Deformation of metal-backed acetabular components and the impact of liner thickness in a cadaveric model

Markel, David C.; Day, Judd; Siskey, Ryan; Liepins, Imants; Kurtz, Steven M.; Ong, Kevin

doi:10.1007/s00264-010-1077-6

Cited by 33 publications

(48 citation statements)

References 20 publications

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“…Recent studies have begun to examine the effect of polyethylene liner deformation in regard to frictional torque, liner fracture, and volumetric wear in foam block and finite element analyses [8,11,14]. Schmidig et al [14] observed higher magnitudes of deformation in the polyethylene liner than in the shell in which they were inserted.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical and cadaveric investigations have described component pinching between the ischial and ilial columns after press-fit implantation of thin-walled acetabular cups [5,16,17], resulting in deformation of the acetabular cup in underreamed specimens. This deformation could be accompanied by increased micromotion at the bone-implant interface or lead to an increase in wear due to induced changes in component sphericity, degradation of fluid-film lubrication, or induced equatorial contact [5,6,8,11,14,17].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acetabular Cup Design Influences Deformational Response in Total Hip Arthroplasty

Meding

Small

Jones³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Press-fit acetabular components are susceptible to deformation in an underreamed socket, with excessive deformation of metal-on-metal (MOM) components potentially leading to increased torsional friction and micromotion. Specifically, however, it remains unclear how cup diameter, design, and time from implantation affect shell deformation. Questions/purposes We asked whether (1) changes in component geometry and material altered maximum shell deformation and (2) time-dependent deformational relaxation processes occurred. Methods Diametral deformation was quantified after press-fit implantation of metal shells into a previously validated polyurethane model. Experimental groups (n = 6-8) consisted of 48-, 54-, 60-, and 66-mm MOM cups of 6-mm wall thickness, 58-mm cups of 10-mm wall thickness, and CoCrMo and Ti6Al4V 58-mm modular cups. Results Greater cup diameter, thinner wall construction, and Ti6Al4V modular designs generated conditions for maximum shell deformation ranging from 0.047 to 0.267 mm. Relaxation (18%-32%) was observed 120 hours postimplantation in thin-walled and modular designs. ConclusionsOur findings demonstrate a reduction of shell deformation over time and suggest, under physiologic loading, early component deformation varies with design. Clinical Relevance Component deformation should be a design consideration regardless of bearing surface. Designs neglecting to adequately address deformational changes in vivo could be susceptible to diminished cup survival, increased wear, and premature revision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acetabular Cup Design Influences Deformational Response in Total Hip Arthroplasty

Meding

Small

Jones³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…Micromotion at the microscopic scale as well as excessive stresses at the bone-implant interface may lead to aseptic loosening which is one of the most common causes of implant surgical failure. Different biomechanical tests have been developed in order to assess the AC stability, such as tangential [13,14], torsional [15,16], edge loading [17][18][19][20], and pull-out tests [21]. Different biomechanical tests have been developed in order to assess the AC stability, such as tangential [13,14], torsional [15,16], edge loading [17][18][19][20], and pull-out tests [21].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Evaluation of the Acetabular Cup Primary Stability by Impact Analysis

Michel

Bosc

Vayron

et al. 2015

Journal of Biomechanical Engineering

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The implant primary stability of the acetabular cup (AC) is an important parameter for the surgical success of press-fit procedures used for the insertion of cementless hip prostheses. In previous studies by our group (Mathieu, V., Michel, A., Lachaniette, C. H. F., Poignard, A., Hernigou, P., Allain, J., and Haiat, G., 2013, "Variation of the Impact Duration During the in vitro Insertion of Acetabular Cup Implants," Med. Eng. Phys., 35(11), pp. 1558-1563) and (Michel, A., Bosc, R., Mathieu, V., Hernigou, P., and Haiat, G., 2014, "Monitoring the Press-Fit Insertion of an Acetabular Cup by Impact Measurements: Influence of Bone Abrasion," Proc. Inst. Mech. Eng., Part H, 228(10), pp. 1027-1034), the impact momentum and duration were shown to carry information on the press-fit insertion of the AC within bone tissue. The aim of the present study is to relate the impact momentum recorded during the AC insertion to the AC biomechanical primary stability. The experimental protocol consisted in testing 13 bovine bone samples that underwent successively series of 15 reproducible mass falls impacts (5 kg, 5 cm) followed by tangential stability testing. Each bone sample was tested with different hole sizes in order to obtain different stability configurations. The impact momentum and the tangential primary stability reach a maximum value for an interference fit equal to around 1 mm. Moreover, a correlation between the impact momentum and the stability was obtained with all samples and all configuration (R2 = 0.65). The implant primary stability can be assessed through the measurement of the impact force signal analysis. This study opens new paths for the development of a medical device which could be used as a decision support system to assist the surgeon during the insertion of the AC implant.

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“…This 3.8 mm liner had previously been used successfully in THA, and the Pritchett study was similarly successful with a Kaplan–Meier survivorship of 97%. Pritchett stated that two notable concerns of fabricating cross‐linked polyethylene liners that are thinner than 3.8 mm is that the liners would be prone to fracture and the metal shell and liner would be susceptible to abnormal cup deformation …”

Section: Discussionmentioning

confidence: 99%

Wear testing of a canine hip resurfacing implant that uses highly cross‐linked polyethylene

Warburton

Everingham

Helms

et al. 2017

Journal Orthopaedic Research

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Hip resurfacing offers advantages for young, active patients afflicted with hip osteoarthritis and may also be a beneficial treatment for adult canines. Conventional hip resurfacing uses metal-on-metal bearings to preserve bone stock, but it may be feasible to use metal-on-polyethylene bearings to reduce metal wear debris while still preserving bone. This study characterized the short-term wear behavior of a novel hip resurfacing implant for canines that uses a 1.5 mm thick liner of highly cross-linked polyethylene in the acetabular component. This implant was tested in an orbital bearing machine that simulated canine gait for 1.1 million cycles. Wear of the liner was evaluated using gravimetric analysis and by measuring wear depth with an optical scanner. The liners had a steady-state mass wear rate of 0.99 ± 0.17 mg per million cycles and an average wear depth in the central liner region of 0.028 mm. No liners, shells, or femoral heads had any catastrophic failure due to yielding or fracture. These results suggest that the thin liners will not prematurely crack after implantation in canines. This is the first hip resurfacing device developed for canines, and this study is the first to characterize the in vitro wear of highly cross-linked polyethylene liners in a hip resurfacing implant. The canine implant developed in this study may be an attractive treatment option for canines afflicted with hip osteoarthritis, and since canines are the preferred animal model for human hip replacement, this implant can support the development of metal-on-polyethylene hip resurfacing technology for human patients. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1196-1205, 2018.

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Deformation of metal-backed acetabular components and the impact of liner thickness in a cadaveric model

Cited by 33 publications

References 20 publications

Acetabular Cup Design Influences Deformational Response in Total Hip Arthroplasty

Acetabular Cup Design Influences Deformational Response in Total Hip Arthroplasty

In Vitro Evaluation of the Acetabular Cup Primary Stability by Impact Analysis

Wear testing of a canine hip resurfacing implant that uses highly cross‐linked polyethylene

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