Background. Modularity finds frequent application in total hip replacement, allowing a preferable individual configuration and a simplified revision by retaining the femoral stem and replacing the prosthetic head. However, micromotions within the interface between the head and the stem taper can arise, resulting in the release of wear debris and corrosion products. The aim of our experimental study was to evaluate the influence of different taper damages on the fixation and fracture stability of ceramic femoral heads, after static and dynamic implant loading. Methods. Ceramic ball heads (36 mm diameter) and 12/14 stem tapers made of titanium with various mild damage patterns (intact, scratched, and truncated) were tested. The heads were assembled on the taper with a quasistatic load of 2 kN and separated into a static and a dynamic group afterwards. The dynamic group (n=18) was loaded over 1.5 million gait cycles in a hip wear simulator (ISO 14242-1). In contrast, the static group (n=18) was not mechanically loaded after assembly. To determine the taper stability, all heads of the dynamic and static groups were either pulled off (ASTM 2009) or turned off (ISO 7206-16). A head fracture test (ISO 7206-10) was also performed. Subsequent to the fixation stability tests, the taper surface was visually evaluated in terms of any signs of wear or corrosion after the dynamic loading. Results. In 10 of the 18 cases, discoloration of the taper was determined after the dynamic loading and subsequent cleaning, indicating the first signs of corrosion. Pull-off forces as well as turn-off moments were increased between 23% and 54% after the dynamic loading compared to the unloaded tapers. No significant influence of taper damage was determined in terms of taper fixation strength. However, the taper damage led to a decrease in fracture strength by approximately 20% (scratched) and 40% (truncated), respectively. Conclusion. The results suggest that careful handling and accurate manufacturing of the stem taper are crucial for the ceramic head fracture strength, even though a mild damage showed no significant influence on taper stability. Moreover, our data indicate that a further seating of the prosthetic head may occur during daily activities, when the resulting hip force increases the assembly load.
Human skeletal muscle atrophies in response to reduced mechanical loading. The study aimed to define the muscle‐specific anatomical cross‐sectional area (ACSA) location that is most sensitive to immobilization and to investigate the effectiveness of resistive vibration exercise, alone, or combined with protein supplementation, against muscle atrophy. Eleven individuals (35.2 ± 8.1 years, 22.6 ± 1.7 kg/m2) were analysed in trial 1, and eight subjects (37.1 ± 6.7 years, 23.0 ± 1.8 kg/m2) in trial 2. Subject received control (CON), vibration training (RVE) (25 minutes à 2 sessions/wk), or RVE + nutrition (NEX) interventions (whey protein + potassium/bicarbonate). Magnetic resonance images (MRI) of both thighs were acquired before, during, and 6 days after 21‐days of bed rest to determine ACSAs in regions of interest (ROI) between 10% and 90% of the proximal end of the M. rectus femoris tendon and the end of the femoral neck. Muscle atrophy was highest at the location of their greatest ACSA. ACSA of all muscles at 70% of ROI was reduced after bed rest during CON (range −4.7% to −14.8%) and remained reduced after 6 days of recovery for the majority of muscles (range −3.4% to −8.3%) except for M. vastus lateralis, M. vastus medialis, M. sartorius, and knee flexors. Applied countermeasures had no effect. In conclusion, thigh muscle atrophy can be monitored using ACSA and RVE or NEX was not sufficient to prevent muscle atrophy during 21‐days bed rest.
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