骨水泥凝固前有无血液环境对骨水泥与骨界面稳定性的影响

目的:研究在有血和无血环境下粘合骨水泥和骨,比较两种粘合骨水泥的方式对骨与骨水泥界面稳定性影响的区别。方法:选取新鲜猪肱骨头20块,随机分成两组:实验组在有血的环境下用骨水泥将股骨头与金属粘合;对照组在无血的环境下用骨水泥将肱骨头和金属粘合,再将两组实验材料分别做拉伸试验,至骨与骨水泥界面断裂,最后再沿垂直于截骨面的方向做骨切片,在扫描电镜下观察并测量出每个实验对象中骨水泥的最大浸润深度。比较两组实验过程中拉力的最大载荷和断裂时的拉力以及骨水泥最大浸润深度。结果:实验组10个实验对象拉力最大载荷平均为738.50±262.15 N,断裂时的拉力平均为656.50±242.88N,骨水泥最大浸润深度平均为1.22±0.19 MM;对照组10个实验对象实验过程中拉力最大载平均为739.60±306.98 N,断裂时的拉力平均为658.80±264.56 N,骨水泥最大浸润深度平均为1.22±0.21 MM。20个实验对象在实验过程中均无意外断裂的情况发生,均在骨与骨水泥界面发生断裂。两组实验的拉力最大载荷与断裂拉力以及骨水泥最大浸润深度,均无统计学差异(P0.05)。结论:血液环境不能增加骨与骨水泥界面的不稳定因素。因此,与应用止血带相比,在TKA手术中不用止血带可能不会对骨与骨水泥界面稳定性和假体的寿命产生影响。

Impact of Bone Cement and Bone Interface with or without Blood Environment on the Stability before Cement Solidification

ABSTRACT Objective: To study the difference between the two kinds of bonding cement on the stability of the interface between bone and cement. Methods: 20 pigs were randomly divided into two groups: the experimental group was treated with bone cement and the femoral head was bonded with the metal in the blood group, while the control group was treated with bone cement to bind the humer- al head and the metal under the condition of non blood. Then the experimental materials were subjected to tensile tests, respectively, to the interface between bone and cement, and then the bone slices were cut perpendicular to the bone surface. Then the maximum infiltra- tion depth of each subject bone cement were observed and measured under the scanning electron microscope, and the maximum tensile force and tensile force at the time of fracture and the maximum depth of bone cement between the two groups were compared. Results: The 10 subjects in the experimental group: the maximum load averaged tension was 738.50±262.15 N, the fracture of tensile average was 656.50±242.88 N, and the maximum bone cement infiltration depth average was 1.22±0.19 MM. The 10 subjects in the control group: the maximum tensile load average was 739.60±306.98 N, the fracture of tensile average was 658.80±264.56 N, and the maxi- mum bone cement infiltration depth average was 1.22±0.21 MM. There was no accident in the 20 subjects in the process of experiment, and all on the surface of bone and bone cement fracture. There was no statistical difference on the tensile maximum load and fracture and the maximum bone cement infiltration depth between the two groups (P>0.05). Conclusion: The blood environment could not increase the unstable factors of bone cement interface. Therefore, the use of tourniquet in TKA surgery without tourniquet may not affect the sta- bility of the bone cement interface and the life of the prosthesis.