Stemmed TKA in a Femur With a Total Hip Arthroplasty Is There a Safe Distance Between the Stem Tips?

被引：52

作者：

Soenen, Marc ^{[1
,2
]}

Baracchi, Matteo ^{[3
]}

De Corte, Ronny ^{[4
]}

Labey, Luc ^{[4
]}

Innocenti, Bernardo ^{[4
,5
]}

机构：

[1] Polyclin Parc, Cholet, France

[2] Roger Salengro Hosp, Univ Hosp Ctr, Orthoped Serv C, Lille, France

[3] Univ Florence, Dept Mech & Ind Technol, Florence, Italy

[4] Smith & Nephew, European Ctr Knee Res, Louvain, Belgium

[5] Univ Libre Brussels, BEAMS Dept, B-1050 Brussels, Belgium

来源：

JOURNAL OF ARTHROPLASTY | 2013年 / 28卷 / 08期

关键词：

interprosthetic femoral fracture; stemmed TKA; THA; risk for fracture; TOTAL KNEE ARTHROPLASTY; FINITE-ELEMENT MODELS; INTERPROSTHETIC FEMORAL FRACTURES; PERIPROSTHETIC FRACTURE; MECHANICAL VALIDATION; PROXIMAL FEMUR; CORTICAL BONE; RISK-FACTORS; STRESS; REPLACEMENT;

D O I：

10.1016/j.arth.2013.01.010

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

When a stemmed TKA is needed in a femur in which a THA is already present, choosing an appropriate length for the TKA stem is crucial. Many surgeons intuitively fear that the distance between the stem tips correlates with the femur risk for fracture (RF). However, to date, no biomechanical data to support this intuition are available. Therefore, in this study, the RF in such a configuration was determined and compared for several activities, using a finite element modeling technique. During gait and sideways falling no difference in RF among different stem lengths was shown. However, a clear threshold appears during four-point bending. Stem tip distances shorter than 110 mm dramatically increased RF and, in osteoporotic bone, will certainly lead to fracture (RF>1) and thus should be avoided. (C) 2013 Elsevier Inc. All rights reserved.

引用

页码：1437 / 1445

页数：9

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