Cemented Total Hip Replacement Cable Debris and Acetabular Construct Durability

Early Experience with a Novel Nonmetallic Cable in Reconstructive Hip Surgery

“…While these modalities are in widespread use, their metallic composition poses a number of limitations and potential complications, including fraying, third-body generation, accelerated wear of the bearing surface, and injury to the surgical team [2,3,26]. These concerns necessitate the continued development of alternative materials for cerclage fixation.…”

“…Concerns with the use of metallic cables, however, primarily relate to cable fretting or even breakage and the associated generation of metallic debris [26], particularly with intraarticular migration, and if they come in direct contact with the femoral component [24]. This debris has been implicated as a third-body generator that may accelerate polyethylene wear and has been associated with an increased rate of acetabular component loosening [1,2,14,16].…”

“…These fixation options share the goal of counteracting deforming forces about the femur and providing secure fixation and reliable healing of the osteotomy [9,22]. These systems have been effective for these purposes but fraying, third-body generation, accelerated wear of the bearing surface, and injury to the surgical team by cut wire ends remain concerns [2,26]. Recently nonmetallic cables have been introduced to address these concerns.…”

“…The purpose of this report is to (1) determine the union rate of osteotomies and fractures where the nonmetallic cable was utilized; (2) identify any complications associated with use of the nonmetallic cable such as breakage; (3) identify any other associated complications in this series of complex primary and revision total hip arthroplasties.…”

Force relaxation and sprinback of novel elastic orthopedic cables

“…These issues led to the development of second generation multi-braided cables, which offer greater compression [3] and less displacement [4], but are still associated with a significant complication rate [5]. Fatigue and fray of multi-braided metal cables causing metallic debris and third-body polyethylene wear have been reported [6][7][8]. Cable loosening contributes to poor fixation and delayed fracture or osteotomy healing.…”