| Project/Area Number |
09671512
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Nara Medical University |
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Principal Investigator |
KAWATE Kenji Nara Medical University, Orthopaedic Surgery, Assistant Professor, 医学部, 助手 (70275329)
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| Co-Investigator(Kenkyū-buntansha) |
YOSHIKAWA Takafumi Nara Medical University, Pathology, Lecturer, 医学部, 講師 (90275347)
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| Project Period (FY) |
1997 – 1999
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| Project Status |
Completed (Fiscal Year 1999)
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| Budget Amount *help |
¥1,600,000 (Direct Cost: ¥1,600,000)
Fiscal Year 1999: ¥200,000 (Direct Cost: ¥200,000)
Fiscal Year 1998: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | Total hip arthroplasty / Initial stability / Direct insertion technique / Reaming / Polyethylene particle / Osteolysis / Micro motion / 人工骨頭 / 人工関節 / ラスピング / ポリエチレン紛 |
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| Research Abstract |
The purpose of this study was to clarify the advantages of direct insertion technique without any preparation of the femoral canal for the initial stability of femoral components and osteolysis.
In the first and second studies, sand-blasted tapered titan alloy rods were implanted in 30 SAW BONE Foam Cortex TIBIA and 24 pig femora. Group LR1 (Line-to-line reaming technique) included 10 bone models which were inserted with the rod into the canal after reaming. Group UR1 (Underreaming technique) included 10 bone models which were inserted with the rod after 0.5 mm underreaming. Group DI1 (Direct insertion technique) included 10 bone models which were inserted with the rod without reaming. Group LR2 (Line-to-line reaming technique) included 8 pig femora which were inserted with the rod after reaming. Group UR2 (Underreaming technique) included 8 pig femora which were inserted with the rod after 0.5mm underreaming. Group DI2(Direct insertion technique)included 8 pig femora which were inserte
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d with the rod without reaming. A pullout test was performed on samples using a testing machine. In the third study, each sand-blasted titan alloy femoral stem was selected from one of 3 sizes and inserted in 20 femora of 10 beagles. Twenty femora were divided into 4 groups. Group R0 (Rasping insertion technique) included 5 femora which were inserted with the stem after reaming just after sacrifice. Group R2 (Rasping insertion technique) included 5 femora which were inserted with the stem after reaming and harvested 2 weeks after surgery. Group D0 (Direct insertion technique) included 5 femora which were inserted with the stem without reaming just after sacrifice. Group D2 (Direct insertion technique) included 5 femora which were inserted with the stem without reaming and harvested 2 weeks after surgery. The micro motion and displacement of the stem were measured after 40 kgf loading. Next, polyethylene particles (200mg) were injected into 4 hip joints of 4 other beagles after surgery with rasping insertion technique or direct insertion technique.
In the first and second studies, there were significant differences between Group LR1 (21.2±5.5kgf) and Group UR1 (47±6.9kgf), and between Group LR1 and Group DI1 (39.9±19kgf). There was also a significant difference between Group LR2 (34±16.5kgf) and Group DI2 (56.3±1.6kgf). In the third study on micro motion, there was a significant difference between Group R2 (48.6±23.9μm) and Group D2 (20.0±4.8μm). In the third study on displacement, there was a significant difference between Group R0 (7.2±3.0μm) and Group D0 (2.6±1.0μm). The polyethylene particles did not generate osteolysis in all femora.
The results of the third study suggested that the direct insertion technique generated good stability just after surgery and less soft tissue surrounding the stem 2 weeks after surgery. The results of the first and second studies suggested that meticulous study was needed to clarify the difference between direct insertion technique and underreaming technique. Less
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