摘要
背景:在因骨溶解和内衬失败进行翻修手术时,用骨水泥将新聚乙烯内衬固定于稳定金属髋臼内是可选择的手术方式。如果金属髋臼外翻或前倾角度不良,单纯更换内衬可有脱位的风险。目的:了解聚乙烯内衬在一定范围内改变接触面积以骨水泥固定于金属髋臼内的早期力学强度。方法:选用40个60 mm外径的金属髋臼、40个28 mm内径的聚乙烯内衬,其中8个聚乙烯内衬外径51 mm为标准锁定组即对照组,32个聚乙烯内衬外径47 mm按内衬与髋臼赤道面交角不同平均分为0°、10°、20°、30°四个实验组。内衬外表面纹理化后以骨水泥固定于金属髋臼内,各组分别进行杠杆及扭转力学实验,观察内衬或内衬-骨水泥界面失败的情况,测量标准锁定装置及骨水泥固定内衬的最大抗杠杆力及抗扭力扭矩。结果:对照组所有内衬均出现分离或移位,实验组各组均未出现内衬-骨水泥界面的失败。4个实验组的最大抗杠杆力及抗扭力扭矩均优于对照组(P<0.05)。实验组各组间最大抗杠杆力及最大抗扭力扭矩的差异无统计学意义(P>0.05)。结论:聚乙烯内衬以骨水泥固定于金属髋臼内可以获得足够的初始固定力学强度。聚乙烯内衬外表面纹理化后,内衬与骨水泥、金属髋臼接触面积减少在一定范围内不会影响内衬-骨水泥界面的初始固定力学强度。
Background： Cementing polyethylene liner into a well-fixed and well-positioned acetabular metal shell has been considered as an alternative procedure in cases of osteolysis or liner failure. If a stable cup was inappropriately inclined or anteverted,liner exchange would be in risk of dislocation.Objective： To evaluate the strength of cementing polyethylene liner into a metal acetabular shell with different contact areas in early term of the procedure.Methods： According to liner fixed methods and different degree versions with respect to the shell, 40 pairs of metal acetabular cups and polyethylene liners were divided into groups. 51 mm outer diameter（OD） liners were fixed in 60 mm ODmetal shells with standard locking mechanism and 47 mm OD liners were cemented into identical shells. Lever- out and torsion tests were performed to observe constructs＇ fail and measure the early strength of standard locking mechanism and liner-cement interface.Results： All liners with standard locking mechanism failed in control group, while none of liners in experimental groups were disengaged from the cement mantle. Lever- out and torque strength in experimental groups were significantly greater than that in the control group（P〈0.05）, but no significant difference was found between four cemented liner groups（P〈0.05）.Conclusions： Cementing a polyethylene liner into a well-fixed shell is strong and safe in early fixation. With textured liner,declined contact area between polyethylene and cement will not weaken the liner-cement interface.
出处
《中国骨与关节外科》
2015年第4期348-351,343,共5页
Chinese Journal of Bone and Joint Surgery
基金
广东省科技厅项目(项目编号:2013B021800306)
广州市属高校科技计划项目(项目编号:1201420096)
广州医科大学科研项目(项目编号:2013C36)
