Stress relaxation mechanics characteristics of femoral prosthesis after simulating hip replacement

doi:10.3969/j.issn.2095-4344.0035

Abstract

Abstract:

BACKGROUND: The previous biomechanical study of hip and hip replacement mostly analyzed the compressive, flexural and torsional mechanical properties and the three-dimensional finite element mechanics after prosthesis placement. There are few reports about the stress relaxation characteristics after femoral implant replacement.

OBJECTIVE: To compare and analyze two kinds of artificial prostheses after hip replacement from the angle of rheology by simulating femoral stress relaxation experiment so as to provide stress relaxation characteristics parameters.

METHODS: Eight femoral samples were randomly selected as the conventional prosthesis group. The specimen was fixed to the operation platform. The specimens were taken from the part of 1.5 cm above trochanter minor to trochanter major. After removal of the femoral head and most of the femoral neck, cancellous bone distal to the femoral section was removed. Medullary cavity was dredged from the distal side of trochanter major to determine the position of medullary cavity. The medullary cavity hammer was used to expand the medullary cavity. The detritus inside was removed. An additional eight femoral specimens were randomly taken for femoral neck prosthesis group. Two groups of samples were placed on the workbench, and experiment was conducted at increased strain speed of 50%/min. The time was set at 7 200 s, and 100 data were collected.

RESULTS AND CONCLUSION: (1) Stress relaxation amount was 0.384 MPa at 7 200 s in normal femur as previously reported. The stress relaxation amount was 0.379 MPa and 0.362 MPa in the conventional prosthesis group and femoral neck prosthesis group. The stress relaxation amount was significantly larger in the femoral neck prosthesis group than in the conventional prosthesis group at 7 200 s (P < 0.05). (2) Two groups of stress relaxation data were obtained and stress relaxation equation was established by three parameters of the model. It is conducive to clarify the stress relaxation characteristics of different implants into the femur. (3) Femoral neck prosthesis group and conventional prosthesis group have different stress relaxation mechanics. Due to the retention of the femoral neck, less impact was found on the stress relaxation mechanics.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Hip, Stress, Mechanical, Prosthesis Implantation, Tissue Engineering

CLC Number:

R318

Wang Gang, Li Xin-ying, Zhang Shu-quan, Li Ya-jun. Stress relaxation mechanics characteristics of femoral prosthesis after simulating hip replacement[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(3): 385-391.

Figures/Tables 4

2.1 传统型假体置入组应力松弛曲线传统型假体置入组应力松弛曲线见图1。传统型人工假体置入组初始应力为1.57 MPa，7 200 s时应力为1.32 MPa，应力松弛最初 1 200 s变化较快，之后应变缓慢下降，达到7 200 s时应力松弛曲线基本趋于水平。 2.2 保留股骨颈解剖型假体置入组应力松弛曲线保留股骨颈解剖型假体置入组应力松弛曲线见图2。保留股骨颈解剖型人工假体组初始应力为1.57 MPa，7 200 s时应力为1.34 MPa，应力松弛最初1 200 s变化较快，之后应变缓慢下降，达到7 200 s时应力松弛曲线基本趋于水平。已有研究报道正常股骨7 200 s应力松弛量为 0.384 MPa[21]，如图1，2所示，保留股骨颈解剖型假体置入组7 200 s应力松弛量为0.379 MPa，传统型假体置入组7 200 s应力松弛量为0.362 MPa，保留股骨颈解剖型假体置入组7 200 s应力松弛量大于传统型假体置入组，差异有显著性意义(P < 0.05)。 2.3 传统型假体置入组标本归一化应力松弛函数曲线传统型假体置入组标本归一化应力松弛函数曲线见图3。传统型人工假体置入组初始应力松弛函数值为1，7 200 s时归一化应力松弛函数值为0.78。应力松弛函数最初1 200 s变化较快，之后缓慢下降，达到7 200 s时应力松弛函数曲线基本趋于水平。 2.4 保留股骨颈解剖型假体组置入组归一化应力松弛函数曲线保留股骨颈解剖型人工假体组置入组归一化应力松弛函数曲线见图4。保留股骨颈解剖型人工假体置入组初始应力松弛函数值为1，7 200 s时归一化应力松弛函数值为0.76。应力松弛函数最初1 200 s变化较快，之后缓慢下降，达到7 200 s时应力松弛函数曲线基本趋于水平。如图3，4所示，保留股骨颈解剖型假体置入组7 200 s应力松弛函数值为0.76，传统型假体置入组7 200 s应力松弛函数值为0.78，保留股骨颈解剖型假体置入组7 200 s应力松弛量小于传统型假体置入组，差异有显著性意义(P < 0.05)。"

References

[1] 朱本清.股骨假体置换术后粘弹性和稳定性的实验研究[D].北华大学,2001.

[2] Rodrigues SP, Paiva JM, De Francesco S, et al. Artifact level producedby different femoral head prostheses in CT imaging: diamond coatedsilicon nitride as total hip replacement material. J Mater Sci Mater Med. 2013;24(1): 231-239.

[3] 杜东鹏,潘奇,姜文雄,等. 髋关节置换治疗老年股骨粗隆间骨折的假体选择[J]. 创伤外科杂志,2013,15(5): 400-403.

[4] Gillam MH, Lie SA, Salter A, et al. The progression of end-stage os-teoarthritis: analysis of data from the Australian and Norwegian jointreplacement registries using a multi-state model. Osteoarthritis Cartilage. 2013; 21(3): 405-412.

[5] 华寒冰,毕郑刚. 高龄患者半髋关节置换后骨折风险的评估方法[J]. 中国组织工程研究,2014,18(31): 5062-5067.

[6] Kin KJ, Chiba J, Rubash HE, et al.The characterization of cytokines in the interface tissue obtained from failed cementless total hip arthroplasty with and without femour osteolysis. Clin Orthop.1994;47(300):304-310.

[7] 孙振辉,刘月驹,李衡. 髋关节置换与内固定术治疗老年移位型股骨颈骨折术后再手术率和并发症的系统评价[J]. 中华创伤骨科杂志,2014,16(2):115-121.

[8] 关群,熊小江,唐进,等. 人工关节置换治疗老年股骨转子间不稳定骨折[J]. 中华创伤杂志,2014,30(3):211-216.

[9] 季烈峰,陈巨坤,徐丁, 等.股骨近端防旋髓内钉与解剖锁定钢板治疗老年股骨转子间骨折疗效比较[J].中华创伤骨科杂志, 2014,16(8):727-730.

[10] Gavaskar AS, Subramanian M, Tummala NC. Results of proximal femur nail antirotation for low velocity trochanteric fractures in elderly. Indian J Orthop. 2012; 46(5):556-560.

[11] Hwang JH, Garg AK, Oh JK, et al. A biomechanical evaluation of proximal femoral nail antirotation with respect to helical blade position in femoral head: A cadaveric study. Indian J Orthop. 2012;46(6):627-632.

[12] Niikura T, Lee SY, Matsumoto T, et al. Backout of the helical blade of proximal femoral nail antirotation and accompanying fracture nonunion. Orthopedics. 2012;35(8):e1264-1266.

[13] Matharu GS, Mc Bryde CW, Pynsent WB, et al. The outcome of the Birmingham Hip Resurfacing in patients aged < 50 years up to 14 years post-operatively. Bone Joint J. 2013; 95-B(9): 1172-1177.

[14] Yoo MC, Cho YJ, Kim KI, et al. Resurfacing arthroplasty in osteonecrosis of the femoral head-minimum 3 years follow-up. J Bone Joint Surg (Br). 2010;92-B(Suppl I): 145.

[15] Sandiford NA, Ahmed S, Doctor C, et al. Patient satisfaction and clinical results at a mean eight years following BHR arthroplasty: results from a district general hospital. Hip Int. 2014;24(3): 249-255.

[16] Pailhe R, Matharu GS, Sharma A, et al. Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up. Int Orthop. 2014;38(6):1139-1145.

[17] Daniel J, Pradhan C, Ziaee H, et al. Results of Birmingham hip resurfacing at 12 to 15 years: a single-surgeon series. Bone Joint J. 2014;96-B (10): 1298-1306.

[18] Kretzer JP, Jakubowitz E, Krachler M, et al. Metal release and corrosion effects of modular neck total hip arthroplasty. Int Orthop. 2009;33(6): 1531-1536.

[19] Wang Y, Li ZW, Luo M, et al. Biological conduits combining bone marrow mesenchymal stem cells and extracellular matrix to treat longsegment. Neural Regen Res. 2015; 10(6):965-971.

[20] Jin H, Yang Q, Ji F, et al.Human amniotic epithelial cell transplantation for the repair of injured brachial plexus nerve: evaluation of nerve viscoelastic properties. Neural Regen Res.2015;10(2):260-265.

[21] 王墨林,周安国,马洪顺. 去势大鼠所致骨质疏松对骨的粘弹性力学性质影响[J].北京生物医学工程,2008,27(3):272-275.

[22] 于涛.保留股骨颈解剖型股骨上端假体的生物力学研究[D].吉林大学,2003.

[23] Kim YH,Kim JS,Cho SH.Strain distribution in the prximal human femur.An in vitro comparison in the intact femur and after insertion of reference and experimental femoral stems.J Bone Joint Surg(Br). 2001;83(2):295-301.

[24] 张鹏,孔杰,刘泽淼,等.全髋关节置换后外侧结构重建前后的生物力学变化[J]. 中华关节外科杂志,2014,8(6):779-782.

[25] Hirata Y,Inaba Y, Kobayashi N,et al. Comparison of mechanicalstress and change in bone mineral density between two types of femo-ral implant using finite element analysis. J Arthroplasty. 2013;10:1731-1735.

[26] Liu WG,Liu SH,Yin QF,et al. Biomechanical characteristics of hip prosthesis in hip arthroplasty treating elderly patients with Evans I-III intertrochanteric fracture of femur. Acta Academiae Medicinae Sinicae. 2013;1:108-111.

[27] 郑忠,李超雄,李坚,等. 成人先天性髋臼发育不良人工髋关节置换术髋臼安装方法的力学比较[C].//中国骨伤发展战略高层论坛暨中西医结合骨伤学术大会, 2004.

[28] 郭磊,赵玉岩,范广宇,等. 髋臼发育不良的生物力学实验研究[J].中国医科大学学报, 2001,30(4):277-278.

[29] Kokubo Y, Uchida K, Oki H, et al. Modified metaphyseal-loading anterolaterally flared anatomic femoral stem: five- to nine-year prospective follow-up evaluation and results of three-dimensional finite element analysis. Artif Organs. 2013;2: 175-182.

[30] Bougherara H, Zdero R, Dubov A, et al. A preliminary biomechanicalstudy of a novel carbon-fibre hip implant versus standard metallic hipimplants Med Eng Phys. 2011;1: 121-128.

[31] Reimeringer M, Nuno N, Desmarais TC, et al. The influence of unce-mented femoral stem length and design on its primary stability: a finite element analysis. Computer Methods Biomech Biomed Eng. 2013;11: 1221-1231.

[32] 张玉朵,张伟,王玉林,等.人工髋关节置换前后股骨及假体的生物力学分析[J]. 中国临床解剖学杂志,2007,25(5):579-582.

[33] Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocationafter primary total hip arthroplasty: a multivariate analysis. J Arthroplasty. 2002;17(3):282-288.