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首页> 外文期刊>Proceedings of the Institution of Mechanical Engineers, Part H. Journal of Engineering in Medicine >Using 'subcement' to simulate the long-term fatigue response of cemented femoral stems in a cadaver model: could a novel preclinical screening test have caught the Exeter matt problem?
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Using 'subcement' to simulate the long-term fatigue response of cemented femoral stems in a cadaver model: could a novel preclinical screening test have caught the Exeter matt problem?

机译：在尸体模型中，使用“地下室”模拟水泥骨股骨杆的长期疲劳响应：一种新的临床前筛查测试是否可以解决埃克塞特无光问题？

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摘要

Previously, cement was formulated with degraded fatigue properties (subcement) to simulate long-term fatigue in short-term cadaver tests. The present study determined the efficacy of subcement in a 'preclinical' test of a design change with known clinical consequences: the 'polished'-to-'matt' transition of the Exeter stem (revision rates for polished stems were twice those for matt stems). Contemporary stems were bead blasted to give Ra51 mm (matt finish). Matt and polished stems were compared in cadaver pairs under stairclimbing loads (three pairs of size 1; three pairs of size 3). Stem micromotion was monitored during loading. Post-test transverse sections were examined for cement damage. Cyclic retroversion decreased for polished stems but increased for matt stems (p>0.0001). The implant size had a substantial effect; retroversion of (larger) size-3 stems was half that of size-1 stems, and polished size-3 stems subsided 2.5 times more than the others. Cement damage measures were similar and open through-cracks occurred around both stems of two pairs. Stem retroversion within the mantle resulted in stem-cement gaps of 50-150 mm. Combining information on cyclic motion, cracks, and gaps, it was concluded that this test 'predicted' higher revision rates for matt stems (it also implied that polished size-3 stems might be superior to size-1 stems).
机译：以前，水泥的配方具有降低的疲劳性能（水泥），可在短期尸体测试中模拟长期疲劳。本研究确定了在进行具有已知临床后果的设计变更的“临床前”测试中小药的功效：埃克塞特茎从“抛光”到“哑光”的过渡（抛光茎的修订率是哑光茎的修订率的两倍） ）。当代茎经过喷砂处理，得到Ra51毫米（无光泽）。比较了在楼梯荷载下（三对尺寸为1;三对尺寸为3）在尸体对中的哑光和抛光茎。在装载过程中监测茎微动。测试后的横断面检查水泥是否损坏。磨光茎的循环逆行性下降，而无光泽茎的回旋性上升（p> 0.0001）。植入物的尺寸有很大的影响。 （较大的）3号茎的倒退是1号茎的一半，而3号抛光的茎下降了2.5倍。水泥的破坏措施是相似的，并且在两对的两个茎周围都出现了开裂。地幔内的茎逆行导致茎-水泥间隙为50-150 mm。结合有关循环运动，裂纹和间隙的信息，得出的结论是，该测试“预测”了哑光烟梗的更高修整率（也暗示抛光的3号烟梗可能优于1号烟梗）。

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