RESUMO
The increase of revision surgeries in hip replacement procedure in Colombian young adult population can be addressed by a new design of femoral stem that reduces stress shielding. A new femoral stem was designed using topology optimization as a design aid to reduce the mass in the femoral stem and its overall stiffness, combined with the theoretical, computational, and experimental assessment of the new design that complies with a static and fatigue safety factor greater than one. The new femoral stem design can be used as a design tool to reduce the number of revision surgeries caused by stress shielding.
RESUMO
The endurance properties of a femoral stem under fatigue loading must be known and the methodology proposed in this work provides the mathematical tools for designers of femoral stems and orthopedic surgeons to select the adequate material and femoral stem design with a new graph that condensate the information in an easy to use selection process. Initially, the theoretical and computational development of the fatigue analysis provides comparable results with an average error of 8.3%. And the formulated methodology with the aim of selecting the mechanical device with the best fatigue performance with an average error of 8.7%.
Assuntos
Prótese de Quadril , Estresse Mecânico , Desenho de Prótese , Fêmur/cirurgia , Análise de Elementos FinitosRESUMO
The maximum stresses on a femoral stem must be known for selecting the right size and shape of the shaft cross-sectional area for reducing the stress shielding effect generated after the total hip arthroplasty (THA) surgical procedure. The methodology proposed in this study provides the tools to the designers of femoral stems and orthopedic surgeons to select the adequate femoral stem cross section, decreasing the stiffness of the stem, thus reducing the stress shielding effect in the patient bones. The first contribution is the theoretical development of the maximum static stress calculation for 12 different femoral stem models with the beam theory, followed by the comparison with the static finite element analysis (FEA) simulations and finally the experimental corroboration of one femoral stem model measuring the strain with linear strain gages and transform it to stresses, the three different approaches provide comparable results, with a maximum average error of less than 8.5%. The second contribution is the formulation of a new selection methodology based on maximum stresses in the femoral stem and the cross section area for decreasing the stress shielding effect, optimizing the area needed for withstand the loads and decreasing the overall stiffens of the stem.
Assuntos
Artroplastia de Quadril , Prótese de Quadril , Artroplastia de Quadril/métodos , Fêmur/cirurgia , Análise de Elementos Finitos , Humanos , Desenho de Prótese , Estresse MecânicoRESUMO
El presente estudio tuvo como objetivo la caracterización histológica e inmunocitoquímica de la grasa infrapatelar de Hoffa (GIH) en 12 pacientes intervenidos por artroscopia, meningoplastia o remplazo de rodilla. Las fibras elásticas estuvieron presentes en la grasa infrapatelar con distribución unidireccional fascicular, se plantea una relación funcional en la biomecánicas del movimiento articular de la rodilla. Por otra parte las pruebas de inmunocitoquimica arrojaron marcaje positivo para vimentina, marcador de células del tejido conectivo; células mesenquimales y negativo para el resto de los anticuerpos estudiados.
Assuntos
Articulação do Joelho , Tecido Elástico , Vimentina , ColômbiaRESUMO
Introducción: La grasa infrapatelar de Hoffa es una inclusión infraarticular presente en la rodilla y existen evidencias que células multipotentes están presentes en tejido adiposo del humano adulto. Objetivo: El propósito de este trabajo es aislar e identificar células mesenquimales a partir de muestras de la grasa de Hoffa tomadas de pacientes a los que se les practicó cirugía de rodilla que expongan este tejido. Metodología: Una vez obtenido el consentimiento informado de un total de 12 pacientes, se obtuvo la muestra de tejido graso. La grasa fue disgregada incubándola en colagenasa en PBS a 37ºC y con agitación, luego se inactivó con suero fetal bovino, se separaron mediante centrifugación los adipocitos maduros de las células multipotentes y se obtuvieron las muestras para sembrar en medio Mesencult. Una porción de muestra fue utilizada para identificación mediante citometría de flujo y otra parte para ser coloreada con azul de metileno. Resultados y Discusión: Tanto en las tinciones con azul de metileno como en los cultivos celulares se han apreciado células con la morfología propia de una célula mesenquimal en forma de estrella y que fueron corroborados mediante citometría de flujo para los marcadores CD13, CD29, CD59 y CD105; igualmente hemos podido observar la efectividad del tratamiento enzimático. Conclusiones: En la actualidad nos encontramos consolidando los cultivos primarios para posteriormente diferenciarlos en líneas celulares específicas que puedan ser utilizadas en estudios de patologías, tales como obesidad, diabetes y trastornos articulares...
Introduction: The infrapatellar fat pad (sometimes know Hoffa's pad) is a soft tissue that lies beneath the patella (kneecap) separating it from the femoral condyle. There is evidence suggesting the presence of stem cells on adipose tissue in the adult human. Objective: The purpose of this work is to isolate and identify grown stem cells from Hoffa's fat samples obtained from patients undergoing surgeries exposing this tissue. Materials and Methods: After obtaining informed consent, the biopsy of Hoff's fat pad was obtained. The samples were incubated with collagenase and PBS a 37ºC and agitated, then it was inactivated with fetal bovine serum and centrifuged, washed twice with PBS, the pellet was resuspended and one part was cultivated on Mesencult medium the other part was used for flow cytometry and stained with methylene blue for morphologic analysis. Also before and after the enzyme digestion, the samples were added to 10% formaldehyde to evaluate the collagenase treatment. Results and analysis: The results show the effectiveness of the enzymatic treatment, the architecture of the adipose tissue was lost. The star shape stem cells morphology was appreciated with methylene blue in the cultures, it was corroborated by flow cytometry with CD13, CD29, CD59 and CD 105 markers. Conclusions: Primary cultures are consolidating, the next aim will be to obtain differentiated specific cell types that can be use in the study of obesity, diabetes and articular illnesses...