Primary cup stability in THA with augmentation of acetabular defect. A comparison of healthy and osteoporotic bone

Amirouche, Farid; Solitro, Giovanni F.; Broviak, Stefanie; Goldstein, Wayne M.; Gonzalez, Mark H.; Barmada, Riad

doi:10.1016/j.otsr.2015.07.007

Cited by 13 publications

(6 citation statements)

References 32 publications

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“…However, as the test was devised to compare two reconstruction techniques, paired specimens were adopted; thus, providing a reliable comparison. Moreover, the number of the specimen is comparable with the sample size of other biomechanical analyses related to implant stability [19,26,27]. The in vitro behavior of cadaveric specimens is different from living tissue.…”

Section: Discussionmentioning

confidence: 82%

Primary Stability of Revision Acetabular Reconstructions Using an Innovative Bone Graft Substitute: A Comparative Biomechanical Study on Cadaveric Pelvises

et al. 2020

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Hip implant failure is mainly due to aseptic loosening of the cotyle and is typically accompanied by defects in the acetabular region. Revision surgery aims to repair such defects before implantation by means of reconstruction materials, whose morselized bone graft represents the gold standard. Due to the limited availability of bone tissue, synthetic substitutes are also used. The aim of this study was to evaluate if a synthetic fully resorbable tri-calcium phosphate-based substitute can provide adequate mechanical stability when employed to restore severe, contained defects, in comparison with morselized bone graft. Five cadaveric pelvises were adopted, one side was reconstructed with morselized bone graft and the other with the synthetic substitute, consisting of dense calcium phosphate granules within a collagen matrix. During the biomechanical test, cyclic load packages of increasing magnitude were applied to each specimen until failure. Bone/implant motions were measured through Digital Image Correlation and were expressed in terms of permanent and inducible translations and rotations. The reconstruction types exhibited a similar behavior, consisting of an initial settling trend followed by failure as bone fracture (i.e., no failure of the reconstruction material). When 2.2 Body Weight was applied, the permanent translations were not significantly different between the two reconstructions (p = 0.06–1.0) and were below 1.0 mm. Similarly, the inducible translations did not differ significantly (p = 0.06–1.0) and were below 0.160 mm. Rotations presented the same order of magnitude but were qualitatively different. Overall, the synthetic substitute provided adequate mechanical stability in comparison with morselized bone graft, thus representing a reliable alternative to treat severe, contained acetabular defects.

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Section: Discussionmentioning

confidence: 82%

Primary Stability of Revision Acetabular Reconstructions Using an Innovative Bone Graft Substitute: A Comparative Biomechanical Study on Cadaveric Pelvises

et al. 2020

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“…The numerical results were compared with experimental measurements under walking and stair-climbing loading [31]. Similar approaches have been carried out for femoral stem implants [88][89][90][91].…”

Section: Micromotion Measurementmentioning

confidence: 99%

Biomechanical behaviours of the bone–implant interface: a review

Gao

Fraulob

Haïat

2019

J. R. Soc. Interface.

163

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In recent decades, cementless implants have been widely used in clinical practice to replace missing organs, to replace damaged or missing bone tissue or to restore joint functionality. However, there remain risks of failure which may have dramatic consequences. The success of an implant depends on its stability, which is determined by the biomechanical properties of the bone–implant interface (BII). The aim of this review article is to provide more insight on the current state of the art concerning the evolution of the biomechanical properties of the BII as a function of the implant's environment. The main characteristics of the BII and the determinants of implant stability are first introduced. Then, the different mechanical methods that have been employed to derive the macroscopic properties of the BII will be described. The experimental multi-modality approaches used to determine the microscopic biomechanical properties of periprosthetic newly formed bone tissue are also reviewed. Eventually, the influence of the implant's properties, in terms of both surface properties and biomaterials, is investigated. A better understanding of the phenomena occurring at the BII will lead to (i) medical devices that help surgeons to determine an implant's stability and (ii) an improvement in the quality of implants.

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“…Bone cement fixation is particularly suitable for aged patients with osteoporosis, as the early stability is generally good (1). With the development of new bone cement technology, the use of bone cement in artificial hip replacements is now more commonly accepted in clinics (2)(3)(4). However, bone cement in the proximal femoral medullary cavity (PFMC) can cause potential complications, such as high intraosseous pressure in the proximal femur and systemic bone cement implantation syndrome, including hypotension, arrhythmia, severe hypoxemia, myocardial infarction and increased pulmonary artery pressure (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Changes in bone density, intraosseous pressure of distal femoral articular cartilage and subchondral bone after proximal femoral medullary cavity cement filling in rabbits

Zhang

et al. 2021

Exp Ther Med

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Bone cement is widely used, particularly in hip replacements, but the potential clinical complications of its use have been largely unrecognized. The purpose of the present study was to investigate the effects of bone cement in the proximal femoral medullary cavity (PFMC) on bone mineral density (BMD), intraosseous pressure (IOP), articular cartilage and subchondral bone in the distal femurs of rabbits. A total of 32 New Zealand white rabbits were randomly numbered and the left hind limb of the odd-numbered rabbits and the right hind limb of the even numbered rabbits were selected as the experimental side. For each rabbit, the non-experimental hind limb was labeled as the control side by the principal investigator. An intramedullary injection of polymethyl methacrylate was made into the experimental hindlimb of each rabbit and the PFMC filled with bone cement. BMD and IOP of the distal femur of the bilateral hindlimb were measured at 4 and 16 weeks after surgery, and histological and ultra-fine structural features were examined by light and transmission electron microscopy, respectively. At week 4 after the operation, IOP in the experimental limb was significantly higher and BMD lower compared with the control limb. At the 16th week after operation, the IOP in the experimental limb was lower than at the 4th week after operation, but still higher compared with controls, and the BMD was significantly higher than the controls. In the controls, IOP and BMD was not significantly different between the 4th and 16th week after operation. Compared with controls, the cartilage in the experimental group was thinner, the chondrocytes partially necrotic and the trabecular structure of the subchondral bone broken. Analysis of ultra-fine structural features in the experimental group showed chondrocytes with necrotic cytoplasm and pyknotic nuclei relative to controls. The results indicated that blockage of the PFMC with bone cement resulted in an increase in the IOP in the distal femur, a change in BMD and damage to the subchondral bone and articular cartilage.

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Primary cup stability in THA with augmentation of acetabular defect. A comparison of healthy and osteoporotic bone

Abstract: Level IV, experimental and cadaveric study.

Cited by 13 publications

References 32 publications

Primary Stability of Revision Acetabular Reconstructions Using an Innovative Bone Graft Substitute: A Comparative Biomechanical Study on Cadaveric Pelvises

Primary Stability of Revision Acetabular Reconstructions Using an Innovative Bone Graft Substitute: A Comparative Biomechanical Study on Cadaveric Pelvises

Biomechanical behaviours of the bone–implant interface: a review

Changes in bone density, intraosseous pressure of distal femoral articular cartilage and subchondral bone after proximal femoral medullary cavity cement filling in rabbits

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