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首页> 外文期刊>Journal of Biomechanics >Comparative in vitro study on the long term performance of cemented hip stems: validation of a protocol to discriminate between 'good' and 'bad' designs.
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Comparative in vitro study on the long term performance of cemented hip stems: validation of a protocol to discriminate between 'good' and 'bad' designs.

机译：骨水泥髋关节长期性能的体外比较研究：区分“好”和“坏”设计方案的验证。

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摘要

The long-term clinical success of cemented hip stems is influenced both by the implant design, and by the surgical procedure. A methodology is proposed for discriminating between implant designs with different clinical outcomes. The protocol was designed with industrial pre-clinical validation in mind.Two cemented stem types were tested, one (Lubinus SPII) having good and the other (Muller Curved) having poor clinical outcomes. Three implants for each type were subjected to a mechanical in vitro test of one million loading cycles. Each cycle reproduced the load components of stair climbing. Interface shear micromotion was measured during the test in the direction of rotation and along the stem axis. The stem roughness before and after the test was compared. After the test, the cement mantles were retrieved and inspected through dye penetrants to detect evidences of micro-damage. For each specimen, the events of the loosening process were examined, based on the in vitro data available, so as to analyze the whole failure mechanism.The protocol developed was sensitive to the implant design, with significantly different results being found for the two stem types, both in terms of stem-cement micromotions, surface roughness alteration, and cement mantle damage. The information yielded by the three different investigation techniques was consistent for each of the two groups of specimens tested, allowing a better understanding of the failure process. In vitro inducible micromotion and permanent migration measurements, together with cement-stem interface fretting damage and cement fatigue damage, can help predicting the clinical performance of cemented stems.
机译：髋骨骨水泥的长期临床成功既受植入物设计的影响，也受手术程序的影响。提出了一种用于区分具有不同临床结果的植入物设计的方法。设计该方案时要考虑到临床前的临床验证，测试了两种骨水泥型，一种（Lubinus SPII）良好，另一种（Muller Curved）临床结果差。对每种类型的三个植入物进行一百万次加载循环的机械体外测试。每个周期都再现了爬楼梯的载荷分量。在测试过程中沿旋转方向和沿阀杆轴线测量了界面剪切微运动。比较测试前后的茎粗度。测试后，取回水泥地幔，并通过染料渗透剂进行检查，以发现微损伤的迹象。对于每个标本，根据可用的体外数据检查松动过程的事件，以分析整个失效机制。制定的方案对植入物设计敏感，两个茎的结果差异很大类型，包括干水泥微运动，表面粗糙度变化和水泥地幔破坏。三种不同的调查技术得出的信息对于两组测试样本中的每组都是一致的，从而可以更好地了解破坏过程。体外诱导的微动和永久迁移测量，以及水泥-茎界面微动损伤和水泥疲劳损伤，可以帮助预测水泥杆的临床表现。

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