GLUTEAL ATTACHMENT TO FEMORAL ALLOGRAFTS IN HIP REVISION

本研究的目标是增加功能性使用和长期- 全髋关节置换术和髋关节翻修术患者的远期结局。 这项研究是重要的，因为需要使用全骨 节段性同种异体移植物，以取代近端股骨， 继发于绝经、废用、多次翻修的骨量不足 关节成形术，或有肿瘤浸润。问题在于 事实上，由于肌肉不足或失败而导致的功能障碍 通常发生与同种异体移植物的再附着。工作假设 这项调查是，有具体的长期时间有关 功能性负重、密度测定、组织学 和同种异体移植物结合过程中的机械特性 股骨近端重建后的肌腱和骨， 选择最佳的重建技术。使用 犬模型，三种臀肌附着方法，股骨近端 将比较同种异体移植物：（a）宿主肌腱与同种异体肌腱 使用水平褥式缝合的连接，（B）宿主骨到同种异体移植物 使用缆线夹系统的骨附着，和（3）宿主骨双皮质 半壳包裹同种异体骨，不破坏 宿主肌腱-骨界面。假体将被固定在冷冻的 同种异体移植物和这种复合骨水泥的股骨远端后， 切除股骨近端25%将对动物进行评价 每两个月进行一次X线摄影、密度测定和功能性负重 以及9（24只犬）和18（24只犬）个月时的组织学和机械 在人道安乐死后进行测试。

The goals of this research are to increase the functional use and long- term outcome of patients with total hip replacement and hip revision. This study is important due to the necessity of using whole bone segmental allografts to replace proximal femurs that have become deficient in bone stock secondary to menopause, disuse, multiple revision arthroplasties, or that have tumor infiltration. The problem lies in the fact that functional impairment due to inadequate or failed muscle reattachment to the allograft commonly occurs. The working hypothesis for this investigation is that there are specific long-term time-related changes that occur in functional weight-bearing, densitometry, histology, and mechanical characteristics during the incorporation of the allograft tendon and bone following proximal femoral reconstruction that will allow selection of the optimal technique for this reconstruction. Using a canine model, three methods of gluteal attachment to proximal femoral allografts will be compared: (a) a host tendon to allograft tendon attachment using horizontal mattress sutures, (b)a host bone to allograft bone attachment using a cable grip system, and (3) a host bone bicortical half-shell wrapped around the allograft bone without disruption of the host tendon-bone interface. The prosthesis will be cemented to a frozen allograft and this composite cemented to the distal femur after an excision of the proximal 25% of the femur. The animals will be evaluated bimonthly with radiography, densitometry, and functional weight-bearing and at 9 (24 dogs) and 18 (24 dogs) months with histology and mechanical testing following humane euthanasia.