Method of express-modelling wear of polyethylene insert of metal cup or polyethylene cup under dynamic conditions at different angles of horizontal inclination in experimental module of hip joint endoprosthesis

FIELD: medicine.

SUBSTANCE: method of the express-modelling wear of a polyethylene insert of a metal cup or a polyethylene cup under dynamic conditions at different angles of horizontal inclination in an experimental module of the hip joint endoprosthesis consists in carrying out long-term and multiple cyclic movements in the hip joint endoprosthesis module under experiment conditions. The experimental module of the hip joint endoprosthesis, which has a leg, a polyethylene insert of the metal cup or the polyethylene cup and a head, consisting of ceramics, metal, metal alloys and other materials with a rough surface, is used in the method. The experimental module of the hip joint endoprosthesis is fixed in the device in such a way that the head is located in the polyethylene cup or in the polyethylene insert of the metal cup of the endoprosthesis module, after which the device with the polyethylene insert of the metal cup or the polyethylene cup is installed in such a way that the longitudinal axis of the module head and neck has a 10-degree deviation relative to the plane of entrance into the polyethylene insert of the metal cup or into the polyethylene cup. After that dynamic tests for joined compression and cyclic twisting in the friction pair are carried out. Then, the worn polyethylene cup or the polyethylene insert and the head with the rough surface are replaced with new ones. The device with the new polyethylene insert of the metal cup or the polyethylene cup is installed in such a way that the longitudinal axis of the module head and neck has a 20-degree deviation relative to the plane of entrance into the polyethylene insert of the metal cup or into the polyethylene cup, after which dynamic tests for joined compression and cyclic twisting in the friction pair are carried out, after which the worn polyethylene cup or the polyethylene insert and the head with the rough surface are replaced with new ones. Then the device with the new polyethylene insert of the metal cup or the polyethylene cup is installed in such a way that the longitudinal axis of the module head and neck has a 30-degree deviation relative to the plane of entrance into the polyethylene insert of the metal cup or into the polyethylene cup, after which dynamic tests for joined compression and cyclic twisting in the friction pair are carried out, after which the wear of the polyethylene insert of the cup or the polyethylene cup of the experimental module of the hip joint endoprosthesis is analysed.

EFFECT: efficiency under dynamic conditions.

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The method relates to medicine, namely to operative orthopedics, hip replacement, experimental medicine, biomechanics.

In patients with coxarthrosis (KA) in most cases there is external rotation contracture (NQF) hip joint (hip) of varying severity, combined with Shebalino-adduction contracture [Kolesnik A. I. New technological solutions and prevention of complications in total hip arthroplasty: dis. ... d-RA med. Sciences: 14.00.22 / A. Kolesnik. - Kursk, 2002. - 295 p.; Akhtyamov I. F. Errors and complications of hip replacement surgery: Hands. for physicians / Akhtyamov I. F., I. I. Kuzmin. - Kazan: Center for rapid printing, 2006. - 328 p.; Guide to hip replacement / ed. by P. M. Tihilov, V. M. Shapovalov. - SPb., 2008. - 324 p.]. A series of papers with information about the NQF in various forms of SPACECRAFT and the operational methods of elimination [Kolesnik A. I. New technological solutions and prevention of complications in total hip arthroplasty: dis. ... d-RA med. Sciences: 14.00.22 / A. Kolesnik. - Kursk, 2002. - 295 p.]. The need for intraoperative eliminate the NQF at the total hip patients with coxarthrosis write many authors [Kolesnik A. I. New technological solutions and prevention of complications in endoproteinase� hip: dis. ... d-RA med. Sciences: 14.00.22 / A. Kolesnik. - Kursk, 2002. - 295 p.; Guide to hip replacement / ed. by P. M. Tihilov, V. M. Shapovalov. - SPb., 2008. - 324 p.; Method of transposition muscle groups external rotators of the hip in arthroplasty patients with coxarthrosis with external rotation contracture of the hip joint / I. M. Solodilov, S. G. Gray, M. F. Latif, S. P. sevryukova, L. S. Afanaseva // Youth science and modernity: proceedings of the 75th anniversary summary. Vseros. scientific. Conf. students and young scientists with international. participation]. 75th anniversary of Kazan state medical University (Kursk, 20-21 APR. 2010). - Kursk, 2010. - Part 1. - S. 153-154; Method of transposition muscle groups external rotators of the hip in arthroplasty patients with coxarthrosis with external rotation contracture of the hip joint / A. Kolesnik, Bezhin A. I., V. N. Mishustin, I. M. Solodilov, S. G. Gray, M. F. Latif, S. P. Sevryukova, In Proc. proc. IX Congress of traumatologists and orthopedists Russia (Saratov, 15-17 Sept. 2010). - Saratov, 2010 - Vol. 1. - Pp. 417-418; analysis of the results of anatomical and surgical simulation and elimination of external rotation contracture of the hip joint / I. M. Solodilov, S. G. Gray, E. V. Kolobaev, S. A. Kravchenko, A. V. Alpeyev, C. V. Ganeev, E. V. Korneva, A. D. Mikhailov // Youth science and modernity: proceedings of the 77th all-Russia. scientific. Conf. students and young scientists (Moscow, 18-19 APR. 2012). - Kursk, 2012. - �. 1. - P. 241].

In patients with coxarthrosis clinically and radiographically distinguish 3 degrees external rotation contracture of the hip joint [Kolesnik A. I. New technological solutions and prevention of complications in total hip arthroplasty: dis. ... d-RA med. Sciences: 14.00.22 / A. Kolesnik. - Kursk, 2002. - 295 p.].

The presence of the NQF in patients with coxarthrosis affects the biomechanics of the hip joint, many authors recommend intraoperative Troubleshooting NQF TBS to restore muscular balance," TBS and improve the results of arthroplasty, better recovery functions TBS [Kolesnik A. I. New technological solutions and prevention of complications in total hip arthroplasty: dis. ... d-RA med. Sciences: 14.00.22. / Andrei Kolesnik. - Kursk, 2002. - 295 p.; Akhtyamov I. F. Errors and complications of hip replacement surgery: Hands. for physicians / Akhtyamov I. F., I. I. Kuzmin. - Kazan: Center for rapid printing, 2006. - 328 p.; Guide to hip replacement / ed. by P. M. Tihilov, V. M. Shapovalov. - SPb., 2008. - 324 p.].

The preservation of the NQF in arthroplasty patients KA causes a disturbance of the distribution of the friction forces in the hip endoprosthesis, which leads to uneven wear of the rubbing surfaces of components of the implant, resulting in yavl�is early wear and instability of endoprosthesis components, impairs early and late results of arthroplasty patients KA [Patent RU No. 2139004 C1, 6 A61B 17/56. Inventions (applications and patents). - 1999. - №28. - P. 8; Patent RU No. 2423942 C1, AV 17/56 dated 20.07.2011. Bul. 20 dated 20.07.2011.; Patent No. 2423908, 20.07.2011].

Performance characteristics of friction joint endoprosthesis depend on the structure of the material used, the roughness of the rubbing surfaces and the coefficient of friction. All these parameters can be calibrated in the laboratory. The obtained results allow to predict the longevity of the implant after total hip joint replacement [Gavrushenko N. With. Classification of hip arthroplasty in the quality of the friction node / N. With. Gavrushenko // Proceedings of the Congress of traumatologists and orthopedists Russia with international participation. Yaroslavl, 1999, p. 101-102].

Laboratory evaluation of "wear" an experimental hip prosthesis is an important moment in the development of the design from prototype to production.

Close the solution of this problem can be found in the work of S. A. Agnikula [Agnico S. A., Mitin, V. N., Gavrushenko N. With. Study of the friction pair of hip replacements for dogs, presented on the Russian market // "Vet", 2001, 4, 20-24]. Tests were carried out in 5 one-piece implants with metal-metal bearing couple (CoCrMo/CoCrMo) type K. M. Sivash State�public experimental enterprise of the Central Institute of traumatology and orthopedics. N. N. Priorov (GEO "cyto") and five detachable implants with metal-polymer friction couple (head - Sashmo/acetabular component - high molecular weight polyethylene) Swiss firm MATHYS. Determination of coefficient of friction were performed on a universal testing machine Zwick 1464 (photo 3). When testing used two sensors: force sensor (scale 1 kN - 1000 N) and torque sensor (scale 5 Nm). Samples were fixed in trehkulachkovym clips. Axial load in the friction Assembly amounted to 300 N, which corresponds to the average value of the vertical component of the reaction support of the pelvic limb of the dog weighing 40-45 kg. For the approximation of the test conditions to real in a pair of friction arthroplasty added to synovial fluid from the joints of healthy donors. The speed of rotation in experiment - 1 Hz (one cycle per second). Programmed from 50 to 150 rpm in a test machine that corresponds to the life of the implant during the replacement of the hip joint = 3 to 6 years.

The closest solution to this problem is presented in the guidelines for the laboratory evaluation of the degree of wear of the rubbing surfaces [hip joints. Laboratory assessment of the degree of wear of the rubbing surfaces. The main recommendations. R 42-610-02" (appr. The Russian Ministry of health 27.02.2002)]. However, in the method description does not say how focused PR�longitudinally axis of the head and the axis of the neck of the leg unit, with respect to the plane of the entrance into the Cup module of the prosthesis. Following the description of the methodology, the spatial ratio of the modulus of the prosthesis may differ from these figures morphometry of the normal hip joint, causing the data on the wear of the polyethylene liner or plastic cups may vary.

The technical result is to develop an efficient method for the rapid simulation of wear of the polyethylene liner or plastic cups experimental module of the endoprosthesis of the hip joint under dynamic conditions.

The technical result is achieved in the following way: using operational module of the endoprosthesis of the hip joint having a stem, a plastic liner metal Cup or plastic Cup and the crown, composed of ceramic, metal, metal alloys and other materials with a rough surface. Experimental module of the endoprosthesis of the hip joint is fixed in a special device so that the head was in a plastic Cup or in a plastic liner metal cups module prosthesis, and then the device with a plastic liner metal Cup or plastic Cup set so that the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to carton s�janovy liner metal Cup or plastic Cup 10°, followed by a dynamic test on joint compression and cyclic torsion in a friction pair, then make the replacement of worn plastic cups or plastic liner and head with a rough surface on new, device with new polyethylene liner metal Cup or plastic Cup set so that the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to the polyethylene liner of a metal Cup or a plastic Cup at 20°, followed by a dynamic test on joint compression and cyclic torsion in a friction pair, then make the replacement of worn plastic cups or plastic liner and head with a rough surface to new, then the device with new polyethylene liner metal Cup or plastic Cup set so that the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to the polyethylene liner of a metal Cup or a plastic Cup at 30°, and conduct dynamic tests on joint compression and cyclic torsion in a friction pair, then examine the wear of the polyethylene liner cups or plastic cups experimental module of the endoprosthesis of the hip joint.

Invented�e is illustrated by the following drawings.

Fig. 1 presents the test of modelling the wear of polyethylene cups in the deviation of the plane of the entrance in a plastic Cup relative to the longitudinal axis of the head and neck of the leg module of the prosthesis 10°: 1 - head; 2 - foot module; 4 - device for fixation of the Cup: 4A - cylinder with graduations; 4B - frame; 5 - the value of the calibration frame 10°.

Fig. 2 presents the test of modelling the wear of polyethylene cups experimental module of the endoprosthesis when the deviation of the plane of the entrance to 10° (close-up): 5 - the value of the calibration frame 10°.

Fig. 3 presents the experimental module of the hip endoprosthesis after the experiment, when the deviation of the plane of the inlet 10°: 1 - head; 2 - foot module; 3 - Cup.

Fig. 4 presents changes in plastic cups after the experiment, when the deviation of the plane of the entrance to 10°.

Fig. 5 shows the replacement of plastic cups.

Fig. 6 presents the test of modelling the wear of polyethylene cups in the value of the IGO 20°: 1 - head; 2 - foot module; 4 - device for fixation of the Cup: 4A - cylinder with graduations; 4B - frame; 6 - value of calibration of the bed 20°.

Fig. 7 shows the test value when the IGO 20° (close up): 6 - the value of calibration of the bed 20°.

Fig.8 �of redstapler experimental module of the hip endoprosthesis after the experiment, when the value of the IGO 20°: 1 - head; 2 - foot module; 3 - Cup.

Fig.9 shows the wear of polyethylene cups after the experiment, when the value of the UGI - 20°.

Fig.10 shows the replacement of plastic cups.

Fig.11 presents the polyethylene Cup with the value of the IGO 30°: 1 - head; 2 - foot module; 4 - device for fixation of the Cup: 4A - cylinder with graduations; 4B - frame; 7 - value of calibration of the bed 30°.

Fig.12 presents the test when the IGO 30°: 7 - the value of calibration of the bed 30°.

Fig.13 shows the test value when the IGO 30° (close up): 1 - head; 3 - Cup.

Fig.14 shows the ending of the test of modelling the wear of polyethylene cups in the value of the IGO - 30° (top view): 1 - head; 3 - Cup.

Fig.15 shows the ending of the test of modelling the wear of polyethylene cups in the value of the IGO - 30° (side view): 1 - head; 3 - Cup.

Fig.16 shows changes in plastic cups after the experiment, in conditions equivalent to NQF AHTS 3rd degree.

The method is carried out as follows. The Express modeling of wear of the polyethylene liner metal cups or plastic cups under dynamic conditions at different angles to the horizontal inclinatio in the experimental module of the prosthesis pelvic�drenovo joint, which consists in conducting the experiment, long-term and repeated cyclic movements in a module of a hip replacement. Experimental module of the endoprosthesis of the hip joint consists of the following components: the stem, the polyethylene liner metal Cup or plastic Cup, head. According to the structure of the head can be represented by ceramics, metal, metal alloy and other materials. The rough surface of the head.

Experimental module of the endoprosthesis of the hip joint is fixed in a special device so that the head was in a plastic Cup or in a plastic liner metal cups module of the prosthesis. An important aspect of method for the rapid simulation of wear of the polyethylene liner metal cups or plastic cups under dynamic conditions at different angles to the horizontal inclinatio in the experimental module of the endoprosthesis of the hip joint is the orientation of the longitudinal axis of the head and neck module relative to the plane of the entrance to the polyethylene liner. The plane of the entrance to the polyethylene liner corresponds to the anteroposterior size of the acetabulum of the hip joint.

The device with a plastic Cup mounted so that the longitudinal axis of the head � cervical module was rejected in relation to the plane of the entrance to the polyethylene liner metal Cup or plastic Cup 10°, which corresponds to the external rotation contracture of the hip joint of the 1st degree. Next up are the dynamic test on joint compression and cyclic torsion in a friction pair (Fig. 1, 2), then evaluate the wear of the polyethylene liner metal cups or plastic cups (Fig. 4). Then produce the replacement of worn plastic cups or plastic liner and head with a rough surface on new experimental components of the prosthesis (Fig. 5).

When performing a new cycle of dynamic testing device with new polyethylene liner metal Cup or plastic Cup mounted so that the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to the polyethylene liner of a metal Cup or a plastic Cup at 20°, which corresponds to the external rotation contracture of the hip joint 2nd degree (Fig.6, 7). After installation of the endoprosthesis of the hip joint with the value of the horizontal angle inclinatio 20° conduct dynamic tests on joint compression and cyclic torsion in a friction pair head - plastic Cup or a plastic liner metal cups (Fig.8). After evaluation of the wear of polyethylene cups or plastic liner metal cha�Ki (Fig.9) carry out the replacement of worn-out plastic cups or plastic liner and head with a rough surface (Fig.10).

In further experiment device with new polyethylene liner metal Cup or plastic Cup mounted so that the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to the polyethylene liner of a metal Cup or a plastic Cup at 30°, which corresponds to the external rotation contracture of the hip joint 3rd degree (Fig.11). Conduct dynamic tests on joint compression and cyclic torsion in a friction pair (Fig.12, 13), then examine the wear of the polyethylene liner cups or plastic cups experimental module of the endoprosthesis of the hip joint (Fig.16).

Thus, the proposed method allows to investigate the wear of the polyethylene liner cups or plastic cups experimental module of the endoprosthesis of the hip joint at different angles of deflection of the longitudinal axis of the head and the axis of the neck of the leg module of the prosthesis relative to the plane of the entrance in a plastic Cup or a plastic liner metal Cup prosthesis module that allows you to evaluate the wear of the polyethylene liner cups or plastic cups experimental module of the prosthesis at various angles to the horizontal inclinatio.

Method for the rapid simulation of polyethylene wear contribution�Sha metal cups or plastic cups under dynamic conditions at different angles to the horizontal inclinatio in the experimental module of the endoprosthesis of the hip joint, which consists in conducting the experiment, long-term and repeated cyclic movements in the module of hip endoprosthesis, characterized in that the use of an experimental module of the endoprosthesis of the hip joint having a stem, a plastic liner metal Cup or plastic Cup and the crown, composed of ceramic, metal, metal alloys and other materials with a rough surface, with the pilot module of the endoprosthesis of the hip joint is fixed in the device so that the head was in a plastic Cup or in a plastic liner metal cups module prosthesis, and then the device with a plastic liner metal Cup or plastic Cup set, to the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to the polyethylene liner metal Cup or plastic Cup 10 degrees, followed by a dynamic test on joint compression and cyclic torsion in a friction pair, then make the replacement of worn plastic cups or plastic liner and head with a rough surface on new, device with new polyethylene liner metal Cup or plastic Cup�th sets, to the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to the polyethylene liner metal Cup or plastic Cup 20 degrees, followed by a dynamic test on joint compression and cyclic torsion in a friction pair, then make the replacement of worn plastic cups or plastic liner and head with a rough surface to new, then the device with new polyethylene liner metal Cup or plastic Cup set so that the longitudinal axis of the head and neck module was rejected in relation to the plane of the entrance to the polyethylene liner of a metal Cup or a plastic Cup at a 30 degree angle, and conduct dynamic tests on joint compression and cyclic torsion in a friction pair, then examine the wear of the polyethylene liner cups or plastic cups experimental module of the endoprosthesis of the hip joint.



 

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