Führt Osteoporose zu einer Reduktion der Primärstabilität zementfreier Hüftpfannen?

The hip joint is subjected to cyclic loading and motion during activities of daily living and this can induce micromotions at the bone-implant interface of cementless total hip replacements. Initial stability has been identified as a crucial factor to achieve osseointegration and long-term survival. Whilst fixation of femoral stems achieves good clinical results, the fixation of acetabular components remains a challenge. In vitro methods assessing cup stability keep the hip joint in a fixed position, overlooking the effect of hip motion. The effect of hip motion on cup micromotion using a hip motion simulator replicating hip flexion-extension and a six degrees of freedom measurement system was investigated. The results show an increase in cup micromotion under dynamic hip motion compared to Static Flexion. This highlights the need to incorporate hip motion and measure all degrees of freedom when assessing cup micromotion. In addition, comparison of two press-fit acetabular cups with different surface coatings suggested similar stability between the two cups. This new method provides a basis for a more representative protocol for future pre-clinical evaluation of different cup designs.

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The effect of dynamic hip motion on the micromotion of press-fit acetabular cups in six degrees of freedom

Crosnier

Keogh

Miles

2016

Medical Engineering & Physics

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In vitro examination of the primary stability of three press-fit acetabular cups under consideration of two different bearing couples

Jahnke

Bott

Ulloa

et al. 2019

Medical Engineering & Physics

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A novel method to assess primary stability of press-fit acetabular cups

Crosnier

Keogh

Miles

2014

Proc Inst Mech Eng H

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Initial stability is an essential prerequisite to achieve osseointegration of press-fit acetabular cups in total hip replacements. Most in vitro methods that assess cup stability do not reproduce physiological loading conditions and use simplified acetabular models with a spherical cavity. The aim of this study was to investigate the effect of bone density and acetabular geometry on cup stability using a novel method for measuring acetabular cup micromotion. A press-fit cup was inserted into Sawbones(®) foam blocks having different densities to simulate normal and osteoporotic bone variations and different acetabular geometries. The stability of the cup was assessed in two ways: (a) measurement of micromotion of the cup in 6 degrees of freedom under physiological loading and (b) uniaxial push-out tests. The results indicate that changes in bone substrate density and acetabular geometry affect the stability of press-fit acetabular cups. They also suggest that cups implanted into weaker, for example, osteoporotic, bone are subjected to higher levels of micromotion and are therefore more prone to loosening. The decrease in stability of the cup in the physiological model suggests that using simplified spherical cavities to model the acetabulum over-estimates the initial stability of press-fit cups. This novel testing method should provide the basis for a more representative protocol for future pre-clinical evaluation of new acetabular cup designs.

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Führt Osteoporose zu einer Reduktion der Primärstabilität zementfreier Hüftpfannen?

Cited by 3 publications

References 10 publications

The effect of dynamic hip motion on the micromotion of press-fit acetabular cups in six degrees of freedom

The effect of dynamic hip motion on the micromotion of press-fit acetabular cups in six degrees of freedom

In vitro examination of the primary stability of three press-fit acetabular cups under consideration of two different bearing couples

A novel method to assess primary stability of press-fit acetabular cups

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