TOTAL SURGICAL REPLACEMENT OF THE HUMAN HIP JOINT

该建议涉及：（1）骨重建和相关 植入后股骨近端的结构变化 非骨水泥型全髋关节置换术（THA）中的多孔涂层股骨部件 和（2）翻修失败的骨水泥型全髋关节置换术， 涂层股骨部件。 骨长入固定的前提是假体将保持 永久地固定在宿主骨上 因此，并发症 由于骨重建是主要的长期问题之一。 的 多孔涂层的位置和股骨柄的刚度是 可能影响机械环境的设计参数， 因此，非骨水泥型多孔股骨近端的重塑 涂层THA。 将使用犬模型提供关于 这两个参数对骨重建和结构的变化， 非骨水泥型THA 据报道，无菌性松动的影像学证据 在骨水泥型THA失败的骨水泥型翻修中为40%。 非骨水泥型多孔 涂层假体用于翻修型关节置换术，但不是 已知在这种情况下是否真的发生骨长入， 对骨重塑的长期影响。 一个犬翻修模型和一个 宿主骨和多孔骨之间界面处间隙的犬模型 涂层将用于提供对骨向内生长过程的了解， 增强这一过程的可能性， 非骨水泥型翻修THA后的重塑。

This proposal is concerned with: (1) bone remodeling and associated structural changes in the proximal femur subsequent to implantation of porous coated femoral components in cementless total hip arthroplasty (THA) and (2) revision of failed cemented total hip arthroplasty with porous coated femoral components. The premise of bone ingrowth fixation is that the prosthesis will remain firmly anchored to the host bone indefinitely. Consequently, complications due to bone remodeling contitute one of the major long-term concerns. The location of the porous coating and the stiffness of the stem are two of the design parameters likely to influence the mechanical environment and, hence, remodeling of the proximal femur subsequent to cementless porous coated THA. A canine model will be used to provide data on the effect of these two parameters on bone remodeling and structural changes following cementless THA. Radiographic evidence of aseptic loosening has been reported to be as high as 40% in cemented revision of failed cemented THA. Cementless porous coated prosthesis are being used for revision arthroplasty, but it is not known if bone ingrowth actually occurs in this situation nor are the long-term effects on bone remodeing known. A canine revision model and a canine model of a gap at the interface between the host bone and the porous coating will be used to provide insight into the process of bone ingrowth, into the possibility of enhancing this process, and into cortical bone remodeling following cementless revision THA.