This paper presents a probabilistic approach for studying the reliability of cementless hip prostheses in the presence of mechanical uncertainties and its application to the investigation of the influence of bone-impl...This paper presents a probabilistic approach for studying the reliability of cementless hip prostheses in the presence of mechanical uncertainties and its application to the investigation of the influence of bone-implant interface properties. The non-linear deterministic model of the bone-implant coupled system and its finite element implementation are described, and the proposed reliability analysis is exposed. It is demonstrated that the distribution (uniform, truncated Gaussian and truncated lognormal distribution) of the two chosen parameters and the truncation lengths have a minor influence on the Hasofer-Lind index. This index logically increases as the failure threshold increases. FORM and SORM approximations are compared with the results obtained using a crude Monte-Carlo method for the estimation of failure probability. The performance of three Monte-Carlo methods is studied in terms of the necessary number of FE calculations. The method based on the Directional Simulation (DS) technique is efficient and less time-consuming. The validity and operational capacity of the proposed approach would not be compromised by an increase in the number of uncertain parameters.展开更多
目的探讨采用非骨水泥型Spotorno(CLS)股骨柄假体行初次全髋关节置换术(total hip arthroplasty,THA)的中远期疗效。方法回顾性分析2013年5月至2015年8月我科采用CLS股骨柄假体行THA手术治疗的78例病人的临床资料,其中男45例(48髋),女33...目的探讨采用非骨水泥型Spotorno(CLS)股骨柄假体行初次全髋关节置换术(total hip arthroplasty,THA)的中远期疗效。方法回顾性分析2013年5月至2015年8月我科采用CLS股骨柄假体行THA手术治疗的78例病人的临床资料,其中男45例(48髋),女33例(38髋),年龄为43~81岁,平均61.3岁。术前诊断为股骨头无菌性坏死39例(39髋),髋关节发育不良28例(36髋),股骨颈骨折7例(7髋),类风湿性关节炎4例(4髋)。术前髋关节Harris评分为(52.10±3.35)分。术后定期随访,复查骨盆X线片,评估是否出现假体下沉、松动、移位等相关并发症,比较手术前后的髋关节Harris评分。结果所有病例均顺利完成手术,术中有3例病人出现股骨距劈裂骨折,采用钢缆环扎后,未见假体松动;2例术后切口出现愈合不佳,经换药后伤口一期愈合。本组病例随访5~7年,平均6.4年。末次随访的Harris评分为(92.39±6.61)分,与术前对比,差异有统计学意义(P<0.05)。随访期间有2例出现了大腿轻度疼痛,1例出现假体周围骨折,未见无菌性松动、神经血管损伤、脱位等并发症,2例(2髋)出现慢性低毒性假体感染并行髋关节二期翻修术,股骨柄远期生存率为97.7%。结论CLS股骨柄假体应用于初次THA,可获得良好的假体初始稳定性,髋关节功能改善明显,中远期疗效满意。展开更多
目的探讨Corail羟基磷灰石全涂层股骨柄假体行全髋关节置换术(total hip arthroplasty,THA)治疗终末期髋关节疾病病人的中期疗效。方法回顾性分析我院2011年10月至2019年5月采用Corail假体行THA治疗的239例(258髋)终末期髋关节疾病病人...目的探讨Corail羟基磷灰石全涂层股骨柄假体行全髋关节置换术(total hip arthroplasty,THA)治疗终末期髋关节疾病病人的中期疗效。方法回顾性分析我院2011年10月至2019年5月采用Corail假体行THA治疗的239例(258髋)终末期髋关节疾病病人的病例资料,其中男137例,女102例,平均年龄为50.4岁(38~79岁)。股骨头缺血性坏死145髋(56.2%),髋关节发育不良58髋(22.4%),髋关节骨性关节炎36髋(14.0%),股骨颈骨折11髋(4.3%),类风湿关节炎8髋(3.1%)。收集病人临床并发症,并采用髋关节Harris评分、疼痛视觉模拟量表(visual analogue scale,VAS)评分评估病人髋关节功能,随访X线片用于跟踪观察假体松动和螺钉断裂情况。结果术后1例出现肺部感染伴胸腔积液,6例术侧大腿出现不同程度疼痛,5例假体感染,6例脱位,7例小腿肌间静脉血栓,15例假体下沉,未见神经血管损伤等并发症。239例均获随访,随访时间为0.5~7.0年,平均5.8年,末次随访Harris评分为(84.84±5.65)分,VAS评分为(1.11±0.79)分,均较术前显著改善,差异均有统计学意义(t=-98.855,P<0.001;t=64.593,P<0.001)。末次随访时股骨柄稳定,未见透亮线迹象,无假体松动,无翻修,股骨柄存活率为100%。结论采用Corail羟基磷灰石全涂层股骨柄假体行THA具有稳定性持久、术后大腿疼痛发生率较低等优点,中期疗效较好。展开更多
文摘This paper presents a probabilistic approach for studying the reliability of cementless hip prostheses in the presence of mechanical uncertainties and its application to the investigation of the influence of bone-implant interface properties. The non-linear deterministic model of the bone-implant coupled system and its finite element implementation are described, and the proposed reliability analysis is exposed. It is demonstrated that the distribution (uniform, truncated Gaussian and truncated lognormal distribution) of the two chosen parameters and the truncation lengths have a minor influence on the Hasofer-Lind index. This index logically increases as the failure threshold increases. FORM and SORM approximations are compared with the results obtained using a crude Monte-Carlo method for the estimation of failure probability. The performance of three Monte-Carlo methods is studied in terms of the necessary number of FE calculations. The method based on the Directional Simulation (DS) technique is efficient and less time-consuming. The validity and operational capacity of the proposed approach would not be compromised by an increase in the number of uncertain parameters.
文摘目的探讨采用非骨水泥型Spotorno(CLS)股骨柄假体行初次全髋关节置换术(total hip arthroplasty,THA)的中远期疗效。方法回顾性分析2013年5月至2015年8月我科采用CLS股骨柄假体行THA手术治疗的78例病人的临床资料,其中男45例(48髋),女33例(38髋),年龄为43~81岁,平均61.3岁。术前诊断为股骨头无菌性坏死39例(39髋),髋关节发育不良28例(36髋),股骨颈骨折7例(7髋),类风湿性关节炎4例(4髋)。术前髋关节Harris评分为(52.10±3.35)分。术后定期随访,复查骨盆X线片,评估是否出现假体下沉、松动、移位等相关并发症,比较手术前后的髋关节Harris评分。结果所有病例均顺利完成手术,术中有3例病人出现股骨距劈裂骨折,采用钢缆环扎后,未见假体松动;2例术后切口出现愈合不佳,经换药后伤口一期愈合。本组病例随访5~7年,平均6.4年。末次随访的Harris评分为(92.39±6.61)分,与术前对比,差异有统计学意义(P<0.05)。随访期间有2例出现了大腿轻度疼痛,1例出现假体周围骨折,未见无菌性松动、神经血管损伤、脱位等并发症,2例(2髋)出现慢性低毒性假体感染并行髋关节二期翻修术,股骨柄远期生存率为97.7%。结论CLS股骨柄假体应用于初次THA,可获得良好的假体初始稳定性,髋关节功能改善明显,中远期疗效满意。
文摘目的探讨Corail羟基磷灰石全涂层股骨柄假体行全髋关节置换术(total hip arthroplasty,THA)治疗终末期髋关节疾病病人的中期疗效。方法回顾性分析我院2011年10月至2019年5月采用Corail假体行THA治疗的239例(258髋)终末期髋关节疾病病人的病例资料,其中男137例,女102例,平均年龄为50.4岁(38~79岁)。股骨头缺血性坏死145髋(56.2%),髋关节发育不良58髋(22.4%),髋关节骨性关节炎36髋(14.0%),股骨颈骨折11髋(4.3%),类风湿关节炎8髋(3.1%)。收集病人临床并发症,并采用髋关节Harris评分、疼痛视觉模拟量表(visual analogue scale,VAS)评分评估病人髋关节功能,随访X线片用于跟踪观察假体松动和螺钉断裂情况。结果术后1例出现肺部感染伴胸腔积液,6例术侧大腿出现不同程度疼痛,5例假体感染,6例脱位,7例小腿肌间静脉血栓,15例假体下沉,未见神经血管损伤等并发症。239例均获随访,随访时间为0.5~7.0年,平均5.8年,末次随访Harris评分为(84.84±5.65)分,VAS评分为(1.11±0.79)分,均较术前显著改善,差异均有统计学意义(t=-98.855,P<0.001;t=64.593,P<0.001)。末次随访时股骨柄稳定,未见透亮线迹象,无假体松动,无翻修,股骨柄存活率为100%。结论采用Corail羟基磷灰石全涂层股骨柄假体行THA具有稳定性持久、术后大腿疼痛发生率较低等优点,中期疗效较好。
