Polyaxial Locking and Compression Screws Improve Construct Stiffness of Acetabular Cup Fixation: A Biomechanical Study

Milne, Lachlan; Kop, Alan; Kuster, Markus S.

doi:10.1016/j.arth.2013.11.007

Cited by 12 publications

(14 citation statements)

References 34 publications

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“…A limitation of this study is the use of simplified replicate acetabular bone models. Previous studies used similar bone models [6,7,15,17,21]. Another study measured comparable micromotion in replicate and cadaveric femurs [36], demonstrating that artificial bone material is an effective substitute to simulate micromotion.…”

Section: Discussionmentioning

confidence: 98%

“…The goal of this study was to assess the relationship between two different initial stability tests; the golden standard test of micromotion versus alternative load-to-failure implant stability metrics derived from a push-out experiment. Different stability metrics were derived from the push-out experiment similarly to ones that are used in previous research; ultimate push-out force [7,30,31], interface stiffness [15,18], push-out energy [21,32]. A push-out experiment was chosen over other load-to-failure tests, as the applied load direction during a push-out test is similar to a physiologic loading direction.…”

Section: Discussionmentioning

confidence: 99%

“…Simplified replicate acetabular bone models were manufactured out of three different materials and using two different press-fits to mimic the acetabulum. This type of bone model is commonly used in the literature as an alternative to mimic the human acetabulum [6,7,14,15,17,21,22]. One rigid cellular polyurethane foam (0.32 g/cc density) and two types of solid rigid polyurethane foam (0.48 and 0.80 g/cc density) were tested using both a 0.7 mm and 1.2 mm press-fit.…”

Section: Discussionmentioning

confidence: 99%

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Two Different Methods to Measure the Stability of Acetabular Implants: A Comparison Using Artificial Acetabular Models

Goossens

Pastrav

Mulier

et al. 2020

Sensors

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The total number of total hip arthroplasties is increasing every year, and approximately 10% of these surgeries are revisions. New implant design and surgical techniques are evolving quickly and demand accurate preclinical evaluation. The initial stability of cementless implants is one of the main concerns of these preclinical evaluations. A broad range of initial stability test methods is currently used, which can be categorized into two main groups: Load-to-failure tests and relative micromotion measurements. Measuring relative micromotion between implant and bone is recognized as the golden standard for implant stability testing as this micromotion is directly linked to the long-term fixation of cementless implants. However, specific custom-made set-ups are required to measure this micromotion, with the result that numerous studies opt to perform more straightforward load-to-failure tests. A custom-made micromotion test set-up for artificial acetabular bone models was developed and used to compare load-to-failure (implant push-out test) with micromotion and to assess the influence of bone material properties and press-fit on the implant stability. The results showed a high degree of correlation between micromotion and load-to-failure stability metrics, which indicates that load-to-failure stability tests can be an appropriate estimator of the primary stability of acetabular implants. Nevertheless, micromotions still apply as the golden standard and are preferred when high accuracy is necessary. Higher bone density resulted in an increase in implant stability. An increase of press-fit from 0.7 mm to 1.2 mm did not significantly increase implant stability.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Two Different Methods to Measure the Stability of Acetabular Implants: A Comparison Using Artificial Acetabular Models

Goossens

Pastrav

Mulier

et al. 2020

Sensors

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show abstract

“…Numerous reports utilizing synthetic pelvis to investigate the mechanical stability of postoperative pelvis for acetabular reconstruction have demonstrated that the synthetic pelvis is a good alternative for in vitro experiments when human pelvis cannot be obtained [ 25 , 27 ]. Gililland et al [ 25 ] used synthetic pelvis to evaluate the mechanical stability of three types of acetabular reconstruction constructs: a cup-cage construct, a posterior column plate construct, and a bicolumnar construct.…”

Section: Discussionmentioning

confidence: 99%

“…Their results demonstrated that the bicolumnar construct provided improved component stability. Recently, Milne et al [ 27 ] compared polyaxial compression locking screws with non-locked and cancellous screw constructs for acetabular cup fixation using synthetic pelvis. Their results revealed that polyaxial locking compression screws significantly improved the construct stiffness compared to non-locked or cancellous screws.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Biomechanical Study of Different Acetabular Reinforcement Devices for Acetabular Reconstruction

2015

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BackgroundAcetabular reinforcement devices (ARDs) are frequently used as load-sharing devices to allow allograft incorporation in revision hip arthroplasty with massive acetabular bone loss. The key to a successful reconstruction is robust fixation of the device to the host acetabulum. Interlocking fixation is expected to improve the initial stability of the postoperative construct. However, all commercially available ARDs are designed with non-locking fixation. This study investigates the efficacy of standard ARDs modified with locking screw mechanisms for improving stability in acetabular reconstruction.MethodsThree types of ARDs were examined to evaluate the postoperative compression and angular stability: i) standard commercial ARDs, ii) standard ARDs modified with monoaxial and iii) standard ARDs modified with polyaxial locking screw mechanisms. All ARDs were implanted into osteomized synthetic pelvis with pelvic discontinuity. Axial compression and torsion tests were then performed using a servohydraulic material testing machine that measured load (angle) versus displacement (torque). Initial stability was compared among the groups.ResultsEquipping ARDs with interlocking mechanisms effectively improved the initial stability at the device/bone interface compared to standard non-locked ARDs. In both compression and torsion experiments, the monoaxial interlocking construct demonstrated the highest construct stiffness (672.6 ± 84.1 N/mm in compression and 13.3 ± 1.0 N·m/degree in torsion), whereas the non-locked construct had the lowest construct stiffness (381.4 ± 117.2 N/mm in compression and 6.9 ± 2.1 N·m/degree in torsion) (P < 0.05).ConclusionsOur study demonstrates the potential benefit of adding a locking mechanism to an ARD. Polyaxial ARDs provide the surgeon with more flexibility in placing the screws at the cost of reduced mechanical performance. This in vitro study provides a preliminary evaluation of biomechanical performance for ARDs with or without interlocking mechanisms, actual clinical trial deserves to be further investigated in future studies.

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Minimum 2-Year Outcomes of a Novel 3D-printed Fully Porous Titanium Acetabular Shell in Revision Total Hip Arthroplasty

et al. 2022

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Polyaxial Locking and Compression Screws Improve Construct Stiffness of Acetabular Cup Fixation: A Biomechanical Study

Cited by 12 publications

References 34 publications

Two Different Methods to Measure the Stability of Acetabular Implants: A Comparison Using Artificial Acetabular Models

Two Different Methods to Measure the Stability of Acetabular Implants: A Comparison Using Artificial Acetabular Models

Preliminary Biomechanical Study of Different Acetabular Reinforcement Devices for Acetabular Reconstruction

Minimum 2-Year Outcomes of a Novel 3D-printed Fully Porous Titanium Acetabular Shell in Revision Total Hip Arthroplasty

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