No abstract

Synthetic mechanical analogue bone models are valuable tools for consistent analysis of implant performance in both equilibrium and fatigue biomechanical testing. Use of these models has previously been limited by the poor fatigue performance when tested under realistic service loads. An objective was to determine whether a new analogue bone model (Fourth-Generation) using enhanced analogue cortical bone provides significantly improved resistance to high load fracture and fatigue as compared to the current (Third-Generation) bone models in clinically relevant in situ type testing of total hip implants. Six Third-Generation and six Fourth-Generation mechanical analogue proximal femur models were implanted with a cemented mock hip arthroplasty. Each specimen was loaded at 5 Hz in simulated one-legged stance under load control with a maximum compressive load of 2670 N and load ratio of 0.1. Average complete structural failure in Third-Generation femurs occurred at 3.16 million cycles; all specimens exhibited substantial displacement and crazing at well below 3 million cycles. In contrast, all Fourth-Generation femurs sustained 10 million cycles without complete structural failure and showed little change in actuator deflection. The Fourth-Generation femur model performance was sufficient to allow the model to be used in biomechanically relevant load bearing levels with an intramedullary device without model compromise that would affect test results.

No abstract

The effects of osteophyte debridement, bony cuts, and soft tissue releases on the functional flexion axis of the knee can be assessed by evaluating 3D kinematics following each step of a total knee arthroplasty. Using a navigated knee system with dedicated software, the functional flexion axis (helical axis) can be determined after each step. Five paired fresh-frozen cadaveric knees were used with a CT scan performed on each specimen identifying implanted fiducial markers. Kinematics data were recorded during each step of sequential osseous cuts and soft tissue releases for both an unloaded and loaded limb by each of three surgeons. The functional helical (flexion/extension) axis was identified for all specimens. The internal/external rotation angle (y) of the helical axis differed from the transepicondylar axis by À8.38 to þ6.78 for the unloaded condition. y ranged from À7.28 to þ7.48 with distraction. Soft tissue releases had no effect on y; until a bony cut of the articular surface, which increased y from À0.38 to þ9.78. Implantation of cruciate retaining prosthetic components subsequently reduced the y range À7.38 to þ4.08. Thus, soft tissue releases had minimal effect on y of the helical axis except for resection of the proximal tibia. Implantation of the CR prosthesis reduced è close to that of the intact knee. In a minority of knees, the helical axis did not coincide exactly with the transepicondylar axis. Interspecimen and left/right variability of y were significant, although interinvestigator variability and an applied distraction force were insignificant. ß