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TOTAL SURGICAL REPLACEMENT OF THE HUMAN HIP JOINT

人类髋关节的完全手术置换

基本信息

批准号：
6171608
负责人：
JORGE O GALANTE
金额：
$ 19.9万
依托单位：
RUSH UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
1979
资助国家：
美国
起止时间：
1979-05-01 至 2002-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6171608
关键词：
arthroplasty biological models bone density dogs femur hip prosthesis hip surgery joints mechanical stress medical implant science medical rehabilitation related tag nonhuman therapy evaluation physiologic bone resorption postoperative state scanning electron microscopy skeletal stress

项目摘要

DESCRIPTION (Adapted from the Applicant's Abstract): This proposal is concerned with adaptive bone remodeling of the femur following cementless and cemented total hip arthroplasty. Clinically, over 50% of the periprosthetic bone mass can be lost following hip arthroplasty. The practical health-related goal is to prolong implant survivorship and facilitate potential revision surgery by minimizing bone loss attributed to stress-shielding, the initial reduction in mechanical loading of the bone in the proximal femur due to load transfer through the prosthesis. The central hypothesis is that (in the absence of osteolysis related to degradation of the implant) stress-shielding represents the most important independent variable or "final common pathway" through which patient, implant and technical factors account for a large proportion of the bone loss following total hip arthroplasty. If this thesis is correct, then factors such as age and source of implant bonding (e.g., bone ingrowth versus cement fixation) play a role in the adaptive process, largely through mechanically-mediated pathways. The applicants propose to test their hypothesis by examining three of its implications: (i) individual variation in stress-shielding explains a large proportion of the individual variation in femoral bone loss following hip replacement; (ii) bone loss has the same relationship to stress-shielding in skeletally mature young and old animals following cementless hip replacement, even though the actual amount of bone loss may vary as a function of age; and (iii) bone loss has the same relationship to stress-shielding in cemented and cementless total hip arthroplasty. Individual estimates of stress-shielding will be made based on animal-specific finite element modeling of a canine model. These estimates will be correlated with measurements of change in periprosthetic bone mass made in the same animals. In this way, the actual variance in the dependent variable (change in bone mass), explained by variance in the independent variable (stress-shielding) and the nature of the relationship (linear or nonlinear), will be determined. Use of an animal model allows other causes of bone loss to be largely eliminated, thus permitting the effects of stress-shielding to be clearly defined.

描述（改编自申请人的摘要）：该提案是关注非骨水泥植入后股骨的适应性骨重建和骨水泥全髋关节置换术。临床上，超过50%的髋关节置换术后假体周围骨质可能丢失。的实际的健康相关目标是延长植入物存活率，通过最大限度地减少由于以下原因导致的骨丢失，促进潜在的翻修手术应力遮挡，即骨的机械负荷的初始减少，由于通过假体的载荷转移，股骨近端。中央假设是（在不存在与降解相关的骨质溶解的情况下，植入物）应力屏蔽代表了最重要的独立可变或“最终共同路径”，患者、植入物和技术因素占骨丢失的很大比例，全髋关节置换术。如果这个论点是正确的，那么年龄等因素以及注入键合的源极（例如，骨长入与骨水泥固定）在适应过程中发挥作用，主要是通过机械介导途径。申请人建议通过检查它的三个含义：（一）个体差异的压力屏蔽解释了股骨骨丢失中很大一部分的个体差异髋关节置换术后;（ii）骨丢失与成年幼龄和老龄动物的应力屏蔽，非骨水泥髋关节置换术，即使实际的骨质流失量可能随着年龄的变化而变化;和（iii）骨丢失与骨水泥型和非骨水泥型全髋关节置换术中的应力遮挡。将根据以下内容对应力屏蔽进行单独估计：犬模型的动物特异性有限元建模。这些估计将与假体周围骨量变化的测量值相关在同一种动物身上做的。这样，因变量的实际方差变量（骨质变化），通过独立变量的方差解释变量（应力屏蔽）和关系的性质（线性或非线性）将被确定。动物模型的使用允许其他原因骨丢失的大部分被消除，从而允许的影响，应明确定义应力屏蔽。

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

ESB Research Award 1992. The mechanism of bone remodeling and resorption around press-fitted THA stems.

DOI：
10.1016/0021-9290(93)90001-u
发表时间：
1993-04
期刊：
Journal of biomechanics
影响因子：
2.4
作者：
B. Rietbergen;R. Huiskes;H. Weinans;D. Sumner;T. Turner;J. Galante
通讯作者：
B. Rietbergen;R. Huiskes;H. Weinans;D. Sumner;T. Turner;J. Galante

Effects of radiation on fixation of non-cemented porous-coated implants in a canine model.

辐射对犬模型中非骨水泥多孔涂层植入物固定的影响。

DOI：
发表时间：
1990
期刊：
The Journal of bone and joint surgery. American volume
影响因子：
0
作者：
Sumner,DR;Turner,TM;Pierson,RH;Kienapfel,H;Urban,RM;Liebner,EJ;Galante,JO
通讯作者：
Galante,JO

Adaptive bone remodeling around bonded noncemented total hip arthroplasty: a comparison between animal experiments and computer simulation.

围绕粘合非骨水泥全髋关节置换术的适应性骨重塑：动物实验与计算机模拟之间的比较。

DOI：
10.1002/jor.1100110405
发表时间：
1993
期刊：
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
影响因子：
0
作者：
Weinans,H;Huiskes,R;vanRietbergen,B;Sumner,DR;Turner,TM;Galante,JO
通讯作者：
Galante,JO

Bone ingrowth into the tibial component of a canine total condylar knee replacement prosthesis.

骨向犬全髁膝关节置换假体的胫骨组件内生长。

DOI：
10.1002/jor.1100070616
发表时间：
1989
期刊：
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
影响因子：
0
作者：
Turner,TM;Urban,RM;Sumner,DR;Skipor,AK;Galante,JO
通讯作者：
Galante,JO

Finite Element analyses to study periprosthetic bone adaptation.

有限元分析研究假体周围骨的适应性。