Biomechanical Evaluation of Acetabular Cup Implantation in Cementless Total Hip Arthroplasty

Margalit, Kate A.; Hayashi, Kei; Jackson, J. D.; Kim, Sun Young; Garcia, Tanya C.; Wiggans, K. Tomo; Aiken, Sean W.; Stover, Susan M.

doi:10.1111/j.1532-950x.2010.00726.x

Cited by 11 publications

(10 citation statements)

References 20 publications

(37 reference statements)

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“…Our results suggest that this approach may not be necessary, as we suspect the loads at failure were not compromised by loss of DAR to a clinically significant degree. In a study of medially displaced BFX cups in normal canine hemipelves [ 17 ], loads at failure were comparable to the loads observed in our cadaveric testing, both of which were well above the physiologic range. Based on these findings, we do not routinely advocate reaming through the medial wall as long as the cup is well engaged between the cranial and caudal acetabular margins, regardless of DAR bone stock.…”

Section: Discussionsupporting

confidence: 78%

The effect of dorsal rim loss on the initial stability of the BioMedtrix cementless acetabular cup

et al. 2015

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BackgroundLoss of dorsal acetabular rim (DAR) is a common sequela to canine hip dysplasia. The purpose of this study is to evaluate the effect of DAR loss on the initial stability of the cementless (BFX) acetabular cup. BFX cups were implanted into foam blocks reamed to resemble acetabulae with simulated 0, 25, 50, and 75% DAR loss. Models were tested in edge loading of the lateral surface of the cup with an indenter, and in centered loading with an articulated femoral prosthesis. Additionally, cups were implanted into paired cadaveric canine hemipelves with either no DAR depletion, or removal of 50% of the DAR, and acutely loaded to failure with an articulated femoral prosthesis.ResultsMean load measured at 1 mm cup displacement during edge loading was not significantly different in foam blocks with loss of 0, 25, 50, and 75% DAR (360 ± 124 N, 352 ± 42 N, 330 ± 81 N, 288 ± 43 N, respectively; P = 0.425). Mean load to failure with centered loads was greatest in blocks with 0% DAR loss (2828 ± 208 N; P < 0.001), but was not significantly different between 25, 50, and 75% DAR loss (2270 ± 301 N, 1924 ± 157 N, 1745 ± 118 N). In cadaveric testing, neither mean load to failure (P = 0.067), stiffness (P = 0.707), nor energy (P = 0.228) were significantly different in control hemipelves and those with 50% depletion of the DAR. Failure in all acetabulae occurred due to acetabular bone fracture at forces in supraphysiologic ranges.ConclusionsBFX cup stability under normal physiologic loads does not appear to be compromised in acetabulae with up to 50% DAR loss.

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Section: Discussionsupporting

confidence: 78%

The effect of dorsal rim loss on the initial stability of the BioMedtrix cementless acetabular cup

et al. 2015

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“…In both groups, the Zurich Cementless acetabular cup sustained compressive loads 12 times greater than the expected force produced during normal activity in the dog (300 N) . This is similar to findings for the BFX Cementless acetabular cup, which sustained loads 10 times that of normal activity in the dog, when acetabular cups were impacted to, and beyond, the medial acetabular wall …”

Section: Discussionsupporting

confidence: 71%

“…18,19 This is similar to findings for the BFX Cementless acetabular cup, which sustained loads 10 times that of normal activity in the dog, when acetabular cups were impacted to, and beyond, the medial acetabular wall. 20 We defined failure mode as cup displacement or pelvic fracture. Clinically, cup displacement can result from inappropriate cup positioning, incomplete impaction, poor dorsal coverage of the implant, or inadequate bony support.…”

Section: Discussionmentioning

confidence: 99%

Effect of Dorsal Acetabular Rim Loss on Stability of the Zurich Cementless Total Hip Acetabular Cup in Dogs

et al. 2014

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“…For cementless canine total hip replacement, the collarless, tapered stem design (BFX system, Biomedtrix) has the longest history and is widely studied. 4,[19][20][21][22] Although clinical results for this implant system are generally good, fixation of cementless femoral components in certain breeds is a clinical challenge due to the lack of taperlock between implant and bone on the endosteal surface. In the current in vitro study using consistently sized femurs (CFI of 1.8-2.4) and a combined loading protocol showed that this design was biomechanically comparable and effective under simulated canine gait for a limited number of loading cycles.…”

Section: Discussionmentioning

confidence: 99%

A Biomechanical Comparison of Four Hip Arthroplasty Designs in a Canine Model

Ordway

Ash

Miller

et al. 2019

Vet Comp Orthop Traumatol

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Objective The aim of this study was to develop an in vitro biomechanical protocol for canine cementless hip arthroplasty that represents physiological gait loading (compression and torsion) and to evaluate if three alternative implant designs improve fixation compared with the traditional collarless, tapered stem in the clinically challenging case of moderate canal flare index. Study Design Twenty-four (six/group) laboratory-prepared canine constructs were tested using a simulated gait and overload (failure) protocol. Construct stiffness, failure load/displacement and migration were measured as outcome variables. Results Simulated gait loading did not show any significant differences between implant types for peak displacement, peak rotation, torsional stiffness, subsidence or inducible displacement. The collared and collarless stem groups were stiffer in compression compared with the collarless with a lateral bolt and short-stem groups. Increasing the loading above simulated gait showed significant reductions in compressive and torsional stiffness for all implant constructs. Despite the reductions, the short-stem group showed significantly higher stiffness compared with the other three groups. Conclusion Peak failure loads (compressive and torsional) in this study were approximately four to seven times the simulated gait loading (430 N, 1.6 Nm) regardless of implant type and highlight the importance of limiting activity level (trotting, jumping) following hip replacement in the postoperative period and during the osseointegration of the implant.

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Biomechanical Evaluation of Acetabular Cup Implantation in Cementless Total Hip Arthroplasty

Cited by 11 publications

References 20 publications

The effect of dorsal rim loss on the initial stability of the BioMedtrix cementless acetabular cup

The effect of dorsal rim loss on the initial stability of the BioMedtrix cementless acetabular cup

Effect of Dorsal Acetabular Rim Loss on Stability of the Zurich Cementless Total Hip Acetabular Cup in Dogs

A Biomechanical Comparison of Four Hip Arthroplasty Designs in a Canine Model

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