髋臼翻修杯初步稳定性的计算机评价:标准与锁定螺钉。

IF 1.7 4区 医学 Q4 BIOPHYSICS
Federico Andrea Bologna, Nicholas Elena, Davide Bentivoglio, Alessandro Aprato, Mara Terzini, Cristina Bignardi, Stefano Giaretta, Alberto Momoli
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引用次数: 0

摘要

鉴于翻修全髋关节置换术的复杂性日益增加,确保髋臼翻修杯(ACs)的最佳稳定性至关重要,特别是在骨库存丢失的情况下。在这项研究中,通过模拟不同的螺钉放置配置,包括所有标准,所有锁定和混合设置,在不同的负载情况下,ac的主要稳定性进行了研究。采用有限元模型模拟“行走”、“下楼梯”和“站立”三种主要载荷情况,评估骨-假体界面的应力分布和微运动。结果表明:“下台阶”;加载工况产生了最高的von Mises应力和滑动距离,标志着它是最关键的加载场景。与使用锁定螺钉相比,使用所有标准螺钉的配置显示出更高的峰值应力和更小的稳定区域。虽然锁紧螺钉提供了更坚固的连接,但混合螺钉配置通过结合标准螺钉的压缩优势和锁紧螺钉的刚性固定提供了平衡的性能。单个标准螺钉配合锁定螺钉的配置显示出更高的稳定性,这表明这种组合在临床应用中是有利的。本研究强调了螺钉类型和放置对确保ACs的初级稳定性的重要性。如果可行,建议使用锁紧螺钉。对于允许两种螺钉类型的ac,从标准压缩螺钉开始,然后锁定螺钉的混合配置似乎是最佳的。未来的研究应进一步探索螺钉几何形状和长度的各种组合,以完善这些发现并提高髋臼翻修的手术效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
In Silico Evaluation of the Primary Stability of Acetabular Revision Cups: Standard Versus Locking Screws.

Given the increasing complexity of revision total hip arthroplasty, ensuring optimal stability of acetabular revision cups (ARCs) is crucial, especially in cases of bone stock loss. In this study, the primary stability of ARCs was investigated by modeling various configurations of screw placements, including all standard, all locking, and mixed setups, under different load scenarios. Finite element (FE) models were implemented to evaluate the stress distribution and micromotions at the bone-prosthesis interface, simulating three primary load cases: "walking," "stairs-down," and "stand-up." The results indicated that the stairs-down load case generated the highest von Mises stresses and sliding distances, marking it as the most critical load scenario. Configurations using all standard screws showed higher peak stresses and reduced stable areas, compared to those utilizing locking screws. While the locking screws provided a stiffer connection, the mixed screw configuration offered a balanced performance by combining the compression benefits of standard screws with the rigid fixation of locking screws. Configurations with a single standard screw complemented by locking screws showed enhanced stability, suggesting this combination could be advantageous in clinical applications. This study underscores the importance of screw type and placement in ensuring the primary stability of ARCs. Locking screws are recommended for use when feasible. For ARCs allowing both screw types, a mixed configuration starting with a standard compression screw followed by locking screws appears optimal. Future research should further explore various combinations of screw geometries and lengths to refine these findings and enhance surgical outcomes in acetabular revisions.

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来源期刊
CiteScore
3.40
自引率
5.90%
发文量
169
审稿时长
4-8 weeks
期刊介绍: Artificial Organs and Prostheses; Bioinstrumentation and Measurements; Bioheat Transfer; Biomaterials; Biomechanics; Bioprocess Engineering; Cellular Mechanics; Design and Control of Biological Systems; Physiological Systems.
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