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The subchondral bone layer and glenoid implant design are relevant for primary stability in glenoid arthroplasty

机译:软骨下骨层和关节盂植入物设计与关节盂关节置换术的初级稳定性有关

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摘要

Background Clinical studies suggest that reaming of the subchondral bone layer to achieve good implant seating is a risk factor for glenoid loosening. This study aims to evaluate (1) the importance of the subchondral bone layer and (2) the influence of the design of the glenoid component.Methods Different techniques for preparation of an A1 glenoid were compared: (1) preserving the subchondral bone layer; (2) removal of the subchondral bone layer; (3) implantation of a glenoid component that does not adapt to the native anatomy. Artificial glenoid bones (?= 5 each) were used with a highly standardized preparation and implantation protocol. Biome-chanical testing was performed during simulated physiological shoulder motion. Using a high-resolution optical system, the micromotions between implant and bone were measured up to 10,000 motion cycles.Results At the 10,000 cycle measuring point, significantly more micromotions were found in the subchondral layer removed group than in the subchondral layer preserved group (j? = 0.0427). The number of micromotions in the nonadapted group was significantly higher than in the subchondral layer preserved group (p = 0.0003) or the subchondral layer removed group (p = 0.0207).Conclusion Conservative reaming proved important to diminish the micromotions of the glenoid component. Implantation of a glenoid component that matches with the bony underlying glenoid can help to preserve the subchondral bone layer without sacrificing proper implant seating.
机译:背景 临床研究表明,为获得良好的种植体位而扩孔软骨下骨层是关节盂松弛的危险因素。本研究旨在评估 (1) 软骨下骨层的重要性和 (2) 关节盂组件设计的影响。方法 比较不同A1关节盂的制备方法:(1)保留软骨下骨层;(2)去除软骨下骨层;(3)植入不适应原生解剖结构的关节盂成分。人工关节盂骨(?= 每个 5 个)与高度标准化的制备和植入方案一起使用。在模拟生理性肩运动期间进行生物群落力学测试。使用高分辨率光学系统,可以测量植入物和骨骼之间的微运动,最多可测量 10,000 个运动周期。结果 在10,000循环测量点,去除软骨下层组的微运动明显多于软骨下层保留组(j?=0.0427)。非适应组的微动次数显著高于软骨下层保留组(p = 0.0003)或软骨下层去除组(p = 0.0207)。结论 保守扩孔对减少关节盂成分的微动具有重要意义。植入与骨下关节盂相匹配的关节盂组件有助于保留软骨下骨层,而不会牺牲适当的种植体坐位。

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