空芯钛棒治疗早期股骨头坏死的体外生物力学实验及临床应用

In vitro biomechanical experiment and clinical application of hollow titanium rod in the treatment of early necrosis of femoral head

目的探讨空芯钛棒对股骨颈生物力学的影响,为临床应用提供实验依据。方法取正常人股骨头颈标本15只,将标本随机分为3组:正常组(A组)、髓芯减压组(B组)、髓芯减压+空芯钛棒置入组(C组)。每组5只标本。将标本置于生物力学机中,股骨头顶部施加压力并逐渐增大至股骨头塌陷,记录股骨转子窝、股骨矩、股骨大转子下三处的应变,及股骨头塌陷时的最大载荷,并进行比较。结果A、B、C 3组载荷到达300 N时,股骨转子窝、股骨矩2处的应变:A、C组之间差异无统计学意义(P>0.05),A、C 2组均大于B组(P<0.05);股骨大转子下的应变:A、C组之间差异无统计学意义(P>0.05),A、C 2组均小于B组(P<0.05)。股骨头塌陷的最大载荷:B组明显小于A、C 2组(P<0.01);A、C 2组之间差异无统计学意义(P>0.05)。结论空芯钛棒植入后,股骨头受压时的应力分布、股骨头颈处承载负荷可一定程度地接近正常,有助于减压后股骨头颈处生物力学性能的恢复,为其临床应用提供了生物力学依据。

Objective To assessthe titanium rob for the treatment of femoral head osteonecrosis and evaluate its biomechanical efficacy.Methods Fifteen normal adult femoral specimens were randomly divided into three groups:group A,normal control;group B,the femoral heads were dealt with decompression;group C,the femoral heads were dealt with the titanium rob.Femoral heads were subjected to axial torque.Strain of fossa trochanterica,femoral calcar and subtrochantarer was calculated and the maximum load of femoral sink and damage was measured.Results No significant difference of the strain of fossa trochanterica and femoral calcar was noted between group A and group C under 300 N loading condition.Compared to group A or group C,group B had lower strain of fossa trochanterica and femoral calcar under 300 N loading condition(P<0.05).No significant difference of the strain of subtrochantarer was noted between group A and group C under 300 N loading condition.Compared to group A or group C,group B had higher strain of subtrochantarer under 300 N loading condition(P<0.05).No significant difference of the maximum load of femoral collapse was noted between group A and group C.Compared to group A or group C,group B had lower maximum load of femoral collapse(P<0.05).Conclusion This new type of the titanium rob graft in femoral head can effectively maintain the biomechanical performance of femoral head and neck,which is worthy of being clinical applied.