BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegra...BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegration and enhances implant stability.However,there is a lack of evidence in the literature on the use of this material in patients with femoral neck fracture.AIM To evaluate the short-term clinical-functional and radiographic outcomes in patients with femoral neck fractures undergoing total hip arthroplasty(THA)with Trabecular Titanium™acetabular cup implants.METHODS The study included 104 patients with medial femoral neck fractures who underwent THA between January 2020 and December 2020 with the Delta TT acetabular cup(Lima Corporate,Villanova di San Daniele del Friuli,Italy).The mean age of the patients was 69.57±10.16 years(range:36-85 years).The followup period ranged from a minimum of 3 to a maximum of 4 years.Three questionnaires(Harris Hip Score,Oxford Hip Score,and EQ5D)were administered along with radiographic evaluations.Statistical methods included the Student's t-test and one-way analysis of variance for comparisons(with significance set at 0.05),and the Kaplan-Meier curve for prosthetic implant survival.RESULTS The mean follow-up was 41.5 months.The Harris Hip Score(HHS)showed a mean increase of 2.74 points(mean HHS 88.52 at 6 months postoperatively and mean HHS 91.26 at the last follow-up)with statistical significance.Similarly,the Oxford Hip Score demonstrated a statistically significant difference between follow-up groups.However,the EQ5D did not show statistically significant differences among the three groups(preoperative,6-month follow-up,and last follow-up).Revision surgery was required in 6 patients.According to Moore's criteria,96%of the acetabular components were radiographically stable and well-integrated at the last follow-up.The Kaplan-Meier curve showed a 96%survival rate.CONCLUSION The clinical and radiographic results obtained in the short to medium term confirm the excellent performance of the Delta TT acetabular cup in terms of osseointegration,providing an optimal solution both for young patients with high functional recovery demands and for fragile patients requiring optimal stability of the acetabular component to reduce the risk of implant failure.展开更多
Acetabular cups,which are among themost important implants in total hip arthroplasty,are usually made from titanium alloys with high porosity and adequate mechanical properties.The current three-dimensional(3D)printin...Acetabular cups,which are among themost important implants in total hip arthroplasty,are usually made from titanium alloys with high porosity and adequate mechanical properties.The current three-dimensional(3D)printing approaches to fabricate customized acetabular cups have some inherent disadvantages such as high cost and energy consumption,residual thermal stress,and relatively low efficiency.Thus,in this work,a direct ink writing method was developed to print a cup structure at room temperature,followed by multi-step heat treatment to form microscale porous structure within the acetabular cup.Our method is facilitated by the development of a self-supporting titanium-6 aluminum-4 vanadium(Ti64)ink that is composed of Ti64 particles,bentonite yield-stress additive,ultraviolet curable polymer,and photo-initiator.The effects of Ti64 and bentonite concentrations on the rheological properties and printability of inks were systematically investigated.Moreover,the printing conditions,geometrical limitations,and maximum curing depth were explored.Finally,some complex 3D structures,including lattices with different gap distances,honeycomb with a well-defined shape,and an acetabular cup with uniformly distributed micropores,were successfully printed/fabricated to validate the effectiveness of the proposed method.展开更多
Clinical two-dimensional linear wear rate data for acetabular cup liners fabricated using approved brands of highly cross-linked ultra-high-molecular-weight polyethylene, as reported in 39 articles in the literature, ...Clinical two-dimensional linear wear rate data for acetabular cup liners fabricated using approved brands of highly cross-linked ultra-high-molecular-weight polyethylene, as reported in 39 articles in the literature, were analyzed using a statistical technique called response surface methodology. The output was a series comprising16 acceptable combinations of femoral head diameter (HD), femoral head material (HM), and HXLPE brand (PB), each of which would yield the optimum wear rate (herein taken to be a wear rate of practically zero). An example of such a combination is 28- mm-diameter Oxinium? femoral head articulated against an acetabular cup liner fabricated from ReflectionTM HXLPE. The findings in this work may guide an orthopaedic surgeon’s selection of the combination of HD, HM, and PB to use in a primary total hip joint replacement.展开更多
目的探讨准确评估人工全髋关节置换术(total hip arthroplasty,THA)中髋臼杯尺寸的方法。方法以2022年12月—2024年7月接受初次THA患者作为研究对象,其中73例(80髋)患者符合选择标准纳入研究。男39例,女34例;年龄56~78岁,平均66.3岁。...目的探讨准确评估人工全髋关节置换术(total hip arthroplasty,THA)中髋臼杯尺寸的方法。方法以2022年12月—2024年7月接受初次THA患者作为研究对象,其中73例(80髋)患者符合选择标准纳入研究。男39例,女34例;年龄56~78岁,平均66.3岁。单髋置换66例,双髋置换7例。其中,骨关节炎29例(34髋),股骨颈骨折35例(35髋),股骨头坏死9例(11髋)。基于X线片,采用术前模板规划法、影像学股骨头直径(diameter of the femoral head,FHD)评估法以及术中实测FHD评估法选择最适配髋臼杯尺寸,并与术中实际植入髋臼杯尺寸进行比较。结果术前模板规划法、影像学FHD评估法及术中实测FHD评估法、实际植入臼杯尺寸分别为(51.25±2.81)、(49.72±3.11)、(49.90±2.74)、(50.57±2.74)mm。前三种评估结果与术中实际植入髋臼杯尺寸相比,差异均无统计学意义(P>0.05)。与术中实际植入髋臼杯相比,术前模板规划法尺寸一致35髋(43.75%),相差1个型号41髋(51.25%),相差2个型号4髋(5%);影像学FHD评估法分别为12髋(15%)、57髋(71.25%)、11髋(13.75%);术中实测FHD评估法分别为26髋(32.5%)、52髋(65%)、2髋(2.5%)。术前模板规划法、影像学FHD评估法及术中实测FHD评估法与实际植入型号一致性分布差异有统计学意义(H=18.579,P<0.001)。结论术中实测FHD评估法作为一种简单、经济且准确的评估方法,可有效指导髋臼杯选择,减少假体磨损风险,提高术后关节稳定性。展开更多
目的 探讨成人发育性髋关节发育不良（developmental dysplasia of hip,DDH）髋臼畸形程度与手术学习曲线对人工全髋关节置换术（total hip arthroplasty,THA）臼杯安装位置的影响。方法 回顾性分析2008年1月-2015年12月收治的130例（14...目的 探讨成人发育性髋关节发育不良（developmental dysplasia of hip,DDH）髋臼畸形程度与手术学习曲线对人工全髋关节置换术（total hip arthroplasty,THA）臼杯安装位置的影响。方法 回顾性分析2008年1月-2015年12月收治的130例（144髋）初次行THA的成人DDH患者临床资料。其中2012年之前收治53例（59髋）,之后收治77例（85髋）。男31例,女85例;年龄31~83岁,平均61岁。单髋置换116例,双髋置换14例。CroweⅠ型48髋,Ⅱ型57髋,Ⅲ/Ⅳ型39髋。所有患者于术后1周内复查骨盆标准前后位X线片,采用medi CAD软件测量髋臼假体前倾角、外展角,髋臼假体骨性覆盖率;计算髋臼实际旋转中心、理想旋转中心分别至泪滴连线的垂直距离之差（竖直距离）以及水平距离【请作者核对此句后对应修改英文】,评价臼杯位置合格率。结果 与2013年-2015年组同一类型患者相比,2008年-2012年组CroweⅠ型患者臼杯前倾角显著减小、臼杯位置合格率降低,Ⅱ型患者水平距离增大、臼杯位置合格率亦降低,Ⅲ/Ⅳ型患者臼杯前倾角减小、水平距离增大,比较差异有统计学意义（P〈0.05）;其余指标比较,差异均无统计学意义（P〉0.05）。在CroweⅠ、Ⅱ、Ⅲ/Ⅳ各型中,2008年-2012年组和2013年-2015年组竖直距离均随着髋臼畸形程度的增加而增加,比较差异有统计学意义（P〈0.05）;其余指标比较,差异均无统计学意义（P〉0.05）。结论 成人DDH患者初次行THA时,臼杯安装位置不良风险较高,需要术前仔细评估髋臼畸形特点,不断总结手术经验,提高臼杯安装准确度。展开更多
背景:髋关节置换是治疗股骨头坏死、骨性关节炎、髋关节发育不良以及老年股骨颈骨折等髋关节疾病最有效的方法,因此有必要对髋关节置换的生物力学行为展开研究。目的:采用有限元仿真的方法模拟髋关节置换后骨小梁结构髋臼杯和实体结构...背景:髋关节置换是治疗股骨头坏死、骨性关节炎、髋关节发育不良以及老年股骨颈骨折等髋关节疾病最有效的方法,因此有必要对髋关节置换的生物力学行为展开研究。目的:采用有限元仿真的方法模拟髋关节置换后骨小梁结构髋臼杯和实体结构髋臼杯模型的接触应力和米氏应力大小和分布情况,分析其对假体及髋关节的影响。方法:通过3-Matic Research 11.0软件设计了2种不同结构的髋关节假体组件模型:骨小梁结构髋臼杯和实体结构髋臼杯模型。并将设计好的模型经Hypermesh 14.0软件划分网格并赋予材料属性,最后导入有限元分析软件Abaqus 6.13软件中仿真分析,比较相同状态下2种髋臼杯的应力值和应力分布情况。结果与结论:骨小梁结构髋臼杯的应力呈散点状分布,分布范围广。实体结构髋臼杯容易出现应力集中现象,应力分布集中在受力点附近。骨小梁结构髋臼杯相对于实体结构髋臼杯而言,应力分布范围更大,应力分布更均匀,从而可以减轻髋关节假体之间的磨损,降低髋关节假体发生无菌性松动的风险。展开更多
目的:探讨不使用髋臼杯螺钉辅助固定的非骨水泥压配臼杯在人工全髋关节置换中的应用价值。方法:对2011年1月~2015年1月期间因髋关节疾病在我院行全髋关节置换术的符合入选标准的80例患者进行回顾性分析。其中37例患者采用单纯压配固定(p...目的:探讨不使用髋臼杯螺钉辅助固定的非骨水泥压配臼杯在人工全髋关节置换中的应用价值。方法:对2011年1月~2015年1月期间因髋关节疾病在我院行全髋关节置换术的符合入选标准的80例患者进行回顾性分析。其中37例患者采用单纯压配固定(press-fit group,PG),43例患者采用压配联合髋臼杯螺钉固定(press-fit with screws group,PSG)。详细记录并比较两组患者的手术时间、术中出血量、术后伤口引流量、术前及末次随访时的Harris评分;分析并比较两组患者假体周围骨溶解、假体松动情况。结果:单纯压配固定的患者手术时间、术中出血及术后引流量均小于髋臼杯螺钉辅助压配固定的患者(P<0.05)。末次随访时采用单纯压配固定的患者出现髋臼假体周围骨溶解现象少于采用压配联合髋臼杯螺钉固定,但差异无统计学意义(P>0.05)。两组患者末次随访时均未出现假体周围骨折,假体松动等。两组患者末次随访时Harris评分均提高(P<0.05),两组患者手术前及末次随访时Harris评分间差异无统计学意义(P>0.05)。结论:全髋关节置换术是治疗髋关节疾病的有效手段。对于初次行全髋关节置换的老年患者,采用单纯压配固定更有利。展开更多
文摘BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegration and enhances implant stability.However,there is a lack of evidence in the literature on the use of this material in patients with femoral neck fracture.AIM To evaluate the short-term clinical-functional and radiographic outcomes in patients with femoral neck fractures undergoing total hip arthroplasty(THA)with Trabecular Titanium™acetabular cup implants.METHODS The study included 104 patients with medial femoral neck fractures who underwent THA between January 2020 and December 2020 with the Delta TT acetabular cup(Lima Corporate,Villanova di San Daniele del Friuli,Italy).The mean age of the patients was 69.57±10.16 years(range:36-85 years).The followup period ranged from a minimum of 3 to a maximum of 4 years.Three questionnaires(Harris Hip Score,Oxford Hip Score,and EQ5D)were administered along with radiographic evaluations.Statistical methods included the Student's t-test and one-way analysis of variance for comparisons(with significance set at 0.05),and the Kaplan-Meier curve for prosthetic implant survival.RESULTS The mean follow-up was 41.5 months.The Harris Hip Score(HHS)showed a mean increase of 2.74 points(mean HHS 88.52 at 6 months postoperatively and mean HHS 91.26 at the last follow-up)with statistical significance.Similarly,the Oxford Hip Score demonstrated a statistically significant difference between follow-up groups.However,the EQ5D did not show statistically significant differences among the three groups(preoperative,6-month follow-up,and last follow-up).Revision surgery was required in 6 patients.According to Moore's criteria,96%of the acetabular components were radiographically stable and well-integrated at the last follow-up.The Kaplan-Meier curve showed a 96%survival rate.CONCLUSION The clinical and radiographic results obtained in the short to medium term confirm the excellent performance of the Delta TT acetabular cup in terms of osseointegration,providing an optimal solution both for young patients with high functional recovery demands and for fragile patients requiring optimal stability of the acetabular component to reduce the risk of implant failure.
基金supported by the Micro Grant (PG20473) at the University of Nevada, Reno, USA
文摘Acetabular cups,which are among themost important implants in total hip arthroplasty,are usually made from titanium alloys with high porosity and adequate mechanical properties.The current three-dimensional(3D)printing approaches to fabricate customized acetabular cups have some inherent disadvantages such as high cost and energy consumption,residual thermal stress,and relatively low efficiency.Thus,in this work,a direct ink writing method was developed to print a cup structure at room temperature,followed by multi-step heat treatment to form microscale porous structure within the acetabular cup.Our method is facilitated by the development of a self-supporting titanium-6 aluminum-4 vanadium(Ti64)ink that is composed of Ti64 particles,bentonite yield-stress additive,ultraviolet curable polymer,and photo-initiator.The effects of Ti64 and bentonite concentrations on the rheological properties and printability of inks were systematically investigated.Moreover,the printing conditions,geometrical limitations,and maximum curing depth were explored.Finally,some complex 3D structures,including lattices with different gap distances,honeycomb with a well-defined shape,and an acetabular cup with uniformly distributed micropores,were successfully printed/fabricated to validate the effectiveness of the proposed method.
文摘Clinical two-dimensional linear wear rate data for acetabular cup liners fabricated using approved brands of highly cross-linked ultra-high-molecular-weight polyethylene, as reported in 39 articles in the literature, were analyzed using a statistical technique called response surface methodology. The output was a series comprising16 acceptable combinations of femoral head diameter (HD), femoral head material (HM), and HXLPE brand (PB), each of which would yield the optimum wear rate (herein taken to be a wear rate of practically zero). An example of such a combination is 28- mm-diameter Oxinium? femoral head articulated against an acetabular cup liner fabricated from ReflectionTM HXLPE. The findings in this work may guide an orthopaedic surgeon’s selection of the combination of HD, HM, and PB to use in a primary total hip joint replacement.
文摘目的探讨准确评估人工全髋关节置换术(total hip arthroplasty,THA)中髋臼杯尺寸的方法。方法以2022年12月—2024年7月接受初次THA患者作为研究对象,其中73例(80髋)患者符合选择标准纳入研究。男39例,女34例;年龄56~78岁,平均66.3岁。单髋置换66例,双髋置换7例。其中,骨关节炎29例(34髋),股骨颈骨折35例(35髋),股骨头坏死9例(11髋)。基于X线片,采用术前模板规划法、影像学股骨头直径(diameter of the femoral head,FHD)评估法以及术中实测FHD评估法选择最适配髋臼杯尺寸,并与术中实际植入髋臼杯尺寸进行比较。结果术前模板规划法、影像学FHD评估法及术中实测FHD评估法、实际植入臼杯尺寸分别为(51.25±2.81)、(49.72±3.11)、(49.90±2.74)、(50.57±2.74)mm。前三种评估结果与术中实际植入髋臼杯尺寸相比,差异均无统计学意义(P>0.05)。与术中实际植入髋臼杯相比,术前模板规划法尺寸一致35髋(43.75%),相差1个型号41髋(51.25%),相差2个型号4髋(5%);影像学FHD评估法分别为12髋(15%)、57髋(71.25%)、11髋(13.75%);术中实测FHD评估法分别为26髋(32.5%)、52髋(65%)、2髋(2.5%)。术前模板规划法、影像学FHD评估法及术中实测FHD评估法与实际植入型号一致性分布差异有统计学意义(H=18.579,P<0.001)。结论术中实测FHD评估法作为一种简单、经济且准确的评估方法,可有效指导髋臼杯选择,减少假体磨损风险,提高术后关节稳定性。
文摘背景:髋关节置换是治疗股骨头坏死、骨性关节炎、髋关节发育不良以及老年股骨颈骨折等髋关节疾病最有效的方法,因此有必要对髋关节置换的生物力学行为展开研究。目的:采用有限元仿真的方法模拟髋关节置换后骨小梁结构髋臼杯和实体结构髋臼杯模型的接触应力和米氏应力大小和分布情况,分析其对假体及髋关节的影响。方法:通过3-Matic Research 11.0软件设计了2种不同结构的髋关节假体组件模型:骨小梁结构髋臼杯和实体结构髋臼杯模型。并将设计好的模型经Hypermesh 14.0软件划分网格并赋予材料属性,最后导入有限元分析软件Abaqus 6.13软件中仿真分析,比较相同状态下2种髋臼杯的应力值和应力分布情况。结果与结论:骨小梁结构髋臼杯的应力呈散点状分布,分布范围广。实体结构髋臼杯容易出现应力集中现象,应力分布集中在受力点附近。骨小梁结构髋臼杯相对于实体结构髋臼杯而言,应力分布范围更大,应力分布更均匀,从而可以减轻髋关节假体之间的磨损,降低髋关节假体发生无菌性松动的风险。
文摘目的:探讨不使用髋臼杯螺钉辅助固定的非骨水泥压配臼杯在人工全髋关节置换中的应用价值。方法:对2011年1月~2015年1月期间因髋关节疾病在我院行全髋关节置换术的符合入选标准的80例患者进行回顾性分析。其中37例患者采用单纯压配固定(press-fit group,PG),43例患者采用压配联合髋臼杯螺钉固定(press-fit with screws group,PSG)。详细记录并比较两组患者的手术时间、术中出血量、术后伤口引流量、术前及末次随访时的Harris评分;分析并比较两组患者假体周围骨溶解、假体松动情况。结果:单纯压配固定的患者手术时间、术中出血及术后引流量均小于髋臼杯螺钉辅助压配固定的患者(P<0.05)。末次随访时采用单纯压配固定的患者出现髋臼假体周围骨溶解现象少于采用压配联合髋臼杯螺钉固定,但差异无统计学意义(P>0.05)。两组患者末次随访时均未出现假体周围骨折,假体松动等。两组患者末次随访时Harris评分均提高(P<0.05),两组患者手术前及末次随访时Harris评分间差异无统计学意义(P>0.05)。结论:全髋关节置换术是治疗髋关节疾病的有效手段。对于初次行全髋关节置换的老年患者,采用单纯压配固定更有利。
