Fatigue Damage Evolution in Total Joint Replacements

全关节置换术中的疲劳损伤演变

• 批准号: 7634527
• 负责人: KENNETH A. MANN
• 金额: $ 33.32万
• 依托单位: UPSTATE MEDICAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-07-15 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7634527
• 关键词: 3-Dimensional; Accounting; Address; Affect; Arthroplasty; Bone Cements; Characteristics; Clinical; Clinical Data; Clinical assessments; Computer Simulation; Development; Elements; Evolution; Failure; Fatigue; Goals; Grant; Hand; Heating; Hip region structure; Immigration; Implant; In Vitro; Individual; Inferior; Mechanics; Modeling; Morphology; Motion; Nature; Operative Surgical Procedures; Outcome; Patients; Polishes; Porosity; Process; Property; Public Health; Relative (related person); Replacement Arthroplasty; Research; Research Personnel; Retrieval; Risk; Role; Simulate; Specimen; Structure; Surface; System; Techniques; Testing; Time; Total Hip Replacement; Vacuum; Work; base; bone; clinically relevant; computerized tools; design; implantation; improved; insight; interfacial; pre-clinical; programs; research study; response; stem; tool

DESCRIPTION (provided by applicant): Improving the clinical outcomes of total hip replacement continues to be limited by our understanding of the damage response of the system that causes loosening and the multi-factorial nature of the loosening process. Retrospective clinical data point to design, patient, and surgical factors that have an effect on the loosening process, but are often unable to underscore the failure mechanism. Implant migration in the short-term is a strong predictor of clinical loosening suggesting that there are negative factors built in at the time of surgery that contribute to eventual failure. During this last grant cycle, in vitro prepared cemented stem constructs have proven useful to elucidate some relationships between construct morphology and loosening process, but these experiments were limited to lab-prepared specimens and focused on interfacial failure mechanisms. The long-term goal of this research program is to achieve arthroplasties that function successfully for the lifetime of the patient without need for revision. Towards this end, we propose to develop robust experimental and computational tools that can be used for pre-clinical assessment of cemented total hip replacements after initial implantation. The approach used here is to (1) determine the fatigue damage/loosening response of components of the cemented hip construct, (2) combine these to assess the relative contribution to the overall evolution of the fatigue damage/loosening process, (3) validate that the mechanical response of in vitro prepared structures are comparable to post-mortem retrieved structures and (4) assess the role of clinically relevant surgical procedures on the loosening process. Construct morphology is carefully quantified or controlled as this is suspected as having an important role in mechanical function. In summary, we are addressing the long-term goal of improving outcomes of cemented hip replacements from three complementary levels: understanding the fundamental mechanics of individual components of the implant system using both in vitro prepared and post-mortem retrievals, developing a comprehensive damage model that can be used to assess the short-term outcome of implant systems, and assessing the response of clinically relevant variables. This work will be directly applicable to improving public health through development of pre-clinical tests to assess implant components and surgical techniques and to determine conditions that reduce the risk of loosening of joint replacements.

描述（由申请人提供）：改善总髋关节置换术的临床结果继续受到我们对导致松动和松动过程的多因素性质的系统损害响应的理解而受到限制的。回顾性的临床数据指向对松动过程产生影响的设计，患者和手术因素，但通常无法强调失败机制。植入物在短期内迁移是临床松动的有力预测指标，这表明手术时有一些负面因素导致最终失败。在最后一个赠款周期中，事实证明，体外制备的胶结茎结构可用于阐明构建体形态和松动过程之间的某些关系，但是这些实验仅限于实验室准备的标本，并专注于界面故障机制。该研究计划的长期目标是实现在患者一生中成功发挥作用而无需修订的关节层。为此，我们建议开发可靠的实验和计算工具，这些工具可用于临时评估初始植入后胶结的总髋关节置换。这里使用的方法是（1）确定粘性髋关节结构组件的疲劳损伤/松动响应，（2）结合它们以评估对疲劳损伤/松动过程的总体演化的相对贡献，（3）验证验证体面准备结构的机械响应是否可以在结构和临时性的结构中进行均可进行的效果验证，以评估clo的作用。构造形态经过仔细量化或控制，因为这被怀疑是在机械功能中起重要作用。总而言之，我们正在解决改善三个互补级别的固定髋关节替代结果结果的长期目标：了解使用体外准备和验尸的植入系统各个组件的基本机制，并开发一个可用于评估植入系统的短期结果的综合损害模型，并开发一个全面的损害模型，并评估临床响应的响应。这项工作将直接适用于通过开发临床前测试来评估植入物组件和手术技术，并确定降低关节置换风险的状况，从而改善公共卫生。