骨髓腔冲刷对骨水泥-骨界面结合强度的影响

目的研究骨髓腔分别用高压脉冲水枪冲洗、髓腔刷洗(骨髓腔清创,简称"冲刷")处理及不做处理后,骨水泥与骨界面及其结合情况,进行界面力学测定,对结果作比较.并根据该实验提出骨髓腔清创术的概念.方法实验选用马尺骨40根,分4组抗拉力冲洗刷洗组(10根),抗拉力未处理组(10根),抗扭转力冲洗刷洗组(10根),抗扭转力未处理组(10根),处理后用相同方法注入骨水泥.通过CT截面扫描观察界面结合情况.测出抗拉力(2组)、抗扭转力(2组),结果进行统计学分析.最后,分别观察骨水泥表面及骨小梁表面的情况,作对比.结果 CT截面扫描可见冲刷组界面结合率为64.47%,未处理组界面结合率为26.67%,相差37.8%,经统计学检验得P＜0.005,二者的差异有显著性.冲刷组的抗拉力及抗扭转力明显高于未处理组,经统计学检验得P＜0.01,二者的差异有显著性.镜下观察发现两组骨水泥表面及骨小梁表面的情况有明显不同.结论骨髓腔高压脉冲冲洗加刷洗可显著增强骨水泥与骨界面的结合强度,为临床骨水泥假体应用提供了实验依据.

Effect of marrow cavity debridement on the bonding strength of the interface between bone and bonecement

Objective To study the interface between bone and bonecement bonds after washing out or not, the marrow cavity with high pressure and pulsing squirt gun and brush(marrow cavity debridement), to measure the power of interface and compare the results. Morover, torefer to the concept of marrow cavity debridement based on this.Methods Forty horse ulnae were selected and divided into four groups: a group of anti tension and washing out (ten ulnae), a group of anti torsion and washing out (ten ulnae),a group of anti tension and not washing out (ten ulnae), a group of anti torsion and not washing out (ten ulnae).After treatment,filled the bonecement by finger pressing.Observed the interface between bone and bonecement by CT scan.Measured the anti tension (two groups ) and the anti torsion(two groups).The results were statistically analysed.Finally observed the face of the bone and the bonecement. Results CT scan showed that the bonding rate of washing out groups was 64.47%,and that of the unwashing out groups was 26.67%,the difference was 37.80%.The results were statistically analysed,with a P value less than 0.005 indicating significantly different.The anti tension and the anti torsion of washing out groups were much higher than those of unwashing out group .The results were statistically analyzed,with a P value less than 0.01 indicating significantly different.The faces of bone and bonecement of two groups(washing out groups and unwashing out groups )were significantly different.Conclusion To wash out the marrow cavity with high pressure and pulse water and brush can make a significant increase on bonding strength between bone and bonecement.It refered to the experiment basis of prosthesis application.