【摘要】 目的研制一种兔用立体网孔表面生物型人工膝关节假体,观察并探讨其置换入兔膝关节内的功能情况及其生物力学性能。方法30只成年新西兰大白兔随机分成实验组及对照组,行左侧人工膝关节置换术,髌骨不置换。自行设计兔立体网孔表面生物型人工膝关节假体,股骨及胫骨假体髓内茎近端关节面4/5表层由不锈钢网围绕实心圆柱体制成,股骨髁和胫骨平台内表面用2层不锈钢网焊接而成,用于实验组行生物学假体固定;同时制作相同形状、大小假体,其髓内茎以及股骨髁和胫骨平台内表面光滑,用于对照组行骨水泥固定。术后观察动物一般情况,术后1、3、6个月处死动物取材行大体观察和X线片观察假体固定及愈合情况,测量膝关节活动度,并进行生物力学测试,计算假体骨界面最大剪切强度。结果实验组与对照组各死亡1只动物,均在二次实验时补充,其余动物均存活至实验完成,术后7d恢复正常爬行。术后1、3、6个月膝关节功能恢复优良率实验组分别是60%、80%、80%,对照组分别是60%、80%、60%,差异均无统计学意义(P>0.05)。实验组术后标本大体观察见大量骨重建,X线片示假体位置良好,固定牢靠,无脱位及松动发生;对照组大体观察未见骨重建,X线片示假体位置良好,固定牢靠,无脱位及松动发生,仅术后6个月股骨假体周围出现透亮带,产生应力遮挡。术后1个月实验组假体骨最大剪切强度低于对照组,术后3个月和6个月实验组高于对照组,差异均有统计学意义(P<0.01)。结论兔立体网孔表面生物型人工膝关节假体植入动物体内的固定强度在术后3个月和6个月优于骨水泥假体。更多还原

【Abstract】 Objective To develop a kind of biological artificial knee joint prosthesis with stereo mesh surface for rabbit,to observe its function after being implanted into rabbit knee joint and to evaluate its biomechanical property. Methods Thirty adult New Zealand rabbits were randomized into experimental and control groups(n=15),total left knee arthroplasty was performed in both groups,no patella replacement was performed.Biological artificial knee joint prosthesis with stereo mesh surface was self-designed.The adjacent 4/5 surface of femur and tibia stem of the prosthesis was covered by stainless steel stereo mesh,the inner surface of femur condyles and tibia plateau was welded with two layers of stainless steel stereo mesh,then the prosthesis underwent biological fixation in the experimental group.Meanwhile,prosthesis having smooth marrow internal stem,femoral condyle and tibial plateau internal surface and sharing the same shape and size with the experimental group were prepared and fixed with bone cement in the control group.The postoperative general condition of animal was observed.At 1,3 and 6 months after operation,the rabbits were killed for gross observation,X-ray examination was conducted to observe the fixation condition of prosthesis and healing condition,the range of motion(ROM)of knee joints was tested,biomechanics test was carried out and the maximum shear strength of prosthesis bone interface was calculated.Results In each group,there was 1 rabbit died and new one was added during the second experiment.The others survived till the end of the experiment and crawled normally 7 days after operation.For the excellent and good rate concerning the recovery of ROM of the knee joint at 1,3 and 6 months after operation,the experimental group was 60%,80%and 80%,respectively,and the control group was 60%,80%and 60%,respectively,indicating there were no significant differences between two groups(P> 0.05).For the experimental group,the gross observation showed large quantities of bone reconstruction,X-ray films indicated the prosthesis fitted well,with solid fixation and without dislocation and lossening;while for the control group,the grossobservation showed no bone reconstruction,X-ray films displayed the location of prosthesis was good,with solid fixation and without dislocation and loosening.Radiolucent zone around the femur prosthesis and stress shileding occured 6 months after operation.For the maximum shear strength,the experimental group was less than the control group at 1 month after operation; and it was higher than the control group at 3 and 6 months after operation,indicating there were significant differences between two groups(P<0.01).Conclusion The fixation strength of the biological artificial knee joint prosthesis with stereo mesh surface is better than that of the bone cement prosthesis in rabbits at 3 and 6 months after operation.更多还原