tailieunhanh - báo cáo hóa học:" Influence of prosthesis design and implantation technique on implant stresses after cementless revision THR"

Tham khảo tài liệu 'báo cáo hóa học:" influence of prosthesis design and implantation technique on implant stresses after cementless revision thr"', luận văn - báo cáo phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Heller et al. Journal of Orthopaedic Surgery and Research 2011 6 20 http content 6 1 20 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH RESEARCH ARTICLE Open Access Influence of prosthesis design and implantation technique on implant stresses after cementless revision THR Markus O Heller Manav Mehta William R Taylor Dong-Yeong Kim Andrew Speirs Georg N Duda and Carsten Perka Abstract Background Femoral offset influences the forces at the hip and the implant stresses after revision THR. For extended bone defects these forces may cause considerable bending moments within the implant possibly leading to implant failure. This study investigates the influences of femoral anteversion and offset on stresses in the Wagner SL revision stem implant under varying extents of bone defect conditions. Methods Wagner SL revision stems with standard 34 mm and increased offset 44 mm were virtually implanted in a model femur with bone defects of variable extent Paprosky I to IIIb . Variations in surgical technique were simulated by implanting the stems each at 4 or 14 of anteversion. Muscle and joint contact forces were applied to the reconstruction and implant stresses were determined using finite element analyses. Results Whilst increasing the implant s offset by 10 mm led to increased implant stresses in peak tensile stresses altering anteversion played a lesser role 5 . Generally larger stresses were observed with reduced bone support implant stresses increased by as much as 59 for a type IIIb defect. With increased offset the maximum tensile stress was 225 MPa. Conclusion Although increased stresses were observed within the stem with larger offset and increased anteversion these findings indicate that restoration of offset key to restoring joint function is unlikely to result in excessive implant stresses under routine activities if appropriate fixation can be achieved. Keywords revision hip arthroplasty implant stresses implant design surgical technique .

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