The Effects of Interlocking a Universal Hip Cementless Stem on Implant Subsidence and Mechanical Properties of Cadaveric Canine Femora

Objective

To determine if an interlocking bolt would limit subsidence of the biological fixation universal hip (BFX^®) femoral stem under cyclic loading and enhance construct stiffness, yield, and failure properties.

Study Design

Ex vivo biomechanical study.

Animals

Cadaveric canine femora (10 pairs).

Methods

Paired femora implanted with a traditional stem or an interlocking stem (constructs) were cyclically loaded at walk, trot, and gallop loads while implant and bone motions were captured using kinematic markers and high‐speed video. Constructs were then loaded to failure to evaluate failure mechanical properties.

Results

Implant subsidence was greater (P = .037) for the traditional implant (4.19 mm) than the interlocking implant (0.78 mm) only after gallop cyclic loading, and cumulatively after walk, trot, and gallop cyclic loads (5.20 mm vs. 1.28 mm, P = .038). Yield and failure loads were greater (P = .029 and .002, respectively) for the interlocking stem construct (1155 N and 2337 N) than the traditional stem construct (816 N and 1405 N). Version angle change after cyclic loading was greater (P = .020) for the traditional implant (3.89 degrees) than for the interlocking implant (0.16 degrees), whereas stem varus displacement at failure was greater (P = .008) for the interlocking implant (1.5 degrees) than the traditional implant (0.17 degrees).

Conclusion

Addition of a stabilizing bolt enhanced construct stability and limited subsidence of a BFX^® femoral stem. Use of the interlocking implant may decrease postoperative subsidence. However, in vivo effects of the interlocking bolt on osseointegration, bone remodeling, and stress shielding are unknown.     

Early Experience With the Use of an Interlocking Nail for the Repair of Canine Femoral Shaft Fractures

Static locked nailing was used to repair fractures of the femoral diaphysis in 15 dogs. The implant consists of a 5, 6, or 7 mm diameter stainless steel rod made up of two parts: the body of the nail, in which there are 13 threaded holes, and a piece without holes that contains a slot for anchoring the jig. Good limb function was obtained after less than 3 weeks in 12 dogs and these dogs remained sound throughout the study. Radiographic examination revealed fracture healing in 11 of the dogs, between 8 and 16 weeks after surgery. One dog was not returned for follow-up evaluation until 22 weeks after surgery; complete healing was apparent from radiographic examination. The remaining three dogs had to have additional operations, one because of lameness caused by excessive length of the distal screws, one because of a nonunion, and the third because of a sequestrum. Fracture healing in these dogs was observed at 18, 21, and 24 weeks respectively. Loosening of one screw and angulation of the bone occurred in one dog. These complications had no adverse effects on clinical outcome.     

Vascular and Morphologic Changes in Canine Femora after Uncemented Hip Arthroplasty

The effects on femoral remodeling of medullary reaming and insertion of a porous endopros-thesis in uncemented hip arthroplasty (UHA) were measured. A unilateral hip hemiarthroplasty (HA) was performed in 12 dogs, with six dogs receiving full-sized and six dogs receiving undersized femoral endoprostheses. A prosthetic head and neck, or acetabular cup, was not implanted. A control group of six dogs underwent femoral head and neck excision (FHNE) only. All dogs were killed 4 weeks after the surgical procedure. Porosity, vascularity, and bone formation were quantified in each femur of the dogs that had been operated on and in each femur of two unoperated dogs. Full-sized did not differ from undersized HA bones in vascularity, porosity, or bone formation. Femurs in which hemiarthroplasties had been performed (full-sized and undersized) had a three-fold increase in porosity, vascularity, and bone formation compared to the contralateral and the FHNE femurs. Changes in porosity and vascularity were greatest (p < .05) at the metaphyseal level and in the medial and caudal quadrants. There was a strong correlation (R² 0.77 to 0.93, and p − .0001) between the increase in porosity and vascularity. These results support the hypothesis that medullary reaming followed by uncemented prosthetic stem implantation contribute to remodeling of the proximal portion of the femur after UHA.     

In Vitro Biomechanical Comparison of Solid and Tubular Interlocking Nails in Neonatal Bovine Femurs

This study biomechanically evaluates solid and tubular interlocking nails in bovine neonatal femurs. Paired femurs from 40 neonatal dairy calves were obtained for mechanical testing. Intact femurs and four combinations of experimentally manipulated femurs (intact or ostectomized femurs with either a solid or tubular interlocking nail) were tested in craniocaudal and lateromedial bending, eccentric axial compression, and external torsion to evaluate composite rigidity, local/gap stiffness, and load to failure (compression and torsion only). In torsional composite rigidity, femurs with tubular interlocking nails were more compliant than intact femurs or intact femurs with solid interlocking nails (P <.001). Ostectomized femurs with solid interlocking nails were similar to intact femurs with tubular interlocking nails. Within femurs with tubular interlocking nails, ostectomized femurs were more compliant than intact femurs (P <.0001). In craniocaudal and lateromedial bending rigidity, ostectomized femurs were more compliant than intact femurs, regardless of interlocking nail type (P <.001). Within ostectomized femurs, tubular interlocking nails were more compliant than solid interlocking nails in craniocaudal bending (P <.05) and there was a similar trend in lateromedial bending (P=.06). In eccentric axial compression, local/ gap stiffness was significantly greater in intact femurs compared with intact femurs with solid (48% of intact bone) or tubular (45% of intact bone) interlocking nails and ostectomized femurs with solid (18% of intact bone) or tubular (11 % of intact bone) interlocking nails (P <.0001). In torsional testing, local/gap stiffness was not significantly different between intact femurs and intact femurs with interlocking nails, but was significantly lower in ostectomized femurs with solid (2% of intact bone) and tubular (0.2% of intact bone) interlocking nails (P <.0001). In torsional and compressive failure testing, plastic deformation of the tubular interlocking nail occurred at the unoccupied screw hole at the ostectomy site before bone failure. Interlocking nails should be considered as an optional repair method for neonatal bovine femoral fractures. Until the actual physiological loading characteristics of neonatal calf femurs are measured, it is uncertain whether solid or tubular interlocking nails tested in this study will provide sufficient strength and stiffness to stabilize neonatal bovine femoral fractures and facilitate healing.     

In Vitro Evaluation of the Effect of Fracture Configuration on the Mechanical Properties of Standard and Novel Interlocking Nail Systems in Bending

Objective— To investigate the effect of fracture configuration on the mechanical properties of standard interlocking nails (ILNs) and a novel angle-stable ILN (ILNn) in bending.
Study Design— In vitro experimental study.
Sample Population— Synthetic tibial gap fracture bone models.
Methods— Bone models, featuring a 5 or 120 mm central defect, respectively, mimicking a simple diaphyseal and a comminuted fracture involving both metaphyses, were implanted with 6 or 8 mm screwed or bolted standard ILNs (ILN6s, ILN6b, ILN8s, ILN8b, respectively) or an ILNn. Specimens were tested in 4-point bending. Construct angular deformation (AD) and slack were statistically compared ( P <.05).
Results— With increasing gap size, standard ILN construct AD increased significantly by ∼27% in ILN8b and by up to 105% in ILN6s. Similarly, standard ILN construct slack significantly increased by ∼33% in ILN8b (from ∼4.2° to ∼5.6°) and by up to ∼130% in ILN6s (from ∼7° to ∼16°). Conversely, there was no difference in the ILNn construct AD (∼4°) regardless of gap size. ILNn AD was the lowest of all groups and occurred without slack.
Conclusions— This study demonstrated that the angle-stable ILNn provided construct stability regardless of fracture configuration, whereas the intrinsic slack of standard ILNs could jeopardize construct stability in a fracture configuration involving the metaphyses.
Clinical Relevance— Use of standard ILNs may be optimal in diaphyseal fractures where circumferential nail/cortical contact could augment repair stability. Conversely, the angle-stable ILNn may represent a reliable fracture stabilization method for diaphyseal fractures as well as fractures involving the metaphyseal regions.     

In Vivo Evaluation of Intramedullary Interlocking Nail Fixation of Transverse Femoral Osteotomies in Foals

Objective—To evaluate an intramedullary interlocking nail for stabilization of transverse femoral osteotomies in foals.
Study Design—A transverse osteotomy and restabilization with an intramedullary interlocking nail was performed on the right femur in three foals and the left femur in three foals. Animals—Six foals weighing 149 to 207 kg.
Methods—The femur was destabilized with a transverse middiaphyseal osteotomy and repaired with a 0.5-in (12.7 mm) interlocking nail. The implanted femurs were radiographed monthly until completion of the study 6 months after surgery. At the completion of the study, all foals were observed for evidence of lameness, gluteal thickness was determined by ultrasonographic measurement, and a necropsy was performed.
Results—Healing was satisfactory in all foals. Five of the six had osseous bridging of the osteotomy apparent radiographically by 3 to 4 months. The sixth foal had postoperative infection but was healed radiographically in 5 months. There was a mean decrease in gluteal muscle thickness of 6.6 mm ( P = .04) in the operated limb of the five foals that healed without complication. Two foals were lame at the completion of the project; one foal with varus deformities of the contralateral limb was mechanically lame, and another was grade 2/5 lame on the operated limb. On necropsy, there was circumferential enlargement of the diaphysis of all operated limbs with the majority of the callus at the cranial and medial aspects of the cortex. All nails were solid within the medullary cavity.
Conclusions —The intramedullary interlocking nail provided adequate stabilization for repair of the transverse osteotomy.
Clinical Relevance —Further investigation is warranted before use for stabilization of spontaneously occurring fracture configurations.     

犬瘟热病毒的结构多肽分析

差速离心和蔗糖密度梯度离心纯化经鸡胚成纤维细胞蚀斑克隆后的犬瘟热毒Ｓ＿８毒株，采用ＳＤＳ－ＰＡＥＧ电泳及Ｗｅｓｔｅｒｎｂｌｏｔ转印技术详细分析了犬瘟热病毒的结构多肽。回收凝胶中１条６３Ｋｄ的蛋白带，经３种不同的蛋白酶消化后，首次证明在犬瘟热病结构多肽中，融合蛋白Ｆ多肽的两个亚单位（Ｆ＿１和Ｆ＿２）是以胰蛋白酶的特异性水解位点精氨酸为桥梁连接形成Ｆ多肽的。试验结果表明，犬瘟热病毒主要包括Ｌ（２００．５Ｋｄ）、ＨＡ（７４Ｋｄ）、Ｐ（６８Ｋｄ）、Ｆ（６３Ｋｄ）、ＮＰ（５６Ｋｄ）、Ｍ（３５Ｋｄ）等６条结构多肽，同时下蛋白可在电泳中裂解成Ｆ＿１（４１Ｋｄ）和Ｆ＿２（２７Ｋｄ）２个亚单位。试验还发现其它３条分子量分别为５２Ｋｄ、４４Ｋｄ、３２Ｋｄ的病毒蛋白成分，它们是否均为病毒的结构多肽仍需深入研究。     

An In Vitro Biomechanical Investigation of an Interlocking Nail for Fixation of Diaphyseal Tibial Fractures in Adult Horses

The compressive, bending and torsional mechanical properties of osteotomized adult equine tibiae stabilized with an interlocking intramedullary nail (nail-tibia composite) were compared with those of intact tibiae to determine the clinical applicability of the nail for repair of tibial fractures in adult horses. The mean yield load, failure load, and stiffness for the nail-tibia composites were significantly less ( P < .05) than those for the intact tibiae in all loading configurations. The mean compressive yield load for the nail-tibia composites was greater than the compressive load calculated from previously reported in vivo data for walking and trotting, and was equal to the load calculated for recovery from anesthesia. The mean yield bending moment for the nail-tibia composites was greater than the bending moment previously calculated for standing, walking, and recovery from anesthesia. The mean torsional yield load for the nail-tibia composites was less than the torsional load determined for the walk from another in vivo study. The design of the interlocking nail evaluated in the present study should be modified to increase torsional and compressive yield strengths and torsional stiffness before reasonable success could be expected for the treatment of adult equine tibial fractures.     

犬瘟热病毒H、F、N基因试验免疫研究

以构建的真核表达载体pVAXLPH、pVAXLPF和pVAXLPN为基因疫苗,分组进行了免疫小鼠试验,对免疫鼠体内免疫应答水平进行了检测。结果显示:所构建的基因疫苗可以诱导小鼠产生特异性免疫应答反应,pVAXLPH pVAXLPF pVAXLPN 3个基因混合免疫小鼠诱导产生了较强的体液免疫和细胞免疫应答,免疫3次后血清中抗CDV ELISA抗体效价为0.332,而免疫前为0.158;抗CDV中和抗体效价为1∶(4~16);CD4 T/CD8 T比值为2.05±0.38,而对照组为1.99±0.56;免疫小鼠脾细胞对CDVLP及ConA刺激的增殖反应值分别为0.384和0.356。基因疫苗免疫犬试验中,进行了单用基因疫苗免疫和基因疫苗与CDV弱毒疫苗联合免疫效果的比较研究。结果显示,基因疫苗免疫3次后,血清中抗CDV ELISA抗体效价为0.296,抗CDV中和抗体效价为1∶(8~32)。基因疫苗免疫2次,再使用弱毒疫苗加强免疫1次,血清中抗CDV ELISA抗体效价为0.433,抗CDV中和抗体效价为1∶(16~64)。     

An In Vitro Biomechanical Comparison of an Interlocking Nail System and Dynamic Compression Plate Fixation of Ostectomized Equine Third Metacarpal Bones

OBJECTIVE: To compare the mechanical properties of two stabilization methods for ostectomized equine third metacarpi (MC3): (1) an interlocking nail system and (2) two dynamic compression plates. Animal or Sample Population-Ten pairs of adult equine forelimbs intact from the midradius distally. METHODS: Ten pairs of equine MC3 were divided into two test groups (five pairs each): caudocranial four-point bending and torsion. Interlocking nails (6 hole, 13-mm diameter, 230-mm length) were placed in one randomly selected bone from each pair. Two dynamic compression plates one dorsally (12 hole, 4.5-mm broad) and one laterally (10 hole, 4.5-mm broad) were attached to the contralateral bone from each pair. All bones had 1 cm mid-diaphyseal ostectomies. Five construct pairs were tested in caudocranial four-point bending to determine stiffness and failure properties. The remaining five construct pairs were tested in torsion to determine torsional stiffness and yield load. Mean values for each fixation method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS: Mean (+/-SEM) values for the MC3-interlocking nail composite and the MC3-double plate composite, respectively, in four-point bending were: composite rigidity, 3,454+/-407.6 Nm/rad and 3,831+/-436.5 Nm/rad; yield bending moment, 276.4+/-40.17 Nm and 433.75+/-83.99 Nm; failure bending moment, 526.3+/-105.9 Nm and 636.2+/-27.77 Nm. There was no significant difference in the biomechanical values for bending between the two fixation methods. In torsion, mean (+/-SEM) values for the MC3-interlocking nail composite and the MC3-double plate composite were: composite rigidity, 124.1+/-16.61 Nm/rad and 262.4+/-30.51 Nm/rad; gap stiffness, 222.3+/-47.32 Nm/rad and 1,557+/-320.9 Nm/rad; yield load, 94.77+/-7.822 Nm and 130.66+/-20.27 Nm, respectively. Composite rigidity, gap stiffness, and yield load for double plate fixation were significantly higher compared with interlocking nail fixation in torsion. CONCLUSIONS: No significant differences in biomechanical properties were identified between an interlocking nail and double plating techniques for stabilization of ostectomized equine MC3 in caudocranial four-point bending. Double plating fixation was superior to interlocking nail fixation in torsion.     

兰州市犬瘟热、犬细小病毒病及犬副流感的感染调查分析

为查清兰州市宠物犬犬瘟热、犬细小病毒病、犬副流感的感染情况,本研究对2004年~2009年前来宠物医院就诊的有临床症状的犬进行检测,共采集犬瘟热疑似病犬眼鼻分泌物、唾液2238份;犬细小病毒病疑似病犬粪便2423份;犬副流感疑似病犬眼、鼻分泌物334份。用快速检测试纸卡进行检测,结果显示兰州市宠物犬犬瘟热平均阳性率达27.52%,自2004~2009年间呈逐渐下降趋势。犬细小病毒病平均阳性率为25.88%,自2004~2008年间呈逐渐下降趋势,2009年略有反弹。首次证实犬副流感在兰州市宠物犬中流行,其中犬副流感病毒平均阳性率为37.72%,犬腺病毒Ⅱ型平均阳性率为19.46%,从流行周期看,2004年以犬副流感病毒感染为主,2005年以犬腺病毒Ⅱ型感染为主,而后连续两年以混合感染为主,到2008年又以犬副流感病毒感染为主,2009年再次以混合感染为主。     

Morphometric and Structural Examination of the Collateral Ligaments of the Canine Elbow Joint

The aim of this study was to describe morphological differences between the lateral collateral ligament (LCL) and the medial collateral ligament (MCL) of the canine elbow joint. Forty forelimbs of 22 dogs (adult German shepherd dogs and shepherd mongrels) were dissected. The length and width of defined segments of the ligaments (i. e. total length, areas of origin and insertion, 'free part', 'humeral part', 'antebrachial part') were measured in extension (160°) and flexion (30°). Statistical analyses of the data were performed using the data analysis software SAS 8.0. In addition the collateral ligaments of ten forelimbs of five shepherd mongrels were studied histologically. The LCL differs from the MCL in the following morphological items: a) the areas of origin and insertion are larger and in consequence the 'free part' of the lateral ligament is shorter; b) the caudal crus of the LCL is fan-shaped with a broad insertion area at the ulna whereas the caudal crus of the MCL remains slim; c) in the LCL the 'humeral part' varies in length depending on extended or flexed position of the joint, which is due to the spiral shape of the capitulum humeri; d) the microscopical structure of the LCL is organized less tightly; the collagen fibre bundles cross in varying angles. Referring to these details the LCL seems to allow and to limit a slight rotation of the forearm when the elbow joint is extremely flexed.     

Comparison of a New Braid Fixation System to an Interlocking Intramedullary Nail for Tibial Osteotomy Repair in an Ovine Model

Objectives— To compare bone healing of tibial osteotomy repaired with Nitinol wire braid and hardened steel rods (Braid system) and polymethylmethacrylate bone cement with an interlocking intramedullary (IM) nail fixation in an ovine model.
Study Design— In vitro and in vivo experimental study.
Animals— Adult female sheep (n=22).
Methods— Using sheep tibia, a middiaphyseal transverse osteotomy was performed in the right tibia, which were then randomly assigned to the Braid system group or IM nail group (n=5). The left tibia were used as controls. The torsional properties of tibial constructs were compared. The study was repeated in vivo in 12 sheep and mechanical properties and bone healing were evaluated at 12 weeks.
Results— In vitro, there was no significant difference in torsional stiffness between the groups. In vivo, operative time for the Braid system group was significantly shorter than the IM nail group. At 12 weeks, there were no significant differences in maximum torque and torsional stiffness between IM nail and Braid system groups nor were there significant radiographic or histologic differences between the groups.
Conclusions— The Braid system might decrease operative time for repair of transverse middiaphyseal tibial fractures and result in similar bone healing at 12 weeks after surgery compared with an interlocking IM nail repair.
Clinical Relevance— A Nitinol Braid system may be a treatment option for transverse midshaft tibial fractures.