Improving the long-term performance of modular connections in artificial joints

提高人工关节中模块化连接的长期性能

• 批准号: 6346-2012
• 负责人: Wyss, Urs
• 金额: $ 1.46万
• 依托单位: University of Manitoba
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2012
• 资助国家: 加拿大
• 起止时间: 2012-01-01 至 2013-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=510058
• 关键词: Improving; long; term; performance; modular

Artificial joints have been used in increasing numbers since the middle of the last century to treat patients with diseased joints. Early on, mainly hip and knee joints were treated, and the devices were rarely implanted in persons younger than 60 years, as the implant survival rate was typically less than 15 years. Artificial joints have improved much in the last 50 years, and an implant survival rate of 90% or more can be expected after 15 years, in spite of the fact that they are increasingly being implanted in younger and more active patients. Improvements that were introduced in the last few years included manufacturing of artificial joints in separate pieces, such as the head, neck and stem in hip joints, and assembling them during surgery for both, primary and revision surgery. These so-called modular designs allow surgeons intra-operatively to optimally adjust the size, alignment, type of the articulation and fixation to an individual patient. Despite enormous efforts using computer modeling and elaborate near physiological testing, it appears that some of these newer primary and revision designs develop problems at their modular connections. More frequently, there is an increase in corrosion at the modular head-neck interface of hip joints, especially in hips with larger heads that can lead to tissue reactions such as the formation of cysts, pseudotumors and muscle damage. The long term goal of this research is to improve the performance of modular connections in artificial joints to achieve a reduction of revisions due to fractures and corrosion. The first study the applicant and his students will look at is the corrosion and fretting damage at head-neck tapers. The novel tests will be validated by reproducing clinical "damage" observed in a sample of retrieved artificial joints. The expected reduction of revision surgeries will increase the successful long-term performance of artificial joints benefitting the patients, and reduce the costs to health care. Training of engineering HQP in this area of expertise at the University of Manitoba and the Concordia Hip and Knee Institute will support the growth of the medical device industry in Canada.

自上世纪中叶以来，人工关节被越来越多地用于治疗关节疾病患者。早期，主要治疗髋关节和膝关节，这些装置很少植入60岁以下的人，因为植入装置的存活率通常不到15年。人工关节在过去的50年里有了很大的进步，尽管越来越多的人将人工关节植入到更年轻、更活跃的患者身上，但15年后，植入存活率有望达到90%或更高。过去几年引入的改进包括将人工关节制造成单独的部件，如髋关节的头、颈和柄，并在手术期间组装它们，用于初级手术和翻修手术。这些所谓的模块化设计允许外科医生在术中根据个别患者的情况最佳地调整关节的大小、对齐、关节类型和固定。尽管使用计算机建模和复杂的近生理测试付出了巨大的努力，但这些较新的初级和修订设计中的一些似乎在模块连接方面出现了问题。更常见的是，髋关节的模块化头颈界面处的腐蚀增加，特别是在头较大的髋关节，这可能会导致组织反应，如形成囊肿、假瘤和肌肉损伤。这项研究的长期目标是改善人工关节中模块连接的性能，以减少因骨折和腐蚀而造成的修正。申请者和他的学生将看到的第一个研究是头颈锥体的腐蚀和微动损伤。这些新的测试将通过复制临床上观察到的从取回的人工关节样本中观察到的“损伤”来验证。预计翻修手术的减少将提高人工关节的成功长期性能，使患者受益，并降低医疗保健成本。在马尼托巴大学和康科迪亚髋膝研究所接受工程HQP在这一专业领域的培训将支持加拿大医疗器械行业的发展。