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Spongiosaplastik in der Endoprothetik: Einfluss von Knochenpartikeln auf die Primärstabilität zementfreier Implantate
Citation Link: https://doi.org/10.15480/882.4240
Publikationstyp
Bachelor Thesis
Date Issued
2021-11-18
Sprache
German
Author(s)
Advisor
Referee
Title Granting Institution
Technische Universität Hamburg
Place of Title Granting Institution
Hamburg
Examination Date
2021
Institut
TORE-DOI
Citation
Technische Universität Hamburg (2021)
The use of total hip arthroplasty for long-term joint replacement is one of the most
common surgical procedures in Germany. The decisive factor for the longevity of
cementless implants in the body is the primary stability which means a sufficient
initial stability immediately after implantation. This is created by the press-fit,
meaning the undersizing of the cavity in relation to the implant. Osseointegration, the
fusion of the prosthesis with the bone, can only take place in the absence of extreme
micromovements between the prosthesis and the bone. Loosening of the prosthesis,
which can be promoted by reduced bone density, is the most frequent reason for
revision in arthroplasty.
In this paper, the influence of spongiosaplasty on the primary stability of cementless
implants was investigated. In an in vitro study, a cementless press-fit implant was
implanted in 21 porcine humeri using a drop tower under the application of the same
energy for each implantation. Seven of the cavities of the test bones underwent a
lavage with Ringer’s solution before implantation, seven were provided with additional
autologous cancellous bone particles and seven were left native after reaming.
3D-scans were taken before and after implantation to determine the position of the
implant in the bone. The implant was then extracted using a uniaxial material testing
machine measuring the necessary force which serves as a measure of primary stability.
In the group of bones tested with additionally introduced particles, the implant positions
and thus the calculated theoretical press-fit were less scattered than in the test runs
without additional particles. The measured pull-out forces were highest in this group.
It was shown that the primary stability of cementless implants can be increased by
introducing additional particles.
common surgical procedures in Germany. The decisive factor for the longevity of
cementless implants in the body is the primary stability which means a sufficient
initial stability immediately after implantation. This is created by the press-fit,
meaning the undersizing of the cavity in relation to the implant. Osseointegration, the
fusion of the prosthesis with the bone, can only take place in the absence of extreme
micromovements between the prosthesis and the bone. Loosening of the prosthesis,
which can be promoted by reduced bone density, is the most frequent reason for
revision in arthroplasty.
In this paper, the influence of spongiosaplasty on the primary stability of cementless
implants was investigated. In an in vitro study, a cementless press-fit implant was
implanted in 21 porcine humeri using a drop tower under the application of the same
energy for each implantation. Seven of the cavities of the test bones underwent a
lavage with Ringer’s solution before implantation, seven were provided with additional
autologous cancellous bone particles and seven were left native after reaming.
3D-scans were taken before and after implantation to determine the position of the
implant in the bone. The implant was then extracted using a uniaxial material testing
machine measuring the necessary force which serves as a measure of primary stability.
In the group of bones tested with additionally introduced particles, the implant positions
and thus the calculated theoretical press-fit were less scattered than in the test runs
without additional particles. The measured pull-out forces were highest in this group.
It was shown that the primary stability of cementless implants can be increased by
introducing additional particles.
DDC Class
570: Biowissenschaften, Biologie
610: Medizin
620: Ingenieurwissenschaften
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Name
Stiller, Fenja (2021) - Spongiosaplastik in der Endoprothetik Einfluss von Knochenpartikeln auf die Primärstabilität zementfreier Implantate.pdf
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