Comparative study on bone cement filling and core decompression improve mechanical properties of the necrotic femoral head
10.12007/j.issn.0258-4646.2024.11.007
- VernacularTitle:骨水泥填充与髓芯减压植骨改善坏死股骨头力学性能的实验研究
- Author:
Siwei LI
1
;
Linlin CHEN
;
Jiaoyue ZHANG
;
Lina SUN
;
Yuelong TAN
Author Information
1. 中国医科大学第八临床学院,鞍钢集团公司总医院骨科,辽宁鞍山 114002
- Keywords:
osteonecrosis of the femoral head;
cement filling;
mechanical analysis;
bone morphometric parameters
- From:
Journal of China Medical University
2024;53(11):994-998
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes in the structural parameters and mechanical properties of the necrotic femoral head and compare the effects of core decompression and hone grafting with those of bone cement filling on the mechanical properties and pre-vention of articular surface collapse of the necrotic femoral head.Methods Thirty-two fresh human femoral heads were collected from patients who underwent total hip arthroplasty at our hospital between June 2020 and January 2022.The femoral heads were divided into four groups:8 femoral neck fractures(TFF group),8 osteonecrosis of the femoral head(ONFH group),8 osteonecrosis of the femoral head treated with cement percutaneous injection(CPI group),and 8 osteonecrosis of the femoral head treated with core decompression and bone graft(CDBG group).Cement filling or core decompression was performed under radiographic guidance.All samples were scanned and three-dimensionally reconstructed using micro-CT.The spatial heterogeneity of the femoral head was observed,and the bone morphometric parameters of each region of interest were calculated.Mechanical analysis was performed to evaluate the femoral head parameters of dis-placement and stress in vitro.Results Bone microarchitecture and morphometry in necrotic femoral heads were markedly altered.The biomechanical properties of the necrotic zone in the femoral head were markedly weakened.After the necrotic area was filled with bone cement,the biomechanical properties of the necrotic zone of the femoral head increased significantly.In addition,after core decompres-sion and bone grafting in the necrotic area,the biomechanical properties increased significantly in the necrotic zone of the femoral head.Conclusion Bone cement filling or bone grafting in the necrotic area can change the biomechanical mechanism of the femoral head,improve the load-supporting ability,and prevent femoral head collapse.Cement filling may be a practical approach for the treatment of osteonecrosis of the femoral head that can be useful for practicing orthopedists.
