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: 6346-2013
• 负责人: Wyss, Urs
• 金额: $ 1.68万
• 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: 2015
• 资助国家: 加拿大
• 起止时间: 2015-01-01 至 2016-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=568460
• 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, so that a 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 more modular designs, which allow surgeons intra-operatively to optimally adjust the articulation, geometric features and fixation to an individual patient. Despite enormous efforts using computer modeling and elaborate near physiological testing, it appears that some of these new 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 adverse tissue reactions such as the formation of cysts, pseudotumors and muscle damage. The long term goal of this industry independent research is to improve the performance of modular connections in artificial joints to achieve a reduction of revisions due to fractures, corrosion and adverse tissue reactions. The proposed work will look at modular connections through the failure analysis of explanted joints, computer modeling and in vitro testing of improvements of modular connections resulting from this research program. A key outcome will be the development of a novel fatigue test that includes corrosion of modular connections between large heads and the neck of hip implants. The expected reduction of revisions will increase the successful long-term performance of artificial joints benefiting the patients, and reduce the costs to health care. Training of 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，越来越多的人使用人工关节来治疗患有关节疾病的患者。早期主要治疗髋关节和膝关节，很少将装置植入60岁以下的人群，因为植入物的存活率通常低于15年。人工关节在过去 50 年里已经有了很大的进步，尽管越来越多的人工关节被植入到更年轻、更活跃的患者体内，但 15 年后的存活率仍有望达到 90% 或更高。过去几年引入的改进包括更加模块化的设计，使外科医生能够在术中针对个别患者优化关节、几何特征和固定。尽管在计算机建模和详细的近生理测试方面付出了巨大的努力，但其中一些新设计似乎在其模块化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，特别是在头部较大的髋部，可能导致不良组织反应，例如囊肿、假瘤和肌肉损伤的形成。该行业独立研究的长期目标是提高人工关节中模块化连接的性能，以减少因骨折、腐蚀和不良组织反应而导致的翻修。拟议的工作将通过外植关节的故障分析、计算机建模和对本研究项目产生的模块化连接改进的体外测试来研究模块化连接。一个关键成果将是开发一种新颖的疲劳测试，其中包括大头和髋关节植入物颈部之间的模块化连接的腐蚀。预期翻修次数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。曼尼托巴大学和康科迪亚髋关节和膝关节研究所在该专业领域对 HQP 进行培训将支持加拿大医疗器械行业的发展。