GLUTEAL ATTACHMENT TO FEMORAL ALLOGRAFTS IN HIP REVISION

髋关节翻修中臀肌与股骨同种异体移植物的附着

基本信息

批准号：
2769543
负责人：
Grace Elizabeth Pluhar
金额：
$ 3.05万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
1998
资助国家：
美国
起止时间：
1998-09-01 至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/2769543
关键词：
biomechanics dogs femur hip prosthesis hip surgery homologous transplantation musculoskeletal transplantation striated muscles tendons

项目摘要

The goals of this research are to increase the functional use and long- term outcome of patients with total hip replacement and hip revision. This study is important due to the necessity of using whole bone segmental allografts to replace proximal femurs that have become deficient in bone stock secondary to menopause, disuse, multiple revision arthroplasties, or that have tumor infiltration. The problem lies in the fact that functional impairment due to inadequate or failed muscle reattachment to the allograft commonly occurs. The working hypothesis for this investigation is that there are specific long-term time-related changes that occur in functional weight-bearing, densitometry, histology, and mechanical characteristics during the incorporation of the allograft tendon and bone following proximal femoral reconstruction that will allow selection of the optimal technique for this reconstruction. Using a canine model, three methods of gluteal attachment to proximal femoral allografts will be compared: (a) a host tendon to allograft tendon attachment using horizontal mattress sutures, (b)a host bone to allograft bone attachment using a cable grip system, and (3) a host bone bicortical half-shell wrapped around the allograft bone without disruption of the host tendon-bone interface. The prosthesis will be cemented to a frozen allograft and this composite cemented to the distal femur after an excision of the proximal 25% of the femur. The animals will be evaluated bimonthly with radiography, densitometry, and functional weight-bearing and at 9 (24 dogs) and 18 (24 dogs) months with histology and mechanical testing following humane euthanasia.

这项研究的目标是增加功能使用和长期使用全髋关节置换术和髋关节翻修患者的近期结果。由于需要使用全骨，这项研究很重要节段同种异体移植物取代已成为的近端股骨继发于更年期、废用、多次翻修的骨质缺乏关节置换术，或有肿瘤浸润。问题在于事实上，由于肌肉不足或失效而导致功能障碍通常会发生与同种异体移植物的重新附着。工作假设为本次调查发现，存在特定的长期相关的功能性负重、密度测定、组织学发生的变化，和同种异体移植物合并过程中的机械特性股骨近端重建后的肌腱和骨骼将允许选择用于此重建的最佳技术。使用犬模型，臀肌附着到股骨近端的三种方法同种异体移植物将被比较： (a) 宿主肌腱与同种异体移植物肌腱使用水平床垫缝合线连接，(b) 宿主骨与同种异体移植物使用电缆夹系统进行骨附着，以及 (3) 宿主骨双皮质半壳包裹在同种异体移植骨上，而不破坏骨主腱-骨界面。假肢将被粘合到冰冻的同种异体移植物和这种复合材料在股骨远端粘合切除股骨近端 25%。将对动物进行评估双月刊，包含放射线照相、光密度测定和功能性负重在 9 个月（24 只狗）和 18 个月（24 只狗）时进行组织学和机械学检查人道安乐死后进行测试。