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首页> 外文期刊>Journal of Biomechanics >Primary stability of an anatomical cementless hip stem: A statistical analysis
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Primary stability of an anatomical cementless hip stem: A statistical analysis

机译：解剖性非骨水泥髋关节杆的主要稳定性：统计分析

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The primary stability that the surgeon can achieve during surgery is a determinant of the clinical success of cementless implants. Thus, estimating what level of primary stability can be obtained with a new design is an important aspect of pre-clinical evaluation. The primary stability of a cementless hip stem is not only affected by the implant design, but also by other factors such as the mechanical quality of the host bone, the presence of gaps around the bone-implant interface, the body weight of the patient, and the size of the implant. Even the most extensive experimental study can only explore a small sub-set of all possible combinations found in vivo. To overcome this limitation, we propose a combination of experimental and numerical methods. The primary stability of a cementless anatomical stem is assessed in vitro. A finite element model is developed to accurately replicate the same experiment. The model is then parameterised over the various factors that affect the primary stability, and used in a Monte Carlo scheme to assess the primary stability over a simulated population. In this study, the method was used to investigate the mechanical stability of an anatomical cementless stem over more than 1000 simulated cases. Twenty cases were found macroscopically unstable, due to a combination of unfavourable conditions. The rest of the Monte Carlo sample showed on average a peak micromotion under stair climbing loading of 206 +/- 159 mu m. The proposed method can be used to evaluate new designs in conditions more representative of the variability in clinical practice. (c) 2005 Elsevier Ltd. All rights reserved.
机译：外科医生在手术过程中可以达到的主要稳定性是非骨水泥植入物临床成功的决定因素。因此，评估新设计可达到的一级稳定性水平是临床前评估的重要方面。非骨水泥型髋关节的主要稳定性不仅受植入物设计的影响，还受到其他因素的影响，例如宿主骨骼的机械质量，骨骼与植入物界面周围是否存在缝隙，患者的体重，和植入物的尺寸。即使是最广泛的实验研究也只能探索体内发现的所有可能组合的一小部分。为了克服此限制，我们提出了一种实验方法和数值方法的组合。在体外评估非骨水泥解剖茎的主要稳定性。开发了一个有限元模型来精确地复制相同的实验。然后，在影响主要稳定性的各种因素上对模型进行参数化，并在蒙特卡洛方案中使用该模型来评估模拟总体上的主要稳定性。在这项研究中，该方法用于研究超过1000个模拟案例的解剖性非骨水泥柄的机械稳定性。由于不利条件的结合，发现20例在宏观上不稳定。其余的蒙特卡洛样品平均显示出在206 +/- 159微米的爬楼梯载荷下的微动峰值。所提出的方法可用于在更能代表临床实践变异性的条件下评估新设计。 （c）2005 Elsevier Ltd.保留所有权利。

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