Hiyoshi、Yumiko Natsume、Tomohiro Teranishi、Susumu Tamai、Yutaka Ohneda：“非骨水泥柄初始稳定性的实验研究”髋关节。