A Simple Technique to Remove an Incarcerated Ceramic Liner in Revision Hip Arthroplasty

Gurung, B; Shah, Owais; Edwards, Tim; Afzal, Irrum; Gikas, Panagiotis D.; Field, Richard E.

doi:10.1016/j.artd.2023.101142

Cited by 2 publications

(1 citation statement)

References 3 publications

(8 reference statements)

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“…Unlike the polyethylene inlay, the ceramic inlay cannot be deformed, and drilling or perforating it during extraction is very difficult. The current state-of-the-art method involves applying impact to the edge of the metal cup to loosen the inlay, typically using a hammer and chisel [7], a high-frequency drill at the outer diameter of the acetabular cup [8], a hammer and metal impactor after drilling a wedge into the cup [9], or pneumatic systems [10]. The resulting impact can lead to mechanical stress in the ceramic component, damaging the inlay and metal cups, resulting in ceramic splinters ("chipping").…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups

Rotsch,

Kemter-Esser,

Dohndorf

et al. 2024

Bioengineering

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Hip implants have a modular structure which enables patient-specific adaptation but also revision of worn or damaged friction partners without compromising the implant-bone connection. To reduce complications during the extraction of ceramic inlays, this work presents a new approach of a shape-memory-alloy-actuator which enables the loosening of ceramic inlays from acetabular hip cups without ceramic chipping or damaging the metal cup. This technical in vitro study exam-ines two principles of heating currents and hot water for thermal activation of the shape-memory-alloy-actuator to generate a force between the metal cup and the ceramic inlay. Mechanical tests concerning push-in and push-out forces, deformation of the acetabular cup according to international test standards, and force generated by the actuator were generated to prove the feasibility of this new approach to ceramic inlay revision. The required disassembly force for a modular acetabular device achieved an average value of 602 N after static and 713 N after cyclic loading. The actuator can provide a push-out force up to 1951 N. In addition, it is shown that the necessary modifications to the implant modules for the implementation of the shape-memory-actuator-system do not result in any change in the mechanical properties compared to conventional systems.

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Section: Introductionmentioning

confidence: 99%

Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups

Rotsch,

Kemter-Esser,

Dohndorf

et al. 2024

Bioengineering

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Proof of Concept of a New Revision Procedure for Ceramic Inlays of Acetabular Cups Using a Shape-Memory Alloy Actuator System

Rotsch,

Kemter-Esser,

Dohndorf

et al. 2024

Bioengineering

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The revision of ceramic inlays of acetabular cups is a challenging surgical procedure. The mechanical impact during the inlay extraction process can damage the ceramic or metal cup rim. To avoid these risks, a concept for a new revision procedure was developed. It is based on an actuator system, which allows a non-destructive release of the ceramic inlay. To integrate the actuator system, different design concepts of acetabular cup components were investigated, and an actuator based on shape-memory alloy (SMA) wires was developed. The process chain for the actuator, starting from nickel-titanium wires manufactured into the actuator geometry by laser welding and thermo-mechanical treatment for the shape setting process up to the functionality evaluation of the actuator system, was implemented on a laboratory scale. The new revision procedure is based on a phase transformation of the SMA wire actuator, which was obtained through two methods—applying an electrical current by an instrument and rinsing the wire with heated water. The phase transformation of the actuator resulted in a contraction between 3.2% and 4.3% compared to its length after pre-stretching and was able to release the ceramic inlay from the cup. Therefore, the developed actuator design and process chain is a proof of concept towards a new revision procedure for modular acetabular cups.

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A Simple Technique to Remove an Incarcerated Ceramic Liner in Revision Hip Arthroplasty

Cited by 2 publications

References 3 publications

Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups

Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups

Proof of Concept of a New Revision Procedure for Ceramic Inlays of Acetabular Cups Using a Shape-Memory Alloy Actuator System

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