钛合金支撑架植入对狗股骨颈力学强度的影响.docVIP

钛合金支撑架植入对狗股骨颈力学强度的影响 作者：王锐英，吴强，傅德皓，杨述华，杨操 【摘要】 ［目的］对比研究正常股骨颈、单纯髓芯减压、髓芯减压+钛合金支撑架植入治疗实验性狗股骨头坏死对股骨颈的生物力学强度的影响。［方法］取新鲜狗股骨头21对，随机分为3组，每组7对，第1组随机选取一侧，行单纯髓芯减压；第2组随机选取一侧行髓芯减压+钛合金支撑架植入；第3组随机选取其中一侧行单纯髓芯减压，另一侧行髓芯减压+钛合金支撑架植入，治疗模型建立后，在AGS10KND万能生物材料实验机上进行力学性能测试，观察3组标本股骨颈的力学刚度及强度，对实验结果标准化后行统计学分析。［结果］正常股骨颈，单纯髓芯减压组与髓芯减压+钛合金支撑架植入组股骨颈的刚度及最大负载在统计学上有显著差异。［结论］单纯髓芯减压会降低股骨颈的力学强度，增加术后发生股骨颈骨折的可能，钛合金支撑架植入显著增加了股骨颈的力学强度，对髓芯减压后股骨颈骨折的发生有预防作用。 【关键词】 股骨头缺血性坏死； 股骨颈； 支撑架； 生物力学 Abstract：［Objective］To study the biomechanics of the femoral neck on the treatment of ischemic of the femoral head in dogs using titanium alloy cage，single core decompression and normal.［Method］Twentyone couples of fresh moist dogs femur specimens were divided randomly into 3 groups.In 2 groups，biomechanical test of the femoral neck was made on one of every couple in different conditions:core decompression，core decompression with titanium alloy cage implanting.The other of every couple was tested as normal control.In the third group，one of every couple was tested in condition of core decompression with titanium alloy cage implanting.The other of every couple was tested in condition of core decompression.［Result］The stiffness and the max load of the single core decompression were less than that of the normal control.The max load of femoral head after titanium alloy cage implanting were lager than that of the core decompression or the normal control.［Conclusion］The titanium alloy cage implanting could increase mechanical support for femoral neck significantly and prevent femoral neck broken after manipulation. Key words：femoral head necrosis; femoral neak; cage; biomechanics 股骨头坏死的治疗是目前骨科面临的难题。其治疗方法虽多，但疗效均不太满意，往往进一步发展至塌陷或已存在的塌陷进一步加重，最终导致髋关节的残废而不得不行髋关节置换术〔1〕。为防止股骨头修复过程中发生塌陷，促进坏死股骨头修复，作者设计制造了合适大小的中空多孔圆柱状带螺纹的钛合金支撑架，通过股骨颈的钻孔减压隧道植入坏死股骨头软骨下，为股骨头提供支撑。本实验对正常股骨颈、单纯髓芯减压、髓芯减压+钛合金支撑架植入治疗实验性狗股骨头坏死的这3种状态下的股骨颈进行生物力学测试，了解手术对股骨颈的生物力学的影响，为临床提供实验依据。 1 材料与方法 1.1 支撑架 钛合金支撑架为杨述华教授等人设计。中空圆柱状，