Multiacquisition Variable-Resonance Image Combination Magnetic Resonance Imaging Used to Study Detailed Bone Apposition and Fixation of an Additively Manufactured Cementless Acetabular Shell.
Multiacquisition Variable-Resonance Image Combination Magnetic Resonance Imaging Used to Study Detailed Bone Apposition and Fixation of an Additively Manufactured Cementless Acetabular Shell.
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DOI：
10.1016/j.artd.2020.07.019
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发表时间：
2020-12-01
影响因子：
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通讯作者：
Westrich, Geoffrey H
中科院分区：
文献类型：
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作者：
Alamanda, Vignesh K;Demartino, Ivan;Westrich, Geoffrey H
背景技术背景：利用磁共振成像（MRI）在3个维度上评估骨固定的能力可以更好地理解植入物设计和骨整合。我们假设一种新的三维打印的非骨水泥型多孔髋臼部件（斯特赖克Trident II TritaniumTM）将显示出比来自同一制造商的早期髋臼杯更好的固定，如通过多光谱MRI的非侵入性技术所评估的。对19例植入新的3-在1年随访时，20名患者接受了来自同一制造商的上一代髋臼杯。每个髋臼杯均在全球范围内以及9个特定区域进行分级。对每个区域进行整合分级：0，完全骨整合; 1，存在纤维膜; 2，骨质溶解; 3，存在液体。采用混合效应逻辑回归模型比较2组之间的固定。结果：两个队列中的所有髋臼杯均显示大于90%的估计整体骨整合（三维打印髋臼杯，99.4%;常规髋臼杯91.6%），任何髋臼杯均未观察到骨质溶解或液体。三维打印髋臼杯的171个区域中有1个（0.6%）被分级为存在纤维膜，而二维组的180个区域中有15个（8.3%）被分级为纤维膜。值得注意的是，螺钉孔区域被省略，但可能会被读取为纤维膜areas.CONCLUSION：使用多采集可变共振图像组合选择性MRI，我们的分析显示，在3维打印的杯子比对照组在1年的随访更大的骨整合和更少的纤维膜形成。
BACKGROUND: The ability to utilize magnetic resonance imaging (MRI) to assess bony fixation in 3 dimensions may allow a better understanding of the implant design and bony integration. We hypothesized that a new 3-dimensionally printed cementless highly porous acetabular component (Stryker Trident II TritaniumTM) would show better fixation than an earlier cup from the same manufacturer as assessed by the noninvasive technique of multispectral MRI.METHODS: Multiacquisition variable-resonance image combination selective metal suppression MRI was performed in 19 patients implanted with a new 3-dimensionally printed cup and 20 patients who had received a previous-generation cup from the same manufacturer at 1-year follow-up. Each cup was graded globally as well as by 9 specific zones. Integration grades were performed for each zone: 0, full bone integration; 1, fibrous membrane present; 2, osteolysis; and 3, fluid present. A mixed-effects logistic regression model was used to compare fixation between the 2 groups.RESULTS: All cups in both cohorts showed greater than 90% estimated global bony integration (3-dimensionally printed cups, 99.4%; regular cups 91.6%) with no osteolysis or fluid observed in any cup. The 3-dimensionally printed cup had 1 of 171 zones (0.6%) graded as fibrous membrane present, while the 2-dimensional group had 15 of 180 zones (8.3%) graded as fibrous. Of note, screw hole regions were omitted but may be read as fibrous membrane areas.CONCLUSION: Using multiacquisition variable-resonance image combination selective MRI, our analysis showed greater osteointegration and less fibrous membrane formation in the 3-dimensionally printed cups than the control group at 1-year follow-up.