Abstract

Objective The aim of this study was to evaluate the relationship between radiographic fit/fill measurements and biomechanical performance of three canine cementless total hip implant designs using an in vitro biomechanical testing protocol that replicates compression and torsion.

Study Design Eighteen (six/group) canine cadaveric femurs were implanted with one of three cementless total hip implant designs: (1) collarless, (2) collared or (3) lateral bolt stems. Femoral length, canal flare index (CFI), canal fill, stem fit, stem level and stem angle were measured as independent variables. Biomechanical performance was tested using physiological, non-destructive gait loading (loading protocols) and destructive testing (failure protocols).

Results During loading protocols, compressive stiffness was influenced by stem level (p < 0.05) and torsional stiffness was influenced by stem level and CFI for collarless stems (p < 0.05). During failure protocols, peak load was influenced by mediolateral (ML) stem angle (p < 0.05) and CFI (p < 0.01) for collarless stems and CFI for lateral bolt stems (p < 0.05). Peak torque was influenced by ML stem angle, craniocaudal stem angle and CFI for collarless stems (p < 0.05) and average ML fill for collared stems (p < 0.05).

Conclusion Biomechanical performance of collarless stems in cementless hip arthroplasty is more impacted by radiographic fit/fill than lateral bolt and collared stems. As a result, collarless stems may be more dependent on preoperative fit and intraoperative precision.

Author Contribution

Natalie J. Worden and Kristian J. Ash contributed to conception of study, study design, data acquisition, data analysis, interpretation of results and drafting of the submitted manuscript. Nathaniel R. Ordway and Mark A. Miller contributed to conception of study, study design and the acquisition, analysis and interpretation of biomechanical data. Kenneth A. Mann contributed to the conception, design and analysis and interpretation of data for biomechanical testing. Gretchen M. VanDeventer and Robert Hart contributed to conception of study and implantation of stems. Kristian J. Ash contributed to implantation of stems. Dominick M. Valenzano contributed to study design and interpretation of data. Mitsunori Kayano contributed to analysis and interpretation of data. Kei Hayashi contributed to conception of study, study design and interpretation of data. All authors revised and approved the submitted manuscript.

Publication History

Received: 07 November 2019

Accepted: 23 June 2020

Publication Date:
24 September 2020 (online)

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

中文翻译：

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三种用于非骨水泥全髋关节置换的种植体设计的射线照相和生物力学评估。

摘要

目的 这项研究的目的是使用可重复压缩和扭转的体外生物力学测试方案，评估三种犬类非骨水泥全髋关节植入物设计的放射线拟合/填充测量与生物力学性能之间的关系。

研究设计 18个（六个/组）犬尸体股骨被植入以下三种非骨水泥全髋关节植入物设计之一：（1）无领，（2）领或（3）侧向螺栓杆。股骨长度，根管扩张指数（CFI），根管充盈量，根管适合度，根管水平度和根管角均作为独立变量进行测量。使用生理，非破坏性步态负荷（负荷方案）和破坏性试验（失效方案）对生物力学性能进行了测试。

结果 在加载方案中， 无颈椎茎的抗压刚度受茎水平的影响（p <0.05），抗扭刚度受茎水平和CFI的影响（p  <0.05）。在失效方案中，峰值载荷受中外侧（ML）杆角（p  <0.05）和CFI（p  <0.01）（无领杆）和CFI（侧向螺栓杆）（p  <0.05）的影响。峰值扭矩受ML茎角，颅尾茎角和CFI（无领茎）的影响（p  <0.05）和平均ML填充（无领茎）的影响（p  <0.05）。

结论 在无骨水泥型髋关节置换术中，无环茎的生物力学性能比侧向螺栓和带环茎更受射线照相配合/填充影响。结果，无领茎可能更多地取决于术前的贴合度和术中的精确度。

作者贡献

Natalie J. Worden和Kristian J. Ash为研究构想，研究设计，数据采集，数据分析，结果解释和所提交手稿的撰写做出了贡献。Nathaniel R. Ordway和Mark A. Miller为研究概念，研究设计以及生物力学数据的获取，分析和解释做出了贡献。肯尼斯·A·曼（Kenneth A. Mann）为生物力学测试数据的概念，设计，分析和解释做出了贡献。Gretchen M. VanDeventer和Robert Hart为茎的研究和植入概念做出了贡献。Kristian J. Ash促进了茎的植入。Dominick M. Valenzano为研究设计和数据解释做出了贡献。Mitsunori Kayano为数据分析和解释做出了贡献。林敬惠（Kei Hayashi）为研究构想做出了贡献，研究数据的设计和解释。所有作者都修改并批准了提交的手稿。

出版历史

收到：2019年11月7日

接受：2020年6月23日

发布日期：
2020年9月24日（在线）

©2020年。Thieme。版权所有。

Georg Thieme Verlag KG
斯图加特·纽约