标准股骨干假体翻修全髋关节置换术中短股骨干假体的生物力学分析-动脉网

Biomechanical analysis of a short femoral stem used in revision total hip replacement of a standard femoral stem

Nature 等信源发布 2025-01-15 11:31

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可切换为仅中文

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Abstract

摘要

Short-stem total hip arthroplasty (SHA) has become popular because it preserves femoral bone stock and enables the use of short femoral stems in revision total hip arthroplasty (THA). However, no study has evaluated whether a short stem in revision THA, replacing a standard stem, can provide adequate primary stability to facilitate osseous integration.

短柄全髋关节置换术（SHA）已变得流行，因为它保留了股骨骨量，并能够在翻修全髋关节置换术（THA）中使用短柄股骨。然而，没有研究评估THA翻修中的短柄是否可以替代标准柄，提供足够的初级稳定性以促进骨整合。

In this biomechanical study, a metaphyseal anchoring SHA (Tri-Lock BPS) stem and a standard THA (Corail) stem were implanted into ten composite femurs and loaded dynamically from 300 to 1700 N with 1 Hz. Primary stability was estimated using three-dimensional (3D) micromotions at five points around the bone–implant interface.

在这项生物力学研究中，将干骺端锚定SHA（Tri-Lock BPS）茎和标准THA（Corail）茎植入十个复合股骨中，并以1 Hz的频率从300到1700 N动态加载。使用骨-种植体界面周围五个点的三维（3D）微动来估计主要稳定性。

A revision scenario was then established by removing the standard stem and implanting the same Tri-Lock BPS stem, with subsequent measurements of 3D micromotions. In the primary scenario, no significant differences in 3D micromotions were noted between the short and standard stems at most of the test points.

然后通过移除标准杆并植入相同的三锁BPS杆并随后测量3D微动来建立修订方案。在主要情况下，在大多数测试点，短茎和标准茎之间的3D微动没有显着差异。

Compared with the Corail group, the Tri-Lock BPS group presented significantly greater 3D micromotions only at the lateral point of the distal femur (P5: Tri-Lock BPS 32.9 ± 7.54 μm vs. Corail 25.1 ± 4.32 μm; .

与Corail组相比，Tri-Lock BPS组仅在股骨远端的外侧点出现明显更大的3D微动（P5:Tri-Lock BPS 32.9±7.54μm vs.Corail 25.1±4.32μm。

= 0.011). In the revision scenario, no significant differences in the 3D micromotions were noted between the primary and revision Tri-Lock BPS stems at all test points. Our results show that the SHA (Tri-Lock BPS) offers good primary stability, which is similar to that of the standard THA (Corail).

= 0.011）。在修订方案中，在所有测试点，主要和修订三锁BPS茎之间的3D微动没有显着差异。我们的结果表明，SHA（Tri-Lock BPS）具有良好的初级稳定性，与标准THA（Corail）相似。

The Tri-Lock BPS stem obtained comparable stability in this revision scenario as in the primary scenario; therefore, it can be assumed that the Corail standard stem can safely be revised with a Tri-Lock BPS short stem..

Tri-Lock BPS stem在该修订方案中获得了与主要方案相当的稳定性；因此，可以假设珊瑚标准杆可以安全地用三锁BPS短杆进行修改。。

Introduction

简介

Short-stem total hip arthroplasty (SHA) has gained increasing popularity in recent years because it is a bone-conserving procedure for more active or younger patients undergoing total hip arthroplasty

近年来，短柄全髋关节置换术（SHA）越来越受欢迎，因为它是一种用于更活跃或更年轻的全髋关节置换术患者的保骨手术

. Various design-specific short stems with individualized anchorage types have been introduced

.引入了各种具有个性化锚固类型的特定设计短杆

, and the excellent outcomes of the first SHA have been revealed in multiple studies

，并且多项研究揭示了第一个SHA的出色结果

. Compared with a standard cementless stem in conventional total hip arthroplasty (THA), a short cementless stem may have benefits in terms of lower stress shielding with a reduction in proximal bone remodelling

。与传统全髋关节置换术（THA）中的标准非骨水泥假体相比，短的非骨水泥假体可能在降低应力屏蔽和减少近端骨重塑方面具有优势

, bone preservation

，骨骼保存

, minimally invasive surgical techniques with a reduction in soft tissue disruption

，微创手术技术，减少软组织破坏

, and ease of revision surgery

，以及易于翻修手术

. An additional advantage is that it allows the use of a short stem as a revision prosthesis, preserving critical bone for hip revision, particularly in younger patients who may need further revision

。另一个优点是它允许使用短柄作为翻修假体，保留髋关节翻修的关键骨骼，特别是对于可能需要进一步翻修的年轻患者

However, to date, evidence that short-stem implants can be safely used as revision prostheses in THA is lacking. Only a few reports have described the clinical outcomes of the use of short stems as a revision femoral implant

然而，迄今为止，缺乏证据表明短柄植入物可以安全地用作THA的翻修假体。只有少数报告描述了使用短柄作为翻修股骨植入物的临床结果

. There are also some case reports on the revision of fractured stems with the benefits of avoiding distal cement removal in the femoral canal, reducing surgical time and blood loss, and allowing easier femoral revision

。也有一些关于骨折茎修复的病例报告，其优点是避免了股骨管中远端水泥的去除，减少了手术时间和失血，并使股骨修复更容易

. However, no study has yet demonstrated that a stable anchorage of a cementless short stem with sufficient stability can be acquired in such a revision scenario. The major reason for the absence of evidence is that most short implants have only been used in recent years; in particular, long-term follow-up of short stems with noteworthy data as a revision component is not currently available.

然而，尚未有研究表明，在这种修订方案中，可以获得具有足够稳定性的非骨水泥短柄的稳定锚固。缺乏证据的主要原因是大多数短植入物仅在近年来使用；特别是，目前尚无法对短茎进行长期随访，并将值得注意的数据作为修订部分。

. In light of this, it seems highly necessary to assess the biomechanical stability of a short stem when it is applied in revision THA procedures and this is also the novel concept in this study because there are no other studies focusing on this topic.

鉴于此，在THA翻修手术中应用短柄时，评估短柄的生物力学稳定性似乎非常必要，这也是本研究的新概念，因为没有其他研究关注这一主题。

The stability of an implant depends on a combination of primary stability (mechanical stability) and secondary stability (biological stability). Primary stability may affect the implant–bone interface condition and thus influence the mechanical stimuli for bone remodelling in the resurfaced femur

植入物的稳定性取决于一级稳定性（机械稳定性）和二级稳定性（生物稳定性）的组合。初级稳定性可能会影响种植体-骨界面的状况，从而影响重建股骨骨重建的机械刺激

. The primary stability of a prosthetic implant may be defined as the three-dimensional motion at the interface between pairs of points consisting of the layer of bone-forming cells closest to the implant and their corresponding point on the prosthetic surface. Two different types of motion can be characterized: reversible movement of the implant under a cycle of loading (termed micromotion) and irreversible movement of the implant within the femoral canal over time (termed migration).

假体植入物的主要稳定性可以定义为成对点之间的界面处的三维运动，所述成对点由最接近植入物的骨形成细胞层及其在假体表面上的相应点组成。可以表征两种不同类型的运动：在负载循环下植入物的可逆运动（称为微动）和植入物在股管内随时间的不可逆运动（称为迁移）。

. In cementless total hip arthroplasty (THA), primary stability is required to avoid micromotion and aseptic loosening, the main reason for early revision

在非骨水泥全髋关节置换术（THA）中，需要初级稳定性以避免微动和无菌性松动，这是早期翻修的主要原因

. Insufficient primary stability with high micromotion greater than 150 μm may lead to fibrous tissue at the bone–implant interface and consequently cause implant failure or loosening

.高度微动大于150μm的初级稳定性不足可能导致骨-种植体界面处的纤维组织，从而导致种植体失败或松动

. Thus, we chose immediate biomechanical stability to predict long-term effects.

因此，我们选择立即生物力学稳定性来预测长期效果。

Therefore, the present biomechanical analysis aimed to assess whether aseptic failure of a standard THA stem can safely be reversed using a short SHA stem. We assumed that a cementless short SHA stem has the ability to provide adequate primary stability in such a revision situation to allow osseous implant integration (Fig.

因此，目前的生物力学分析旨在评估使用短SHA茎是否可以安全地逆转标准THA茎的无菌性失败。我们假设无骨水泥短SHA茎在这种翻修情况下能够提供足够的初级稳定性，以允许骨植入物整合（图）。

and

和

Fig. 1

图1

(

) Implantation of the metaphyseal anchored SHA stem (Tri-Lock BPS, DePuy Synthes) and (

)植入干骺端锚定的SHA茎（Tri-Lock BPS，DePuy Synthes）和(

B类

) implantation of the standard THA stem (Corail, no collar, DePuy Synthes).

)。

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Fig. 2

图2

The load profile of the setup.

设置的负载配置文件。

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Results

结果

All the implantations and measurement procedures were successfully conducted. The 3D micromotion values at all the test points for both the primary and revision scenarios were less than the threshold value for osteointegration of 150 μm (PMID). The 3D micromotion results are shown in Figs.

所有植入和测量程序均成功进行。主要和修订情景下所有测试点的3D微动值均小于150μm骨整合阈值（PMID）。3D微动结果如图所示。

and

和

Primary implantation (Tri-lock BPS and Corail)

初次植入（Tri-lock BPS和Corail）

In the primary scenario, no significant differences in 3D micromotions were observed between the Corail and Tri-Lock BPS stems for most of the points: proximal points P1 (percentage value of the difference = 9.8%;

在主要情况下，大多数点的珊瑚和三锁BPS茎之间的3D微动没有观察到显着差异：近端点P1（差异的百分比值 = 9.8%;

= 0.306) and P2 (percentage value of the difference = 0.8%;

==0.306）和P2（差值的百分比值）=0.8%；

= 0.951), middle point P3 (percentage value of the difference = 11.4%;

=0.951），中点P3（差值的百分比值=11.4%；

= 0.269), and distal points P4 (percentage value of the difference = 17.7%;

=0.269），和远端点P4（差值的百分比=17.7%；

= 0.156) and P5 (percentage value of the difference = 23.1%;

==0.156）和P5（差值的百分比值）=23.1%；

= 0.016) (Figs.

=.016）（图。

and

和

). The Tri-Lock group revealed significantly higher 3D micromotions than those of Corail group only in the distal part at P5 (P5: Tri-Lock 32.9 ± 8.2 μm vs. Corail 25.1 ± 4.3 μm; percentage value of the difference = 23.1%;

)。Tri-Lock组仅在P5的远端显示出比Corail组显着更高的3D微动（P5:Tri-Lock 32.9±8.2μm对Corail 25.1±4.3μm；差异的百分比值=23.1%；

= 0.016) (Figs.

=.016）（图。

and

和

Fig. 3

图3

Setup configuration for measuring 3D micromotions at the bone–implant interface.

用于测量骨-种植体界面处3D微动的设置配置。

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Fig. 4

图4

3D micromotions determined for (

确定的3D微动(

) the primary situation of the Tri-Lock BPS short stem (Tri-Lock BPS primary), (

)Tri-Lock BPS短阀杆（Tri-Lock BPS primary）的主要情况(

B类

) the primary situation of the Corail standard stem (Corail primary), and (

)珊瑚标准茎（珊瑚初级）的主要情况，以及(

C级

) the revision of the Corail standard stem with a Tri-Lock BPS short stem (Tri-Lock BPS revision). Measurements were registered at 5 points: P1 = medial-proximal, P2 = ventral-proximal, P3 = ventral-median, P4 = ventral-distal, and P5 = lateral-distal.

)使用Tri-Lock BPS短杆修订Corail标准杆（Tri-Lock BPS修订版）。测量记录在5个点：P1=内侧近端，P2=腹侧近端，P3=腹侧中位数，P4=腹侧远端和P5=外侧远端。

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Fig. 5

图5

Direct comparison of the 3D micromotions for the 5 points. (

直接比较5个点的3D微动。（笑声）(

) Tri-Lock BPS-primary vs. Corail-primary stem. (

)Tri-Lock BPS初级与珊瑚初级茎。（笑声）(

B类

) Tri-Lock BPS-primary vs. Tri-Lock BPS-revision stem. Significantly higher 3D micromotions were not registered for the Tri-Lock BPS revision stem after revision of the Corail standard stem. The asterisk (*) indicates a significant difference from Tri-Lock BPS-primary (

)Tri-Lock BPS主阀杆与Tri-Lock BPS修订阀杆。在修订Corail标准杆后，Tri-Lock BPS修订杆未注册明显更高的3D微动。星号（*）表示与Tri-Lock BPS primary有显着差异(

< 0.05).

（0.05）。

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Revision scenario (tri-lock BPS and tri-lock BPS revision stem)

修订场景（tri-lock BPS和tri-lock BPS修订杆）

In the revision scenario, no significant differences in 3D micromotion were noted between the primary Tri-Lock and Tri-Lock as revision stems at any of the test points: proximal points P1 (percentage value of the difference = 14.4%;

= 14.4%;

= 0.141) and P2 (percentage value of the difference = 12.9%;

==0.141）和P2（差值的百分比值）=12.9%；

= 0.292), middle point P3 (percentage value of the difference = 12.5%;

=0.292），中点P3（差值的百分比值=12.5%；

= 0.134), and distal points P4 (percentage value of the difference = 17.9%;

=0.134），和远端点P4（差值的百分比=17.9%；

= 0.239) and P5 ( percentage value of the difference = 2.2%;

==0.239）和P5（差值的百分比值）=2.2%；

= 0.887) (Figs.

=0.887）（图。

and

和

Discussion

讨论

This in vitro study provides the biomechanical rationale that aseptic failure of a standard THA stem can be safely reversed with a short SHA stem. The results indicate that the micromotions of the Tri-Lock BPS stem utilized to revise the standard stem are comparable to those of the Tri-Lock BPS stem used in the primary scenario.

这项体外研究提供了生物力学原理，即标准THA茎的无菌性失败可以用短SHA茎安全地逆转。结果表明，用于修改标准杆的三锁BPS杆的微动与主要方案中使用的三锁BPS杆的微动相当。

Moreover, the acquired data demonstrate a stable revision scenario that provides sufficient primary stability for good osseous integration of implants..

此外，获得的数据表明了一个稳定的修订方案，为植入物的良好骨整合提供了足够的初级稳定性。。

An evaluation of the primary scenarios of the Tri-Lock BPS SHA and Corail THA revealed sufficient primary stability. The Tri-Lock BPS short stem revealed 3D micromotions under the threshold value of 150 μm, which is considered an important prerequisite for osseous integration

对Tri-Lock BPS SHA和Corail THA的主要情景进行的评估显示，其具有足够的主要稳定性。三锁BPS短柄在150μm的阈值下显示出3D微动，这被认为是骨整合的重要先决条件

. Pilliar et al. and Jasty et al. reported that implants subjected to more than 150 micrometres of motion were surrounded by dense fibrous tissue, resulting in aseptic loosening of the cementless implant

. These results are consistent with previous biomechanical studies showing desirable primary stability for Tri-Lock stems

这些结果与先前的生物力学研究一致，表明三锁杆具有理想的初级稳定性

. Tatani et al. used the digital image correlation (DIC) technique for analyzing the strain distribution of Tri-Lock BPS implant, and found that DIC technique was a good preclinical evaluation tool of the biomechanical behavior induced by implants and also identified its potential for experimental FE model validation.

Tatani等人使用数字图像相关（DIC）技术分析了Tri-Lock BPS植入物的应变分布，发现DIC技术是植入物诱导的生物力学行为的良好临床前评估工具，并确定了其用于实验性有限元模型验证的潜力。

Additionally, Tri-Lock BPS implant can reduce the stress shielding in the distal region of femur.

此外，Tri-Lock BPS植入物可以减少股骨远端区域的应力屏蔽。

. The available clinical data with medium-term follow-up further support these biomechanical data. Guo et al. evaluated 84 Tri-Lock BPS SHAs after a mean of four years and reported no occurrence of aseptic loosening of the implants

中期随访的可用临床数据进一步支持了这些生物力学数据。郭等人在平均四年后评估了84个Tri-Lock BPS SHAs，并报告没有发生植入物的无菌性松动

. A retrospective outcome review reported a revision rate of 0.8% after a mean of 8 years in a cohort of 2,040 Tri-Lock BPS SHAs

一项回顾性结果回顾报告称，在2040名Tri-Lock BPS SHAs队列中，平均8年后的修订率为0.8%

The good primary stability of the Corail THA found in this study is consistent with the findings of previous studies

在这项研究中发现的珊瑚THA的良好初级稳定性与先前研究的结果一致

. Kistler et al.

Kistler等人。

and Glismann et al.

Glismann等人。

conducted in vitro biomechanical studies and demonstrated sufficient primary stability of the coronary stem in THA with 3D micromotions less than 150 μm. The good biomechanical stability is consistent with the excellent long-term survival of this stem, which has been reported in multiple studies

进行了体外生物力学研究，并证明了三维微动小于150μm的THA冠状动脉干具有足够的初级稳定性。良好的生物力学稳定性与该茎的长期存活率相一致，这已在多项研究中得到报道

. According to a retrospective study performed by Vidalain JP

根据Vidalain JP进行的回顾性研究

, the survival rate of patients treated with the Corail stem was 96.4% after 23 years. Almeida et al.

，23年后接受珊瑚茎治疗的患者的生存率为96.4%。阿尔梅达等人。

reported no aseptic loosening of the femoral component in a series of 301 coronary THA procedures after 16.9 years. Louboutin et al. evaluated 133 Corail THAs after a mean of 12 years and reported 98% stem survival for revision due to aseptic loosening

据报道，在16.9年后的一系列301例冠状动脉THA手术中，股骨组件没有无菌性松动。Louboutin等人在平均12年后评估了133个珊瑚THA，并报告由于无菌性松动，98%的茎存活率可用于修复

Revising the Corail standard implant with the Tri-Lock BPS stem as a revision implant revealed no significant differences in 3D micromotions between the revision and primary Tri-Lock BPS settings at any of the tested points. This result supports the assumption that adequate bone stock is reserved in the metaphyseal femur to anchor a metaphyseal anchoring Tri-Lock BPS implant in a revision after aseptic failure of coronary THA.

用Tri-Lock BPS茎修订Corail标准植入物作为修订植入物，发现在任何测试点，修订和主要Tri-Lock BPS设置之间的3D微动没有显着差异。这一结果支持这样的假设，即在冠状动脉THA无菌性失败后，在干骺端股骨中保留足够的骨量，以锚定干骺端锚定三锁BPS植入物。

However, it is important to note that this in vitro analysis is only responsible for cases without the occurrence of large defects in the bone stock or bone fractures after removing the coronary stem..

然而，重要的是要注意，这种体外分析仅适用于在移除冠状动脉干后没有发生骨量大缺陷或骨折的情况。。

A comparison of the present biomechanical results with clinical data is challenging because, to our knowledge, only a few clinical studies have described the outcome of revision procedures using short stems as a femoral component

目前的生物力学结果与临床数据的比较具有挑战性，因为据我们所知，只有少数临床研究描述了使用短柄作为股骨组件的翻修程序的结果

. Mauch et al.

Mauch等人。

evaluated 31 patients utilizing Optimys short stems for revision THA after a mean of 2.3 years and revealed that stem fixation was stable in all patients without aseptic loosening. Liu et al. evaluated 381 Tri-Lock BPS SHAs after a mean of 5.9 years and reported a low aseptic loosening rate of the femoral stem (96.8%).

平均2.3年后，对31例使用Optimys短柄进行THA翻修的患者进行了评估，结果显示所有患者的柄固定均稳定，无无菌性松动。Liu等人在平均5.9年后评估了381例Tri-Lock BPS SHAs，并报告股骨柄无菌性松动率低（96.8%）。

There are also case reports on the revision of fractured stems using short femoral stems, which reported a radiologically stable, well-fixed implant in SHAs after 2 to 3.5 years.

也有关于使用短股骨柄修复骨折茎的病例报告，该病例报告了2至3.5年后在SHAs中放射学稳定，固定良好的植入物。

. Although good clinical efficacy is associated with our biomechanical results, long-term clinical and radiological follow-up is needed to draw a definite conclusion.

尽管良好的临床疗效与我们的生物力学结果相关，但需要长期的临床和放射学随访才能得出明确的结论。

Further limitations of the present study must be discussed. First, composite sawbones were chosen rather than cadaveric bones. The absolute micromotion values obtained from the mechanical testing of sawbones are not equal to those of in vitro cadaveric models, which might imitate superior in vitro behaviour.

。首先，选择复合锯骨而不是尸体骨。从锯骨的机械测试中获得的绝对微动值不等于体外尸体模型的微动值，这可能模仿了优越的体外行为。

However, the use of composite bone is considered an effective method for exploring the biomechanical characteristics of implanted femurs with a uniform structure and highly reproducible results.

然而，复合骨的使用被认为是探索植入股骨的生物力学特性的有效方法，具有均匀的结构和高度可重复的结果。

. Second, the femoral stems are cementless implants that require osseous integration, whereas the present study focused only on primary fixation and did not consider long-term biological fixation. Finally, the in vitro biomechanical studies do not completely represent the in vivo scenario because the sawbones highly mimic human bones but not human bones, thus, the results should be further verified in a clinical setting..

其次，股骨柄是需要骨整合的非骨水泥植入物，而本研究仅关注初次固定，未考虑长期生物固定。最后，体外生物力学研究并不能完全代表体内情况，因为锯骨高度模仿人体骨骼，而不是人体骨骼，因此，结果应在临床环境中进一步验证。。

Conclusions

结论

The results of this study demonstrate that the metaphyseal anchored Tri-Lock BPS SHA provides good primary stability comparable to that of conventional Corail THA. The data also suggest that in a revision scenario, the conventional Corail stem can be safely revised with a cementless Tri-Lock BPS stem and acquire similar primary stability as a Tri-Lock BPS stem in a primary scenario.

这项研究的结果表明，干骺端锚定的三锁BPS SHA提供了与传统珊瑚THA相当的良好初级稳定性。数据还表明，在修订方案中，常规珊瑚茎可以用无水泥三锁BPS茎安全修订，并在主要方案中获得与三锁BPS茎相似的主要稳定性。

However, it is also worth noting that this study only provides a biomechanical analysis, and the results should be verified in a clinical setting..

然而，值得注意的是，这项研究只提供了生物力学分析，结果应该在临床环境中得到验证。。

Materials and methods

材料和方法

Implants

植入物

For standard THA, a cementless proximal anchored Corail standard stem (Corail, DePuy Synthes, Warsaw, Indiana, USA) with good long-term clinical results was used (corail size 13,135°, no collar) (Fig.

对于标准THA，使用具有良好长期临床结果的无骨水泥近端锚定珊瑚标准茎（Corail，DePuy Synthes，华沙，印第安纳州，美国）（Corail大小13135°，无领）（图）。

)

. The stem is straight with a stepped geometry and collarless with the concept of proximal anchorage. It has a proximal trapezoidal cross-section and a tapered distal stem with a fully hydroxyapatite-coated (150 micron thickness) nonporous forged titanium alloy stem.

.阀杆是直的，具有阶梯状的几何形状，并且没有近端锚固的概念。它具有近端梯形横截面和锥形远端茎，具有完全羟基磷灰石涂层（150微米厚）的无孔锻造钛合金茎。

For SHA, a metaphyseal anchored Tri-Lock BPS short stem (Tri-Lock Bone Preservation Stem, DePuy Synthes, Warsaw, Indiana, USA) was evaluated (Tri-Lock BPS size 6, 135°) (Fig.

对于SHA，评估了干骺端锚定的Tri-Lock BPS短茎（Tri-Lock Bone Preservation stem，DePuy Synthes，华沙，印第安纳州，美国）（Tri-Lock BPS大小6135°）（图）。

). The rationale for choosing this stem is that although the high-offset Tri-Lock BPS short stem has been widely used, few studies have explored its biomechanical results

)。选择这种茎的理由是，尽管高偏移量三锁BPS短茎已被广泛使用，但很少有研究探索其生物力学结果

. The stem is a cementless, bone preservation stem that is a tapered wedge and collarless and based on the concept of metaphyseal anchorage

茎是一种无骨水泥的骨保存茎，是一种锥形楔形无领茎，基于干骺端支抗的概念

. The distal part is polished, and the proximal part has a highly porous and roughened coating (Gription).

.远端部分被抛光，近端部分具有高度多孔和粗糙的涂层（Gription）。

Specimen preparation

试样制备

Both cementless implants, the Corail THA and Tri-Lock BPS SHA, were implanted without cement in ten composite femurs (Model 3406, left side, Size L, Sawbones Pacific Research Laboratories, USA). All the implantations were performed by a senior orthopaedic surgeon specializing in hip arthroplasty under fluoroscopy according to the manufacturer’s instructions (Fig. .

两种非骨水泥植入物Corail THA和Tri-Lock BPS SHA均在十个复合股骨（3406型，左侧，尺寸L，美国Sawbones Pacific Research Laboratories）中无水泥植入。根据制造商的说明，所有植入均由专门从事髋关节置换术的高级整形外科医生在透视下进行（图）。

). The composite femur was cut 20 cm below the trochanter minor and then firmly embedded in a metal pot (Technovit 3040, Merck, Darmstadt, Germany). To imitate a physiological loading condition in light of the in vitro data from Bergman et al., all the samples were located at an adduction angle of 16° (coronal plane) and a flexion angle of 9° (sagittal plane).

)。将复合股骨在小转子下方20厘米处切开，然后牢固地嵌入金属罐（Technovit 3040，Merck，Darmstadt，Germany）中。为了根据Bergman等人的体外数据模拟生理负荷条件，所有样品的内收角为16°（冠状面），屈曲角为9°（矢状面）。

. All the tests were conducted utilizing a ceramic head with a medium length and a 32 mm diameter.

。所有测试均使用中等长度和32 mm直径的陶瓷头进行。

Loading procedure

装载程序

All the tests for measuring the primary stability were conducted under the same loading conditions. To obtain physiological adapted loading conditions, the test parameters were adjusted to the in vivo measurements of a patient with a bodyweight of about 70 kg, walking on level ground

所有用于测量初级稳定性的测试均在相同的载荷条件下进行。为了获得适应生理的负荷条件，将测试参数调整为在水平地面上行走的体重约70公斤的患者的体内测量值

. A sinusoid dynamic load with an amplitude between 300 and 1700 N at a frequency of 1 Hz was applied similar to former studies described by Fottner et al.

与Fottner等人描述的先前研究相似，应用了频率为1 Hz，振幅在300至1700 N之间的正弦动态载荷。

(Fig.

（图。

). The force was generated using an MTS 809 hydraulic testing machine (MTS Systems Corporation, MN USA) (Fig.

)。该力是使用MTS 809液压试验机（MTS Systems Corporation，MN USA）产生的（图）。

). These physiological loading conditions were also utilized in previous studies, as we described previously

)。正如我们之前描述的那样，这些生理负荷条件也被用于以前的研究中

. To avoid transverse shear stress, the load was applied to the ceramic head (32 mm, size M) utilizing a ceramic liner mounted on an x–y table. The implants were all preconditioned under the designed loading pattern for 10 min (600 cycles) before the first measurement.

为了避免横向剪切应力，使用安装在x–y工作台上的陶瓷衬垫将载荷施加到陶瓷头（32 mm，尺寸M）上。在第一次测量之前，将所有植入物在设计的加载模式下预处理10分钟（600个循环）。

Micromotion registration

微动注册

To determine the primary stability of the implants, 3D micromotions were detected using an optical 3D motion tracking system (ARAMIS Professional 6 M, GOM GmbH, Braunschweig, Germany). Therefore, the marker flag was attached to a metal rod (Flag_implant) that was securely affixed to the implant and transferred the micromotions from the bone–implant interface to the flags through drilling holes on the sawbones, and the relative marker flags (Flag_bone) were attached to the composite femur along the edges of the holes to detect the relative bone–implant micromotion (Fig. .

为了确定植入物的主要稳定性，使用光学3D运动跟踪系统（ARAMIS Professional 6 M，GOM GmbH，不伦瑞克，德国）检测3D微动。因此，标记旗被连接到一根金属棒（flag\U植入物）上，该金属棒牢固地固定在植入物上，并通过在锯骨上钻孔将微动从骨-植入物界面转移到标志上，相对标记旗（flag\U骨）沿着孔的边缘连接到复合股骨上，以检测相对的骨-植入物微动（图）。

). The marker flags attached to the metal ring and the relative marker flags attached to the composite femur were at the same level as the test point, thus enabling the reduction of errors from bone deformation. The micromotion measurement were conducted by analyzed the relative displacement between flag_implant and flag_bone.

)。附着在金属环上的标记标志和附着在复合股骨上的相对标记标志与测试点处于同一水平，从而能够减少骨变形引起的误差。。

The calculation of relative movement at the bone‒implant interface was performed along each coordinate axis (x, y and z) and subsequently converted into 3D micromotion.

沿着每个坐标轴（x，y和z）进行骨-种植体界面相对运动的计算，随后转换为3D微动。

. The samples were preloaded, and every single point was tested for 30 cycles (30 s) during dynamic loading. The time point chosen for the micromotion measurement was at the maximum loading time. The data for each test point were an average of 30 cycles and were considered micromotions

.对样品进行预加载，并在动态加载过程中对每个点进行30个循环（30 s）的测试。选择用于微动测量的时间点处于最大加载时间。每个测试点的数据平均为30个周期，被认为是微动

Primary setting (Tri-lock BPS and Corail stem)

主要设置（Tri-lock BPS和珊瑚茎）

In the primary implantation setting, the 3D micromotions were measured at 5 measurement points (P1-5) for both stems, which were located at three different levels of the composite femur, including 1 on the medial side (P1: medial-proximal), 3 on the ventral side (P2: ventral-proximal, P3: ventral-median and P4: ventral-distal) and 1 on the lateral side (P5: lateral-distal) (Fig. .

。

A–C). The proximal registrations P1 and P2 were placed at the level of the trochanter minor. The distal registrations P4 and P5 were positioned approximately 1 cm above the tip of the stem. The middle registration P3 was positioned medianly between the proximal and distal levels. Owing to the different sizes and shapes of the short and standard implants, the points of the standard THA and SHA do not have identical locations..

A–C）。近端注册P1和P2位于小转子的水平。远端注册P4和P5位于茎尖上方约1厘米处。中间配准P3仅位于近端和远端水平之间。由于短植入物和标准植入物的大小和形状不同，标准THA和SHA的点没有相同的位置。。

Revision setting (tri-lock BPS and tri-lock BPS revision stem)

修订设置（tri-lock BPS和tri-lock BPS修订杆）

For the revision setting, the coronary standard stem of THA was removed after all 3D micromotions were tested. The composite femur was then prepared for the Tri-Lock BPS short stem as a revision stem. The preparation was conducted as described in the primary Tri-Lock BPS scenario with an osteotomy, stepwise broach, and implantation of the same Tri-Lock BPS stem (size 6).

对于修订设置，在测试所有3D微动后，移除THA的冠状动脉标准茎。然后为Tri-Lock BPS短柄准备复合股骨作为翻修柄。如原发性三锁BPS方案中所述进行制备，截骨术，逐步拉刀和植入相同的三锁BPS茎（尺寸6）。

All the tests for the revision Tri-Lock BPS (Tri-Lock BPS-revision) stem were performed under the same set of procedures as those of the primary Tri-Lock BPS stem with identical test points..

修订版Tri-Lock BPS（Tri-Lock BPS修订版）阀杆的所有测试均在与具有相同测试点的主要Tri-Lock BPS阀杆相同的程序下进行。。

Statistics and analysis

统计与分析

The data are presented as the means ± standard deviations (SDs). GraphPad Prism 5 (GraphPad Software, Inc., La Jolla California, USA) was used for the statistical calculations and graphs. After evaluation for normality using the Shapiro‒Wilk test, an unpaired Student’s t test was performed to compare the Corail vs.

数据表示为平均值±标准偏差（SD）。GraphPad Prism 5（GraphPad Software，Inc.，La Jolla California，USA）用于统计计算和图形。在使用Shapiro-Wilk检验评估正态性后，进行了不成对的学生t检验以比较珊瑚与。

Tri-Lock stems in the primary scenario and the Tri-Lock-primary vs. Tri-Lock-revision stems in the revision scenario. A .

Tri-Lock词干在主要场景中，Tri-Lock primary vs.Tri-Lock revision词干在修订场景中。

value < 0.05 was considered to denote significance.

值<0.05被认为表示显着性。

Data availability

数据可用性

Data are available from the corresponding author upon reasonable request.

根据合理的要求，通讯作者可以提供数据。

References

参考文献

Luger, M. et al. Periprosthetic femoral fractures in cementless short versus straight stem total hip arthroplasty: A propensity score matched analysis.

Luger，M.等人。非骨水泥短柄与直柄全髋关节置换术中的假体周围股骨骨折：倾向评分匹配分析。

J. Arthroplasty

J、关节成形术

, 751–756.

https://doi.org/10.1016/j.arth.2022.10.027

(2023).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Reddy, G. B. et al. Survivorship and outcomes of femoral neck preserving stems in primary total hip arthroplasty.

Reddy，G.B.等人。初次全髋关节置换术中保留股骨颈柄的存活率和结果。

J. Arthroplasty

J、关节成形术

, 1606–1611.

https://doi.org/10.1016/j.arth.2022.03.080

(2022).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Kutzner, K. P. Calcar-guided short-stem total hip arthroplasty: Will it be the future standard? Review and perspectives.

Kutzner，K.P。Calcar引导的短柄全髋关节置换术：它会成为未来的标准吗？回顾和展望。

World J. Orthop.

, 534–547.

https://doi.org/10.5312/wjo.v12.i8.534

(2021).

Article

文章

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

de Waard, S. et al. Short-term success of proximal bone stock preservation in short hip stems: A systematic review of the literature.

de Waard，S.等人。短髋关节近端骨储备保存的短期成功：文献的系统综述。

EFORT Open Rev.

EFORT Open版本。

, 1040–1051.

https://doi.org/10.1302/2058-5241.6.210030

(2021).

Article

文章

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Migliorini, F. et al. Short stems for total hip replacement among middle-aged patients.

Migliorini，F。等人。中年患者全髋关节置换术的短柄。

Int. Orthop.

内景矫形。

, 847–855.

https://doi.org/10.1007/s00264-020-04516-x

(2020).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Sivaloganathan, S., Maillot, C., Harman, C., Villet, L. & Rivière, C. Neck-sparing short femoral stems: A meta-analysis.

。

Orthop. Traumatol. Surg. Res.

骨科。创伤。外科研究。

106

, 1481–1494.

https://doi.org/10.1016/j.otsr.2020.05.004

(2020).

Article

文章

PubMed

Google Scholar

谷歌学者

Fawley, D. W., Croker, S., Irving, J. F. & Swank, M. L. Intermediate-term survivorship of total hip arthroplasty with a proximally coated tapered-wedge femoral stem: A retrospective, multi-center registry review.

Fawley，D.W.，Croker，S.，Irving，J.F。＆Swank，M.L。使用近端涂层锥形楔形股骨柄的全髋关节置换术的中期存活率：回顾性，多中心登记审查。

Cureus

, e36623.

，e36623。

https://doi.org/10.7759/cureus.36623

(2023).

Article

文章

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Fontalis, A. et al. 2-Year radiostereometric analysis evaluation of a short, proximally coated, triple-taper blade femoral stem versus a quadrangular-taper stem with reinforced proximal body: A randomized controlled trial.

Fontalis，A。等人。2年放射立体测量分析评估短，近端涂层，三锥形刀片股骨柄与具有增强近端体的四边形锥形柄：一项随机对照试验。

J. Arthroplasty

J、关节成形术

, S152-s161.

，S152-s161。

https://doi.org/10.1016/j.arth.2023.03.030

(2023).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Maeda, T. et al. Relationship between stress shielding and optimal femoral canal contact regions for short, tapered-wedge stem analyzed by 2D and 3D systems in total hip arthroplasty.

Maeda，T。等人。在全髋关节置换术中，通过2D和3D系统分析了短锥形楔形柄的应力屏蔽与最佳股骨管接触区域之间的关系。

J. Clin. Medicine

J、临床。医学

, 3138.

https://doi.org/10.3390/jcm12093138

(2023).

Article

文章

MATH

数学

Google Scholar

谷歌学者

Slullitel, P. A. et al. Influence of femoral component design on proximal femoral bone mass after total hip replacement: A randomized controlled trial.

Slullitel，P.A。等。全髋关节置换术后股骨假体设计对股骨近端骨量的影响：一项随机对照试验。

J. Bone Joint Surg.

J、骨关节外科。

103

, 74–83.

https://doi.org/10.2106/jbjs.20.00351

(2021).

Article

文章

PubMed

Google Scholar

谷歌学者

Luger, M. et al. Digital templating cementless short stem total hip arthroplasty: Is there a difference in planning adherence between the direct anterior approach and minimally invasive anterolateral approach?.

Luger，M.等。数字模板非骨水泥短柄全髋关节置换术：直接前路入路和微创前外侧入路在计划依从性方面是否存在差异？。

Arch. Orthop. Trauma Surg.

拱门。骨科。创伤外科。

143

, 1619–1626.

https://doi.org/10.1007/s00402-022-04374-9

(2023).

Article

文章

PubMed

Google Scholar

谷歌学者

Yang, H., Kim, K., Kim, H. S. & Yoo, J. J. Total hip arthroplasty performed with a novel design type 1 femoral stem: A retrospective minimum 5-year follow-up study.

。

Clin. Orthop. Surg.

临床。骨科。外科。

, 28–34.

https://doi.org/10.4055/cios21048

(2022).

Article

文章

CAS

中科院

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Kim, Y. H., Jang, Y. S. & Kim, E. J. A prospective, randomized comparison of the long-term clinical and radiographic results of an ultra-short vs a conventional length cementless anatomic femoral stem.

Kim，Y.H.，Jang，Y.S.＆Kim，E.J.对超短与常规长度非骨水泥解剖股骨柄的长期临床和影像学结果进行前瞻性随机比较。

J. Arthroplasty

J、关节成形术

, 1707–1713.

https://doi.org/10.1016/j.arth.2020.12.030

(2021).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Boyle, A. B.

博伊尔，A.B.

et al.

等人。

Equivalent revision rates and patient reported outcomes with routine use of a short (125 mm) cemented stem for total hip arthroplasty compared to a standard length (150 mm) cemented stem. A two surgeon series of 1335 patients.

与标准长度（150 mm）骨水泥柄相比，常规使用短（125 mm）骨水泥柄进行全髋关节置换术的翻修率和患者报告的结果相当。1335名患者的两名外科医生系列。

Arch. Orthop. Trauma Surg.

拱门。骨科。创伤外科。

https://doi.org/10.1007/s00402-024-05235-3

(2024).

Mauch, M., Brecht, H., Clauss, M. & Stoffel, K. Use of short stems in revision total hip arthroplasty: A retrospective observational study of 31 patients.

Mauch，M.，Brecht，H.，Clauss，M。＆Stoffel，K。在翻修全髋关节置换术中使用短柄：对31例患者的回顾性观察研究。

Medicina (Kaunas, Lithuania)

Mdicinan(Kans),Lithani

, 2023.

https://doi.org/10.3390/medicina59101822

(1822).

Article

文章

Google Scholar

谷歌学者

Liu, Z. et al. Short uncemented femoral component for hip revision: Prognosis and risk factors associated with failure.

Liu，Z.等人。髋关节翻修用短非骨水泥股骨假体：预后和与失败相关的危险因素。

BMC Surg.

BMC外科。

, 192.

https://doi.org/10.1186/s12893-021-01196-1

(2021).

Article

文章

CAS

中科院

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Evola, F. R., Evola, G. & Sessa, G. Use of short stems in revision of standard femoral stem: A case report.

Evola，F.R.，Evola，G。＆Sessa，G。使用短柄修订标准股骨柄：病例报告。

World J. Orthop.

, 528–533.

https://doi.org/10.5312/wjo.v11.i11.528

(2020).

Article

文章

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Lee, P. Y. F., Woodnutt, D. J. & Golding, D. M. A short femoral stem in revision total hip replacement: An alternative solution for prosthetic fracture: A case report.

Lee，P.Y.F.，Woodnutt，D.J。和Golding，D.M。翻修全髋关节置换术中的短股骨柄：假体骨折的替代解决方案：病例报告。

JBJS Case Connector

JBJS外壳连接器

, e33.

，e33。

https://doi.org/10.2106/jbjs.Cc.16.00174

(2017).

Article

文章

PubMed

Google Scholar

谷歌学者

Thorat, B., Singh, A. & Vohra, R. Role of a bone conserving short stem femoral component in revision total hip arthroplasty: A case report.

Thorat，B.，Singh，A。＆Vohra，R。保留骨的短柄股骨组件在翻修全髋关节置换术中的作用：病例报告。

J. Clin. Orthop. Trauma

J、临床。骨科。创伤

, 29–33.

https://doi.org/10.1016/j.jcot.2020.09.033

(2021).

Article

文章

PubMed

Google Scholar

谷歌学者

Pal, B. & Gupta, S. The effect of primary stability on load transfer and bone remodelling within the uncemented resurfaced femur.

Pal，B。＆Gupta，S。初级稳定性对非骨水泥表面置换股骨内载荷转移和骨重塑的影响。

Proc. Instit. Mech. Eng. Part H, J. Eng. Med.

程序。学院。机械。工程H部分，J.工程医学。

225

, 549–561.

https://doi.org/10.1177/0954411910397102

(2011).

Article

文章

MATH

数学

Google Scholar

谷歌学者

Bühler, D. W., Berlemann, U., Lippuner, K., Jaeger, P. & Nolte, L. P. Three-dimensional primary stability of cementless femoral stems.

Bühler，D.W.，Berlemann，U.，Lippuner，K.，Jaeger，P。＆Nolte，L.P。非骨水泥股骨柄的三维初级稳定性。

Clin. Biomech. (Bristol)

临床。生物技术。（布里斯托尔）

, 75–86.

https://doi.org/10.1016/s0268-0033(96)00059-9

(1997).

Article

文章

Google Scholar

谷歌学者

van Loon, J. et al. Ceramic-on-ceramic articulation in press-fit total hip arthroplasty as a potential reason for early failure, what about the survivors: A ten year follow-up.

van Loon，J.等人，《press-fit全髋关节置换术中的陶瓷对陶瓷关节作为早期失败的潜在原因，幸存者如何：十年随访》。

Int. Orthop.

内景矫形。

, 1447–1454.

https://doi.org/10.1007/s00264-020-04895-1

(2021).

Article

文章

PubMed

Google Scholar

谷歌学者

Pilliar, R. M., Lee, J. M. & Maniatopoulos, C. Observations on the effect of movement on bone ingrowth into porous-surfaced implants.

Pilliar，R.M.，Lee，J.M。＆Maniatopoulos，C。观察运动对骨向内生长到多孔表面植入物中的影响。

Clin. Orthop. Relat. Res.

嘿，克林。Orthope先生。放松。我确实如此。

208

, 108–113 (1986).

Article

文章

Google Scholar

谷歌学者

Jasty, M. et al. In vivo skeletal responses to porous-surfaced implants subjected to small induced motions.

Jasty，M.等人。体内骨骼对受到小诱导运动的多孔表面植入物的反应。

J. Bone Joint Surg.

J、骨关节外科。

, 707–714.

https://doi.org/10.2106/00004623-199705000-00010

(1997).

Article

文章

CAS

中科院

PubMed

Google Scholar

谷歌学者

Richardson, V. R., Chong, A. C. M. & Brown, A. N. Biomechanical comparison of impaction techniques and cross-sectional femoral stem shapes for cementless total hip arthroplasty.

Richardson，V.R.，Chong，A.C.M。和Brown，A.N。非骨水泥全髋关节置换术中冲击技术和横截面股骨柄形状的生物力学比较。

Kansas J. Med.

堪萨斯州J.医学院。

, 30–33.

https://doi.org/10.17161/kjm.vol17.21522

(2024).

Article

文章

Google Scholar

谷歌学者

Drosos, G. I. & Touzopoulos, P. Short stems in total hip replacement: Evidence on primary stability according to the stem type.

。

Hip Int. J. Clin. Exp. Res. Hip Pathol. Therapy

Hip Int.J.Clin。实验研究髋关节病理学。治疗

, 118–127.

https://doi.org/10.1177/1120700018811811

(2019).

Article

文章

Google Scholar

谷歌学者

Tatani, I. et al. Comparative analysis of the biomechanical behavior of two different design metaphyseal-fitting short stems using digital image correlation.

Tatani，I。等人。使用数字图像相关对两种不同设计的干骺端短茎的生物力学行为进行比较分析。

Biomed. Eng. Online

生物医学。工程在线

, 65.

https://doi.org/10.1186/s12938-020-00806-y

(2020).

Article

文章

CAS

中科院

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Guo, J. et al. Comparison of tri-lock bone preservation stem and the conventional standard corail stem in primary total hip arthroplasty.

郭，J。等。三锁骨保存柄与常规标准珊瑚柄在初次全髋关节置换术中的比较。

Orthopaedic Surg.

整形外科。

, 749–757.

https://doi.org/10.1111/os.12946

(2021).

Article

文章

MATH

数学

Google Scholar

谷歌学者

Kistler, M. et al. The effect of a collar on primary stability of standard and undersized cementless hip stems: A biomechanical study.

Kistler，M.等人。项圈对标准和尺寸较小的非骨水泥髋关节柄初级稳定性的影响：生物力学研究。

Arch. Orthop. Trauma Surg.

拱门。骨科。创伤外科。

https://doi.org/10.1007/s00402-024-05374-7

(2024).

Article

文章

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Glismann, K. et al. Small design modifications can improve the primary stability of a fully coated tapered wedge hip stem.

Glismann，K。等人。小的设计修改可以提高全涂层锥形楔形髋关节柄的主要稳定性。

PloS One

公共图书馆

, e0300956.

，e0300956。

https://doi.org/10.1371/journal.pone.0300956

(2024).

Article

文章

CAS

中科院

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Vidalain, J. P. Twenty-year results of the cementless corail stem.

Vidalain，J.P。非骨水泥珊瑚茎的二十年结果。

Int. Orthop.

内景矫形。

, 189–194.

https://doi.org/10.1007/s00264-010-1117-2

(2011).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Almeida, F., Gállego, S., Argüelles, F. & Silvestre, A. Long-term outcome of cementless total hip arthroplasty with threaded Tropic® acetabular cup and Corail® femoral stem.

Almeida，F.，Gállego，S.，Argüelles，F。＆Silvestre，A。螺纹Tropic®髋臼杯和Corail®股骨柄非骨水泥全髋关节置换术的长期结果。

Acta Orthopaedica Belgica

比利时骨科学报

, 393–399 (2021).

Article

文章

PubMed

Google Scholar

谷歌学者

Louboutin, L., Viste, A., Desmarchelier, R. & Fessy, M. H. Long-term survivorship of the Corail™ standard stem.

Louboutin，L.，Viste，A.，Desmarchelier，R。＆Fessy，M.H。Corail™标准茎的长期存活率。

Orthop. Traumatol. Surg. Res.

骨科。创伤。外科研究。

103

, 987–992.

https://doi.org/10.1016/j.otsr.2017.06.010

(2017).

Article

文章

CAS

中科院

PubMed

Google Scholar

谷歌学者

Höch, A. et al. Primary stability of multi-hole cups compared to plate osteosynthesis in osteoporotic anterior column and posterior hemi-transverse acetabular fractures-A biomechanical comparison.

Höch，A。等人。多孔杯与骨质疏松性前柱和后半横向髋臼骨折中的钢板接骨术相比的主要稳定性-生物力学比较。

PloS One

公共图书馆

, e0270866.

，e0270866。

https://doi.org/10.1371/journal.pone.0270866

(2022).

Article

文章

CAS

中科院

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Aziz, M. S. R. et al. Biomechanical analysis using FEA and experiments of a standard plate method versus three cable methods for fixing acetabular fractures with simultaneous THA.

Aziz，M.S.R.等人。使用有限元分析的生物力学分析和标准钢板方法与三种电缆方法的实验，用于同时THA固定髋臼骨折。

Med. Eng. Phys.

工程学。

, 71–78.

https://doi.org/10.1016/j.medengphy.2017.06.004

(2017).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Karayiannis, P. N. et al. Risk factors for significant radiolucent line development in a fully coated hydroxyapatite stem.

Karayiannis，P.N.等人。全涂层羟基磷灰石茎中显着透射线发展的危险因素。

J. Arthroplasty

J、关节成形术

, 3709–3715.

https://doi.org/10.1016/j.arth.2021.07.001

(2021).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Melbye, S. M. et al. How does implant survivorship vary with different corail femoral stem variants? Results of 51,212 cases with up to 30 years of follow-up from the norwegian arthroplasty register.

？挪威关节成形术登记处对51212例患者进行了长达30年的随访。

Clin. Orthop. Related Res.

临床。骨科。相关研究。

479

, 2169–2180.

https://doi.org/10.1097/corr.0000000000001940

(2021).

Article

文章

Google Scholar

谷歌学者

Peng, L. et al. Clinical and radiological results of high offset tri-lock bone preservation stem in unilateral primary total hip arthroplasty at a minimum follow-up of 3 years.

Peng，L.等人。单侧初次全髋关节置换术中高偏移三锁骨保存柄的临床和放射学结果，至少随访3年。

J. Orthop. Surg. Res.

J、骨科。外科研究。

, 635.

https://doi.org/10.1186/s13018-021-02787-7

(2021).

Article

文章

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Wang, Q. X. et al. Correlations between the femoral neck osteotomy angle and radiologic and clinical outcomes analyzed in patients undergoing total hip replacement with metaphyseal fixation.

Wang，Q。X。等人。分析了干骺端固定全髋关节置换术患者股骨颈截骨术角度与放射学和临床结果之间的相关性。

Eur. Rev. Med. Pharmacol. Sci.

欧盟医学院 Pharmacol滑雪。

, 5013–5022.

https://doi.org/10.26355/eurrev_202306_32618

(2023).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Bergmann, G. et al. Hip contact forces and gait patterns from routine activities.

Bergmann，G.等人。常规活动产生的髋关节接触力和步态模式。

J. Biomech.

J. Biomech。

, 859–871.

https://doi.org/10.1016/s0021-9290(01)00040-9

(2001).

Article

文章

CAS

中科院

PubMed

MATH

数学

Google Scholar

谷歌学者

Damm, P., Schwachmeyer, V., Dymke, J., Bender, A. & Bergmann, G. In vivo hip joint loads during three methods of walking with forearm crutches.

Damm，P.，Schwachmeyer，V.，Dymke，J.，Bender，A。＆Bergmann，G。在用前臂拐杖行走的三种方法中，体内髋关节负荷。

Clin. Biomech. (Bristol, Avon)

临床。生物技术。（布里斯托尔，雅芳）

, 530–535.

https://doi.org/10.1016/j.clinbiomech.2012.12.003

(2013).

Article

文章

PubMed

Google Scholar

谷歌学者

Fottner, A. et al. Influence of undersized cementless hip stems on primary stability and strain distribution.

Fottner，A。等人。尺寸过小的非骨水泥髋关节柄对初级稳定性和应变分布的影响。

Arch. Orthop. Trauma Surg.

拱门。骨科。创伤外科。

137

, 1435–1441.

https://doi.org/10.1007/s00402-017-2784-x

(2017).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Yan, S. G. et al. Metaphyseal anchoring short stem hip arthroplasty provides a more physiological load transfer: A comparative finite element analysis study.

Yan，S.G.等人。干骺端锚定短柄髋关节置换术提供了更多的生理负荷转移：一项比较有限元分析研究。

J. Orthop. Surg. Res.

J、骨科。外科研究。

, 498.

https://doi.org/10.1186/s13018-020-02027-4

(2020).

Article

文章

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Yan, S. G. et al. Can the metaphyseal anchored Metha short stem safely be revised with a standard CLS stem? A biomechanical analysis.

Yan，S.G.等人。干骺端锚定的Metha短茎可以用标准的CLS茎安全地修改吗？生物力学分析。

Int. Orthop.

内景矫形。

, 2471–2477.

https://doi.org/10.1007/s00264-017-3497-z

(2017).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Yan, S. G. et al. Primary stability of multi-hole acetabular cup combined with posterior column plating for the fixation of complex acetabular fractures in elderly patients: A biomechanical analysis.

Yan，S.G.等。多孔髋臼杯联合后柱钢板固定老年复杂髋臼骨折的初步稳定性：生物力学分析。

Arch. Orthop. Trauma Surg.

拱门。骨科。创伤外科。

https://doi.org/10.1007/s00402-024-05418-y

(2024).

Article

文章

PubMed

Google Scholar

谷歌学者

Wenzel, L. et al. Biomechanical comparison of acetabular fracture fixation with stand-alone THA or in combination with plating.

Wenzel，L。等人。髋臼骨折固定与独立全髋关节置换术或联合钢板的生物力学比较。

Eur. J. Trauma Emerg. Surg. Off. Publ. Eur. Trauma Soc.

Eur.J.创伤急诊外科。欧洲创伤协会。

, 3185–3192.

https://doi.org/10.1007/s00068-021-01872-0

(2022).

Article

文章

MATH

数学

Google Scholar

谷歌学者

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The author(s) disclose receipt of the following financial support for the research and publication of this article: research fund of Anhui Institute of Translational Medicine [2021zhyx-C33], research fund of Anhui Provincial Higher Education Institutions [2022AH051136], support plan for innovation and entrepreneurship of returned overseas returnees of Anhui Province [2021LCX021], and Anhui Medical University basic and clinical cooperative research promotion plan [2020xkjT028]..

作者透露，本文的研究和发表获得了以下财政支持：安徽省转化医学研究所研究基金[2021zhyx-C33]，安徽省高等院校研究基金[2022AH051136]，安徽省留学回国人员创新创业支持计划[2021LCX021]，安徽医科大学基础与临床合作研究促进计划[2020xkjT028]。。

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Department of Orthopaedic Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China

安徽医科大学第一附属医院骨科，合肥

Shuang G. Yan, Yiliang Cui, Jingtao Lu & Hui Zhang

严双光、崔益良、卢景涛和张辉

Department of Orthopaedic Surgery, Beijing Oriental Electronics Hospital, Hefei, China

Zhi Wang

王志

Department of Orthopaedic Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China

山东第一医科大学附属山东省立医院骨科，济南精武卫七路324号，250021，山东

Fanxiao Liu

刘凡晓

School of Life and Science, Anhui Medical University, Ministry of Education, Hefei, China

安徽医科大学生命科学学院，教育部，合肥

Jingtao Lu

静大鲁

Department of Orthopaedic Surgery, The First Affiliated Hospital of Naval Medical University: Changhai Hospital, Shanghai, China

海军医科大学第一附属医院骨科：上海长海医院

Di Li

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YSG made the study conception and design; YSG. ZW. YC, XH, FL and DL made acquisition, analysis and/or interpretation of data; YSG made drafting/revision of the work for intellectual content and context; YSG prepared Figs.

YSG制定了研究概念和设计；YSG公司。ZW。YC，XH，FL和DL对数据进行了采集，分析和/或解释；YSG起草/修订了知识内容和背景的工作；YSG准备了无花果。

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Hui Zhang

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Yan, S.G., Wang, Z., Cui, Y.

Yan，S.G.，Wang，Z.，Cui，Y。

et al.