摘要
目的骨水泥在髋关节置换术中用于固定假体柄,效果良好,但后期骨水泥-骨界面结合强度降低是导致假体固定失败的重要原因。髓腔环境是影响骨水泥-骨界面结合强度的重要因素,本文通过创造相对干燥的骨髓腔环境,观察其能否提高骨水泥-骨界面的结合强度,为下一步临床应用提供理论依据。方法将10月龄,平均体重122kg的16头活猪的32根股骨随机分为6组:抗拉力实验组(A1)、对照组(A2)和抗压力实验组(B1)、对照组(B2),每组各6根;影像学实验组(C1)和对照组(C2),每组各4根。实验组猪股骨扩髓后干燥髓腔;对照组仅用高压脉冲冲洗髓腔,最后皆用骨水泥枪将骨水泥加压注入髓腔。24h后将实验组与对照组分别进行力学、影像学分析,比较实验组与对照组骨水泥-骨界面的结合强度。结果当对各受测试模型施加拉力或压力达到一定强度时骨水泥柱被整体拉移或发生松动时记录各组标本数据分别为A1组(2.17±0.10)KN,A2组(1.81±0.08)KN,B1组(3.22±0.08)KN,B2组(2.85±0.12)KN,两两配对t检验差异具有统计学意义;CT横扫可见干燥组界面结合率为86.46%,对照组界面结合率为66.67%,经χ2检验得P<0.01,认为C1和C2具有显著差异性。镜下观察发现两组标本的骨水泥及骨小梁表面的情况有明显不同。结论相对干燥的骨髓腔环境可显著增加骨水泥-骨界面抗拉力和压力的力量,并可以明显提高骨水泥-骨小梁之间的微嵌合程度,提高骨水泥-骨界面间的稳定性。
Objective Bone cement is widely used in the total hip arthroplasty to fix prosthesis handle and has achieved good results.But at the later stage,the decreased binding intensity of bone cement-bone interface is an important cause for the failure of prosthesis fixation.Therefore,by creating a relatively dried marrow cavity,we try to observe whether it can increase the bonding intensity of the bone cement-bone interface and provide a theoretical ba sis for its further clinical applications.Methods Totally 32 femurs from 16 pigs with an average age of 10 months and the average weight of 122kg were randomly divided into six groups：the experimental group （A1） and control group（A2） of anti-tensile force,experimental group （B1） and control group （B2） of anti-pressure （n =6 in each group）,experimental group（C1） and control group（C2） of imaging（n =4 in each group）.The marrow cavities of the three experimental groups were dried with improved thermal drying device after expanding,while the control groups were only flushed with high-voltage pulse.All the six groups were pressurized with cement into the marrow cavity by using cement gun.After 24 hours,the experimental groups and control groups underwent mechanics and imaging analysis with data processed by SPSS19.0 respectively.Results The pulling force record when the cement loosened was（2.17 ± 0.10）KN in group A1 and （1.81 ± 0.08）KN in group A2;following the statistical results of Paired-Samples T Test,there was significant statistical difference between the two groups;the stress record was（3.23 ± 0.08）KN in group B1 and （2.85 ± 0.12）KN in group B2 ; following the statistical results of Paired-Samples T Test,similarly,there was significant statistical difference between B1 and B2;the bonding rate was 86.46％ in the experimental groups and 66.67％ in the control group ;following the statistical results of chi-square test（P ＜ 0.01）,there was significant difference between C1 and C2.Microscopic observation revealed t
出处
《创伤外科杂志》
2014年第5期436-439,共4页
Journal of Traumatic Surgery
关键词
髋关节置换
骨髓腔
骨水泥
hip arthroplasty
bone marrow cavity
bone cement
