聚乙烯衬垫与金属外壳的胶结:与机械稳定性有关的因素

K. Bonner, R. Delanois, G. Harbach, M. Bushelow, Michael A. Mont
{"title":"聚乙烯衬垫与金属外壳的胶结:与机械稳定性有关的因素","authors":"K. Bonner, R. Delanois, G. Harbach, M. Bushelow, Michael A. Mont","doi":"10.2106/00004623-200209000-00011","DOIUrl":null,"url":null,"abstract":"Background: Various clinical situations may make polyethylene liner exchange desirable in the setting of a well-fixed metal shell. Options have included a simple polyethylene liner exchange or revision of the entire acetabular shell. A recently introduced technique involves cementation of a new liner into a well-fixed metal shell. The purposes of this study were to quantify the mechanical integrity of this method of liner fixation, to evaluate the factors that may influence immediate liner fixation, and to compare this construct with a standard locking mechanism.Methods: One modular acetabular cup design was evaluated. Variables that may contribute to the mechanical integrity of the construct were evaluated via lever-out and multiaxis dislocation testing methods. The variables included the size of the liner (undersized versus oversized), type of liner (all-polyethylene versus modular design), modification of the modular liner (unmodified versus grooved), and groove configuration (cruciform versus circumferential). Metal shells with and without screw-holes were also tested. The modular locking mechanism was used as the control.Results: None of the constructs failed at the cement-metal interface. All undersized liners required significantly higher loads to failure than either the controls (p < 0.001) or the oversized liners (p < 0.001). Oversized unmodified liners failed at significantly lower loads than the controls did (p < 0.01). The creation of circumferential grooves in the oversized liners significantly improved the strength of the constructs (p < 0.01), making them comparable with the controls. No significant differences were found among the four undersized groups (p > 0.3). The standard locking construct (control) and the oversized unmodified construct failed at a force of 2000 N in the multiaxis dislocation test. No other construct failed with use of this test mode.Conclusions: Cementation of a polyethylene liner into a metal shell can be stronger than a conventional locking mechanism if the liner is undersized. Cementation of an oversized liner into a shell should be performed with caution. The long-term durability of this fixation remains unknown.Clinical Relevance: Cementation of a polyethylene liner in a well-fixed metal shell may provide an alternative option in acetabular revision surgery.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"52 1","pages":"1587–1593"},"PeriodicalIF":0.0000,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"59","resultStr":"{\"title\":\"Cementation of a Polyethylene Liner into a Metal Shell: Factors Related to Mechanical Stability\",\"authors\":\"K. Bonner, R. Delanois, G. Harbach, M. Bushelow, Michael A. Mont\",\"doi\":\"10.2106/00004623-200209000-00011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Various clinical situations may make polyethylene liner exchange desirable in the setting of a well-fixed metal shell. Options have included a simple polyethylene liner exchange or revision of the entire acetabular shell. A recently introduced technique involves cementation of a new liner into a well-fixed metal shell. The purposes of this study were to quantify the mechanical integrity of this method of liner fixation, to evaluate the factors that may influence immediate liner fixation, and to compare this construct with a standard locking mechanism.Methods: One modular acetabular cup design was evaluated. Variables that may contribute to the mechanical integrity of the construct were evaluated via lever-out and multiaxis dislocation testing methods. The variables included the size of the liner (undersized versus oversized), type of liner (all-polyethylene versus modular design), modification of the modular liner (unmodified versus grooved), and groove configuration (cruciform versus circumferential). Metal shells with and without screw-holes were also tested. The modular locking mechanism was used as the control.Results: None of the constructs failed at the cement-metal interface. All undersized liners required significantly higher loads to failure than either the controls (p < 0.001) or the oversized liners (p < 0.001). Oversized unmodified liners failed at significantly lower loads than the controls did (p < 0.01). The creation of circumferential grooves in the oversized liners significantly improved the strength of the constructs (p < 0.01), making them comparable with the controls. No significant differences were found among the four undersized groups (p > 0.3). The standard locking construct (control) and the oversized unmodified construct failed at a force of 2000 N in the multiaxis dislocation test. No other construct failed with use of this test mode.Conclusions: Cementation of a polyethylene liner into a metal shell can be stronger than a conventional locking mechanism if the liner is undersized. Cementation of an oversized liner into a shell should be performed with caution. The long-term durability of this fixation remains unknown.Clinical Relevance: Cementation of a polyethylene liner in a well-fixed metal shell may provide an alternative option in acetabular revision surgery.\",\"PeriodicalId\":22625,\"journal\":{\"name\":\"The Journal of Bone & Joint Surgery\",\"volume\":\"52 1\",\"pages\":\"1587–1593\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2002-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"59\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of Bone & Joint Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2106/00004623-200209000-00011\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of Bone & Joint Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/00004623-200209000-00011","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 59

摘要

背景:不同的临床情况可能使聚乙烯衬垫交换在金属外壳固定良好的情况下是可取的。选择包括简单的聚乙烯衬垫置换或整个髋臼翻修。最近推出的一项技术是将新的尾管固井到固定良好的金属壳中。本研究的目的是量化这种内固定方法的机械完整性,评估可能影响立即内固定的因素,并将这种结构与标准锁定机构进行比较。方法:对一种模块化髋臼杯设计进行评价。通过杠杆伸出和多轴错位测试方法评估可能影响结构机械完整性的变量。变量包括尾管的尺寸(小号还是大号)、尾管的类型(全聚乙烯还是模块化设计)、模块化尾管的修改(未修改还是开槽)以及槽的配置(十字形还是周向)。金属壳带和不带螺丝孔也进行了测试。采用模块化锁紧机构作为控制。结果:在水泥-金属界面处,无一种结构失效。与对照组(p < 0.001)或超大衬管(p < 0.001)相比,所有尺寸过小的衬管需要更高的载荷才能失效。与对照组相比,未修改的超大衬垫在较低负荷下失效(p < 0.01)。在超大衬垫中创建周向凹槽显着提高了构建体的强度(p < 0.01),使其与对照组相当。四组间差异无统计学意义(p > 0.3)。在多轴错位试验中,标准锁定结构(对照)和超大未修改结构在2000n的力下失效。使用此测试模式没有其他构造失败。结论:如果内衬尺寸过小,将聚乙烯内衬胶结到金属外壳中可以比传统的锁定机制更强。在将超大尾管固井到管壳中时,应谨慎操作。这种固定的长期持久性尚不清楚。临床意义:在固定良好的金属外壳内植入聚乙烯内垫可以为髋臼翻修手术提供另一种选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cementation of a Polyethylene Liner into a Metal Shell: Factors Related to Mechanical Stability
Background: Various clinical situations may make polyethylene liner exchange desirable in the setting of a well-fixed metal shell. Options have included a simple polyethylene liner exchange or revision of the entire acetabular shell. A recently introduced technique involves cementation of a new liner into a well-fixed metal shell. The purposes of this study were to quantify the mechanical integrity of this method of liner fixation, to evaluate the factors that may influence immediate liner fixation, and to compare this construct with a standard locking mechanism.Methods: One modular acetabular cup design was evaluated. Variables that may contribute to the mechanical integrity of the construct were evaluated via lever-out and multiaxis dislocation testing methods. The variables included the size of the liner (undersized versus oversized), type of liner (all-polyethylene versus modular design), modification of the modular liner (unmodified versus grooved), and groove configuration (cruciform versus circumferential). Metal shells with and without screw-holes were also tested. The modular locking mechanism was used as the control.Results: None of the constructs failed at the cement-metal interface. All undersized liners required significantly higher loads to failure than either the controls (p < 0.001) or the oversized liners (p < 0.001). Oversized unmodified liners failed at significantly lower loads than the controls did (p < 0.01). The creation of circumferential grooves in the oversized liners significantly improved the strength of the constructs (p < 0.01), making them comparable with the controls. No significant differences were found among the four undersized groups (p > 0.3). The standard locking construct (control) and the oversized unmodified construct failed at a force of 2000 N in the multiaxis dislocation test. No other construct failed with use of this test mode.Conclusions: Cementation of a polyethylene liner into a metal shell can be stronger than a conventional locking mechanism if the liner is undersized. Cementation of an oversized liner into a shell should be performed with caution. The long-term durability of this fixation remains unknown.Clinical Relevance: Cementation of a polyethylene liner in a well-fixed metal shell may provide an alternative option in acetabular revision surgery.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信