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학술지 Primary Stability of Cemetless Stem in THA Improved with Reduced Interfacial Gaps
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박영배, 신호철, 최돈옥, Carolyne Albert, 윤용산
Journal of Biomechanical Engineering, v.130 no.2, pp.1-7
08MC5100, u-로봇 HRI 솔루션 및 핵심 소자 기술 개발, 황대환
Large interfacial gaps between the stem and the bone in cementless total hip arthroplasty may prevent successful bone ingrowth at the sites, and can also be a passage for wear particles. Furthermore, interfacial gaps between the stem and the bone are believed to compromise the primary stability of the implant. Thus, a broaching method that serves to reduce gaps is expected to give clinically preferable results. A modified broach system with a canal guide is introduced to enhance the accuracy of femoral canal shaping in comparison with the conventional broach system for a Versys?꽓 fibermetal taper stem. The primary stability of the hip systems and the ratios of the stem surface in contact with the femur were measured in a composite femur model. With the conventional method, an average of 67% of the stem surface was shown to be in contact with the bone, and an average stem micromotion/migration of 35 μm/290 μm was observed under 1000 cycles of stair climbing loads. With the modified method, the stem-bone contact ratio significantly increased to 82% (p < 0.05), and the average micromotion/migration reduced to 29 μm/49 μm, respectively (p < 0.05 for migration). Our finite element models of the hip systems supported that the difference in micromotion could be attributed to the difference in interfacial contact. Interfacial gaps occurring with the conventional broach system were effectively reduced by the proposed method, resulting in improved primary stability. Copyright © 2008 by ASME.
KSP 제안 키워드
Bone contact, Bone ingrowth, Cementless total hip arthroplasty, Contact ratio, Conventional methods, Finite Element Method(FEM), Interfacial contact, Stair Climbing, Wear particles, modified method, primary stability