Experimental analysis of insertion torques and forces of threaded and press-fit acetabular cups by means of ex vivo and in vivo measurements

• Autorzy: Vogel D. , Rathay A. , Teufel S. , Ellenrieder M. , Zietz C. , Sander M. , Bader R.

Identyfikatory

DOI

10.5277/ABB-00723-2016-02

• Języki publikacji: EN

Abstrakty

EN

In THA sufficient primary implant stability is the precondition for successful secondary stability. Industrial foams of different densities have been used for primary stability investigations. The aim of this study was to analyse and compare the insertion behaviour of threaded and press-fit cups in vivo and ex vivo using bone substitutes with various densities. Methods: Two threaded (Bicon Plus®, Trident® TC) and one press-fit cup (Trident PSL®) were inserted by orthopaedic surgeons (S1, S2) into 10, 20 and 31 pcf blocks using modified surgical instruments allowing measurements of the insertion forces and torques. Furthermore, the insertion behaviour of two cups were analysed intraoperatively. Results:Torques for the threaded cups increased while bone substitute density increased. Maximum insertion torques were observed for S2 with 102 Nm for the Bicon Plus® in 20 pcf blocks and 77 Nm for the Trident® TC in 31 pcf blocks which compares to the in vivo measurement (85 Nm). The average insertion forces for the press-fit cup varied from 5.2-6.8 kN (S1) and 7.2-11.5 kN (S2) ex vivo. Intraoperatively an average insertion force of 8.0 kN was determined. Conclusions: Implantation behaviour was influenced by acetabular cup design, bone substitute and experience of the surgeon. No specific density of bone substitute could be favoured for ex vivo investigations on the implantation behaviour of acetabular cups. The synthetic bone blocks of high density (31 pcf) led to problems regarding cup orientation and seating. Therefore, bone substitutes used should be critically scrutinized in terms of the comparability to the in vivo situation.

Słowa kluczowe

EN

insertion force; insertion torque; acetabular cup; press-fit; threaded; synthetic bone

PL

panewka; gwintowanie; kość; kość syntetyczna

• Wydawca: Oficyna Wydawnicza Politechniki Wrocławskiej
• Czasopismo: Acta of Bioengineering and Biomechanics
• Rocznik: 2017
• Tom: Vol. 19, no. 3
• Strony: 155--163
• Opis fizyczny: Bibliogr. 25 poz., rys.

Twórcy

autor

Vogel D.

• Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, University of Rostock, Rostock, Germany

autor

Rathay A.

• Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, University of Rostock, Rostock, Germany

autor

Teufel S.

• Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, University of Rostock, Rostock, Germany

autor

Ellenrieder M.

• Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, University of Rostock, Rostock, Germany

autor

Zietz C.

• Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, University of Rostock, Rostock, Germany

autor

Sander M.

• Department of Structural Mechanics, University of Rostock, Rostock, Germany

autor

Bader R.

• Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, University of Rostock, Rostock, Germany

Bibliografia

• [1] Adler E., Stuchin S. A., Kummer F. J., Stability of press-fit acetabular cups, J Arthroplasty, 1992, 7(3):295-301.
• [2] Amirouche F., Solitro G., Broviak S., Goldstein W., Gonzalez M., Barmada R., Primary cup stability in THA with augmentation of acetabular defect. A comparison of healthy and osteoporotic bone, Orthop Traumatol Surg Res, 2015, 101(6):667-673.
• [3] Amirouche F., Solitro G., Broviak S., Gonzalez M., Goldstein W., Barmada R., Factors influencing initial cup stability in total hip arthroplasty, Clin Biomech, 2014, 29(10), 1177-118.
• [4] Antoniades G., Smith E. J., Deakin A. H., Wearing S. C., Sarungi M., Primary stability of two uncementedacetabular components of different geometry: hemispherical or peripherallyenhanced?, Bone Joint Res, 2013, 2(12):264-269.
• [5] Crosnier E. A., Keogh P. S., Miles A. W., A novel method to assess primary stability of press-fit acetabular cups, Proc Inst Mech Eng H, 2014, 228(11):1126-1134.
• [6] Curtis M. J., Jinnah R. H., Wilson V. D., Hungerford D. S., The initial stability of uncemented acetabular components, The Journal of bone and joint surgery. British volume, 1992, 74(3):372-376.
• [7] Diehl P., Haenle M., Bergschmidt P., Gollwitzer H., Schauwecker J., Bader R., Mittelmeier W., Cementless total hip arthroplasty: a review (Zementfreie Huftendoprothetik: eine aktuelle Ubersicht / Cementless total hip arthroplasty: a review), Biomed Tech (Berl), 2010, 55(5):251-264.
• [8] Effenberger H,. Bosl O., Witzel U., Linke B., Screw-in performance of threaded cups (Eindrehverhalten von Schraubpfannen). Z Orthop Unfall, 2008, 146(2):185-193.
• [9] Ellenrieder M., Bader R., Bergschmidt P., Mittelmeier W., Press-fit versus threaded acetabular cups in total hip arthroplasty: Functional and radiological results after five years, 2016, Acta Orthop Belg 82(1):60-67.
• [10] Fritsche A., Bialek K., Mittelmeier W., Simnacher M., Fethke K., Wree A., Bader R., Experimental investigations of the insertion and deformation behavior of press-fit and threaded acetabular cups for total hip replacement, J Orthop Sci, 2008, 13(3): 240-247.
• [11] Kanis J. A., Melton L. J.3rd, Christiansen C., Johnston C. C., Khaltaev N., The diagnosis of osteoporosis, J Bone Miner Res, 1994, 9(8):1137-1141.
• [12] Knahr K., Portmann D., Schmucki D., Pospischill M., Howald R., Experimental investigation of threaded cup performance during insertion in total hip replacement, Hip Int, 2004, 14(1):11-17.
• [13] Kody M. H., Kabo J. M., Markolf K. L., Dorey F. J., Amstutz H. C., Strength of initial mechanical fixation of screw ring acetabular components, Clin Orthop Relat Res, 1990, (257):146-153.
• [14] Kroeber M., Ries M.D., Suzuki Y., Renowitzky G., Ashford F., Lotz J., Impact biomechanics and pelvic deformation during insertion of press-fit acetabular cups, J Arthroplasty, 2002, 17(3):349-354.
• [15] Le Cann S., Galland A., Rosa B., Le Corroller T., Pithioux M., Argenson J., Chabrand P., Parratte S., Does surface roughness influence the primary stability of acetabular cups? A numerical and experimental biomechanical evaluation, Med Eng Phys, 2014, 36(9):1185-1190.
• [16] Macdonald W., Carlsson L.V., Charnley G.J., Jacobsson C.M., Press-fit acetabular cup fixation: principles and testing, Proc Inst Mech Eng H, 1999, 213(1):33-39.
• [17] Marcus R., Peritz E., Gabriel K.R., On Closed Testing Procedures with Special Reference to Ordered Analysis of Variance, Biometrika, 1976, 63(3):655
• [18] Mathieu V., Michel A., Flouzat Lachaniette C., Poignard A., Hernigou P., Allain J., Haiat G., Variation of the impact duration during the in vitro insertion of acetabular cup implants, Med Eng Phys, 2013, 35(11):1558-1563.
• [19] Pilliar R. M., Lee J. M., Maniatopoulos C., Observations on the effect of movement on bone ingrowth into porous-surfaced implants, Clin Orthop Relat Res, 1986, (208):108-113.
• [20] Refior H. J., Parhofer R., Ungethuem M., Bloemer W., Special problems of cementless fixation of total hip-joint endoprostheses with reference to the PM type, Arch Orth Traum Surg, 1988, 107(3):158-171
• [21] Schwarz M. L., Scheller G., Effenberger H., Primary stability of threaded cups in THR-an experimental study, Biomed Tech (Berl), 2003, 48(12):334-338.
• [22] Souffrant R., Zietz C., Fritsche A., Kluess D., Mittelmeier W., Bader R., Advanced material modelling in numerical simulation of primary acetabular press-fit cup stability, Comput Methods Biomech Biomed Engin, 2012, 15(8):787-793.
• [23] Urbanski W., Krawczyk A., Dragan S. L., Kulej M., Dragan S. F., Influence of cementless cup surface on stability and bone fixation 2 years after total hip arthroplasty, Acta Bioeng Biomech, 2012, 14(2):27-35.
• [24] Wilkinson J. M., Peel N. F., Elson R. A., Stockley I., Eastell R., Measuring bone mineral density of the pelvis and proximal femur after total hip arthroplasty, J Bone Joint Surg Br, 2001, 83(2):283-288.
• [25] Zietz C., Fritsche A., Kluess D., Mittelmeier W., Bader R., Influence of acetabular cup design on the primary implant stability. An experimental and numerical analysis (Einfluss der Formgebung von kunstlichen Huftpfannen auf die primare Verankerungsfestigkeit: Eine experimentelle und numerische Analyse). Der Orthopade 2009, 38(11):1097-1105.