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
目的评估利用“双杯”技术(去除钛环的钽金属翻修臼杯作为增强块)治疗PaproskyⅢ型髋臼缺损的早期临床效果。方法回顾性地分析评估了2017—2023年在中国科学技术大学附属第一医院(安徽省立医院)接受“双杯”技术进行治疗的54例全髋关节...目的评估利用“双杯”技术(去除钛环的钽金属翻修臼杯作为增强块)治疗PaproskyⅢ型髋臼缺损的早期临床效果。方法回顾性地分析评估了2017—2023年在中国科学技术大学附属第一医院(安徽省立医院)接受“双杯”技术进行治疗的54例全髋关节翻修术病例。其中男女性患者数量一致,均为27例,年龄30~92岁,平均年龄(65.8±12.3)岁。通过记录患者术前和末次随访时Harris髋关节评分、Oxford髋关节评分和36项健康调查简表(36-item short form survey,SF-36)功能评分来评估临床功能结果;对术前、术后髋关节旋转中心位置和双下肢长度差在影像学上进行评估;评估有无假体松动等术后并发症的发生。结果54例患者均获随访,随访时间为8~80个月,平均(35.3±20.9)个月。术前Harris髋关节评分、Oxford髋关节评分和SF-36功能评分分别为(35.6±10.5)分、(24.4±7.1)分和(805.7±47.5)分,末次随访时分别为(90.6±11.5)分、(44.0±4.2)分和(859.4±47.4)分,患者临床功能结果得到显著改善(P<0.001)。此外,末次随访的影像学结果显示,无论是髋关节旋转中心位置还是双下肢长度差与术前相比都有明显改善(P<0.001),实现了良好的生物力学重建。术后无假体周围感染,6例患者发生假体脱位,但只有1例患者在随访中因假体反复脱位进行了二次手术。结论“双杯”技术是进行PaproskyⅢA和ⅢB型严重髋臼缺损重建的可靠选择,其并发症少、安全性高、功能恢复好,值得在临床上大力推广。展开更多
目的设计一种三维角度仪,将其应用在全髋关节置换术(total hip arthroplasty,THA)中,以测量髋臼臼杯把持杆的倾斜角度,评估其是否能提高髋臼臼杯植入角度(外展角和前倾角)的精准度。方法将2020年9月至2022年10月武汉中西医结合骨科医院...目的设计一种三维角度仪,将其应用在全髋关节置换术(total hip arthroplasty,THA)中,以测量髋臼臼杯把持杆的倾斜角度,评估其是否能提高髋臼臼杯植入角度(外展角和前倾角)的精准度。方法将2020年9月至2022年10月武汉中西医结合骨科医院收治的30例患者分成测量仪组(采用三维角度仪辅助进行THA组,15例)和传统组(传统THA组,15例),两组术前规划髋臼臼杯置入的外展角为38º、前倾角为20º,比较两组术后X线片上所测得髋臼臼杯置放的角度(外展角和前倾角)与其术前所规划臼杯置入角度之间的误差。结果测量仪组术后髋臼臼杯置放的角度(外展角和前倾角)与术前所规划角度的误差明显小于传统组。结论相对于传统THA术中医生用肉眼瞄髋臼臼杯置入方向而言,采用此三维角度仪辅助进行THA,能在术中对髋臼臼杯置入的方向进行刻度化测量,能提高髋臼臼杯置入角度的精准度,其操作简单,值得推广。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
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。
文摘目的评估利用“双杯”技术(去除钛环的钽金属翻修臼杯作为增强块)治疗PaproskyⅢ型髋臼缺损的早期临床效果。方法回顾性地分析评估了2017—2023年在中国科学技术大学附属第一医院(安徽省立医院)接受“双杯”技术进行治疗的54例全髋关节翻修术病例。其中男女性患者数量一致,均为27例,年龄30~92岁,平均年龄(65.8±12.3)岁。通过记录患者术前和末次随访时Harris髋关节评分、Oxford髋关节评分和36项健康调查简表(36-item short form survey,SF-36)功能评分来评估临床功能结果;对术前、术后髋关节旋转中心位置和双下肢长度差在影像学上进行评估;评估有无假体松动等术后并发症的发生。结果54例患者均获随访,随访时间为8~80个月,平均(35.3±20.9)个月。术前Harris髋关节评分、Oxford髋关节评分和SF-36功能评分分别为(35.6±10.5)分、(24.4±7.1)分和(805.7±47.5)分,末次随访时分别为(90.6±11.5)分、(44.0±4.2)分和(859.4±47.4)分,患者临床功能结果得到显著改善(P<0.001)。此外,末次随访的影像学结果显示,无论是髋关节旋转中心位置还是双下肢长度差与术前相比都有明显改善(P<0.001),实现了良好的生物力学重建。术后无假体周围感染,6例患者发生假体脱位,但只有1例患者在随访中因假体反复脱位进行了二次手术。结论“双杯”技术是进行PaproskyⅢA和ⅢB型严重髋臼缺损重建的可靠选择,其并发症少、安全性高、功能恢复好,值得在临床上大力推广。
文摘目的设计一种三维角度仪,将其应用在全髋关节置换术(total hip arthroplasty,THA)中,以测量髋臼臼杯把持杆的倾斜角度,评估其是否能提高髋臼臼杯植入角度(外展角和前倾角)的精准度。方法将2020年9月至2022年10月武汉中西医结合骨科医院收治的30例患者分成测量仪组(采用三维角度仪辅助进行THA组,15例)和传统组(传统THA组,15例),两组术前规划髋臼臼杯置入的外展角为38º、前倾角为20º,比较两组术后X线片上所测得髋臼臼杯置放的角度(外展角和前倾角)与其术前所规划臼杯置入角度之间的误差。结果测量仪组术后髋臼臼杯置放的角度(外展角和前倾角)与术前所规划角度的误差明显小于传统组。结论相对于传统THA术中医生用肉眼瞄髋臼臼杯置入方向而言,采用此三维角度仪辅助进行THA,能在术中对髋臼臼杯置入的方向进行刻度化测量,能提高髋臼臼杯置入角度的精准度,其操作简单,值得推广。
