股骨近端窗不同位置的生物力学比较：一项尸体研究

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-06-06 DOI:10.1016/j.clinbiomech.2025.106589

Matthias Trost , Lennard Loweg , Julian Koettnitz , Malte Holschen , Christian Karl Spies , Martin Scaal , Peer Eysel , Johannes Oppermann

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引用次数: 0

摘要

背景：在翻修髋关节置换术中，更换骨水泥假体是一项具有挑战性的手术，因为通常需要股骨窗来实现完全骨水泥去除。本生物力学研究的目的是比较股骨近端窗不同位置的稳定性。方法36根浸泡过的人尸体股骨分为6组：方形或圆角腹侧窗组；有方形或圆角的侧窗；背窗有方形或圆角。从小粗隆中间开始，在远端方向锯开一个1.6 × 10 cm大小的窗口。在固定位移速率为20 mm/min的轴向载荷下，利用材料试验机测量股骨的生物力学性能。结果：两组间的平均破坏强度无显著差异(腹侧窗：方角6688 N，圆角5391 N；侧窗：方角2889 N，圆角4402 N；背窗：方角5082 N，圆角3626 N) （P = 0.08）。两组间通过窗骨折数量差异有统计学意义(腹侧窗：方角3例，圆角0例；侧窗：方角5个，圆角5个；背窗：方角5个，圆角2个)（P = 0.01）。股骨近端侧窗骨折发生率最高，腹侧窗骨折发生率最低。因此，外科医生在翻修髋关节置换术中更换骨水泥假体时可能会考虑使用腹侧窗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Biomechanical comparison of different locations for a proximal femoral window: A cadaver study

Background

In revision hip arthroplasty, changing a cemented stem is a challenging procedure, as a femoral window is often necessary to achieve total cement removal. The aim of this biomechanical study was to compare the stability of different locations for a proximal femoral window.

Methods

Thirty-six macerated human cadaver femora were assigned to one of the six groups: ventral window with square or rounded corners; lateral window with square or rounded corners; and dorsal window with square or rounded corners. Starting at the middle of the lesser trochanter, a window 1.6 × 10 cm in size was sawed in a distal direction. The biomechanical properties of the femora were measured using a materials testing machine in axial loading at a fixed displacement rate of 20 mm/min.

Findings

The mean failure strength did not differ significantly between the groups (ventral window: square corners 6688 N, rounded corners 5391 N; lateral window: square corners 2889 N, rounded corners 4402 N; dorsal window: square corners 5082 N, rounded corners 3626 N) (P = 0.08). The number of fractures through the window differed significantly between the groups (ventral window: square corners 3, rounded corners 0; lateral window: square corners 5, rounded corners 5; dorsal window: square corners 5, rounded corners 2) (P = 0.01).

Interpretation

Lateral locations of the proximal femoral window were associated with the largest number of fractures through the window, and ventral locations with the smallest number. Surgeons may therefore consider using a ventral window when changing a cemented stem in revision hip arthroplasty.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.