The Influence of the Pelvic Bone on the Computational Results of the Acetabular Component of a Total Hip Prosthesis

2010 ◽  
Vol 132 (5) ◽  
Author(s):  
Sara Barreto ◽  
João Folgado ◽  
Paulo R. Fernandes ◽  
Jacinto Monteiro
Keyword(s):  
Contact Pressure ◽  
Acetabular Component ◽  
Computational Models ◽  
Hip Prosthesis ◽  
Pelvic Bone ◽  
Major Influence ◽  
Linear Wear ◽  
Acetabular Cup ◽  
Total Hip ◽  
Metal Backing

The computational models developed to evaluate the hip joint performance usually neglect the presence of the pelvic bone. However, deformation depends on the stiffness of the underlying bone, and thus, the inclusion of the pelvic bone in the model influences the computed contact pressure and wear. This work discusses the influence of the pelvic bone, and how it depends on the acetabular component stiffness. It was modeled as two different polyethylene acetabular cups, considering or not a metal-backing for both 28 mm and 32 mm diametric cups. Two finite element models are developed, considering either the acetabular component rigidly fixed or attached to the deformable bone. Results present 28% and 42% difference on the contact pressure for a polyethylene cup without metal-backing when the support conditions are changed, for the 28 mm and 32 mm cups, respectively. Linear wear results present 21% and 31% difference for the same type of cups of 28 mm and 32 mm, correspondingly. The numerical results obtained in the present work show that to model the pelvic bone of the patient with a metal-backed cup did not greatly affect contact pressures and linear wear. However, when a total hip replacement is performed with an all-polyethylene acetabular cup, the presence of the pelvic bone in the model has a major influence.

scholarly journals The Effect of Bottom Profile Dimples on the Femoral Head on Wear in Metal-on-Metal Total Hip Arthroplasty

2021 ◽  
Vol 12 (2) ◽  
pp. 38
Author(s):  
J. Jamari ◽  
Muhammad Imam Ammarullah ◽  
Amir Putra Md Saad ◽  
Ardiyansyah Syahrom ◽  
Mohammad Uddin ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Contact Pressure ◽  
Hip Arthroplasty ◽  
Surface Texturing ◽  
Linear Wear ◽  
Daily Routine ◽  
Textured Surface ◽  
Acetabular Cup ◽  
Total Hip

Wear and wear-induced debris is a significant factor in causing failure in implants. Reducing contact pressure by using a textured surface between the femoral head and acetabular cup is crucial to improving the implant’s life. This study presented the effect of surface texturing as dimples on the wear evolution of total hip arthroplasty. It was implemented by developing finite element analysis from the prediction model without dimples and with bottom profile dimples of flat, drill, and ball types. Simulations were carried out by performing 3D physiological loading of the hip joint under normal walking conditions. A geometry update was initiated based on the patient’s daily routine activities. Our results showed that the addition of dimples reduced contact pressure and wear. The bottom profile dimples of the ball type had the best ability to reduce wear relative to the other types, reducing cumulative linear wear by 24.3% and cumulative volumetric wear by 31% compared to no dimples. The findings demonstrated that surface texturing with appropriate dimple bottom geometry on a bearing surface is able to extend the lifetime of hip implants.

Wear Failure Analysis of UHMWPE Acetabular Cups in THR

2019 ◽  
Vol 957 ◽  
pp. 417-426
Author(s):  
Corneliu Nicolae Druga ◽  
Ileana Constanta Rosca ◽  
Radu Necula
Keyword(s):  
Femoral Component ◽  
Total Hip Replacement ◽  
Acetabular Component ◽  
Hip Replacement ◽  
Hip Prosthesis ◽  
Polyethylene Wear ◽  
Femoral Shaft ◽  
Hip Resurfacing ◽  
Total Hip ◽  
Joint Prostheses

The UHMWPE acetabular cups are the most popular joints for joint prostheses after Charnley introduced UHMWPE for the acetabular component in 1962. It has been demonstrated that polyethylene wear remains the main source of particles in the THR and therefore requires particular attention. The paper presents a series of theoretical and practical aspects regarding the wear of acetabular cups (made of UHMWPE) from the total hip prosthesis component. At the same time, the other tribological phenomena that occur in these MoP (metal on polyethylene) combinations are treated, such as lubrication and friction. Total Hip Replacement & Hip Resurfacing A hip replacement involves replacing the hip joint with a mechanical bearing system which is comprised of a femoral component and an acetabular component. During a hip replacement the acetabulum is reamed and the acetabular component is fitted into the cavity and the femoral component can either be placed over a reamed femoral head, in a procedure referred to as hip resurfacing, or positioned inside the femoral shaft during a total hip replacement [1]. Fig. 1. Total Hip Replacement (a) and Hip Resurfacing Replacement (b) [2].

Dislocation of a dual mobility total hip replacement following fracture of the polyethylene liner

2016 ◽  
Vol 29 (03) ◽  
pp. 259-264
Author(s):  
Pierre Guillaumot ◽  
Jean-Luc Chancrin ◽  
Bertrand Vedrine
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Prosthesis ◽  
Polyethylene Liner ◽  
Acetabular Cup ◽  
Dual Mobility ◽  
Total Hip ◽  
Initial Surgery ◽  
Acute Rupture ◽  
Cemented Cup

SummaryAn eight-year-old male English Setter was referred for management of a dislocation of a cemented dual mobility canine total hip prosthesis that occurred four months after the initial surgery. Revision surgery showed that the dislocation was associated with fracture of the ultra-high molecular weight polyethylene liner. The dislocation was successfully reduced after replacing the liner. A dual mobility acetabular component is composed of a mobile polyethylene liner inside a metallic cemented cup. Chronic wear of the components of a canine dual mobility total hip replacement has not been described previously. The use of this type of implant is fairly recent and limited long term follow-up of the implanted cases may be the explanation. Acute rupture of a polyethylene liner has never been described in humans, the only case of rupture of a polyethylene liner occurred 10 years after implantation. The case presented here of rupture of the polyethylene liner of a dual mobility total hip replacement is a hitherto unreported failure mode in this model of acetabular cup in the dog.

scholarly journals The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jan H. Göthlin ◽  
Mats Geijer
Keyword(s):  
Total Hip Arthroplasty ◽  
Prospective Study ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Clinical Utility ◽  
Hip Prosthesis ◽  
Joint Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
A Prospective Study

Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty.Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis.Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip.Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections.

scholarly journals Anatomic Anteversion of the Acetabular Component Correlates with Polyethylene Linear Wear in Total Hip Arthroplasty: The Three-Dimensional Numerical Analysis

2016 ◽  
Vol 06 (06) ◽  
pp. 126-134
Author(s):  
Ima Kosukegawa ◽  
Satoshi Nagoya ◽  
Mitsunori Kaya ◽  
Mikito Sasaki ◽  
Shunichiro Okazaki ◽  
...  
Keyword(s):  
Numerical Analysis ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Linear Wear ◽  
Total Hip

scholarly journals Comparison of Conventional Polyethylene Wear and Signs of Cup Failure in Two Similar Total Hip Designs

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Thomas B. Pace ◽  
Kevin C. Keith ◽  
Estefania Alvarez ◽  
Rebecca G. Snider ◽  
Stephanie L. Tanner ◽  
...  
Keyword(s):  
Polyethylene Wear ◽  
Limiting Factor ◽  
Linear Wear ◽  
Acetabular Cup ◽  
Linear Wear Rate ◽  
Total Hip ◽  
Functional Behavior ◽  
Radiographic Data

Multiple factors have been identified as contributing to polyethylene wear and debris generation of the acetabular lining. Polyethylene wear is the primary limiting factor in the functional behavior and consequent longevity of a total hip arthroplasty (THA). This retrospective study reviewed the clinical and radiographic data of 77 consecutive THAs comparing in vivo polyethylene wear of two similar acetabular cup liners. Minimum follow-up was 7 years (range 7–15). The incidence of measurable wear in a group of machined liners sterilized with ethylene oxide and composed of GUR 1050 stock resin was significantly higher (61%) than the compression-molded, GUR 1020, O2-free gamma irradiation sterilized group (24%)(P=0.0004). Clinically, at a 9-year average followup, both groups had comparable HHS scores and incidence of thigh or groin pain, though the machined group had an increased incidence of osteolysis and annual linear wear rate.

scholarly journals Intraoperative evaluation of acetabular cup position during anterior approach total hip arthroplasty: are we accurately interpreting?

2019 ◽  
Vol 30 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Dimitri E Delagrammaticas ◽  
George Ochenjele ◽  
Brett D Rosenthal ◽  
Benjamin Assenmacher ◽  
David W Manning ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Mean Value ◽  
Radiographic Evaluation ◽  
Acetabular Cup ◽  
Component Placement ◽  
Total Hip ◽  
Value Measurement ◽  
Posterior Anterior

Introduction: Intraoperative radiographic evaluation during total hip arthroplasty (THA) has shown to improve the accuracy of acetabular component placement, however, differences in interpretation based on radiographic technique has not been established. This study aims to determine if differences exist in the interpretation of acetabular component abduction and anteversion between different radiographic projections. Methods: 55 consecutive direct anterior THAs in 49 patients were prospectively enrolled. Target anteversion and abduction was defined by the Lewinnek zone. Fluoroscopy was used to direct acetabular component placement intraoperatively. After final cup implantation, fluoroscopic posterior-anterior hip and pelvis images were obtained for analysis. After completion of the procedure, an anterior-posterior plain pelvis radiograph was obtained in the operating room. Acetabulum component abduction and anteversion were postoperatively determined using specialised software on each of the 3 image acquisition methods. Results: Average acetabular cup abduction for intraoperative fluoroscopic posterior-anterior hip (FH), intraoperative fluoroscopic posterior-anterior pelvis (FP), and postoperative, standard, anteroposterior pelvis radiographs (PP) was 40.95° ± 2.87°, 38.87° ± 3.82° and 41.73° ± 2.96° respectively. The fluoroscopic hip and fluoroscopic pelvis tended to underestimate acetabular cup abduction compared to the postoperative pelvis ( p < 0.001). Average acetabular cup anteversion for FH, FP, and PP was 19.89° ± 4.87°, 24.38° ± 5.31° and 13.36° ± 3.52° respectively. Both the fluoroscopic hip and fluoroscopic pelvis overestimated anteversion compared to the AP pelvis, with a 6.38° greater mean value measurement for FH ( p < 0.001), and an 11° greater mean value measurement for FP ( p < 0.001). Conclusions: Fluoroscopic technique and differences between radiographic projections may result in discrepancies in component position interpretation. Our results support the use of the fluoroscopic posterior-anterior hip as the choice fluoroscopic imaging technique.

Outcome and complications after dual mobility total hip replacement

2012 ◽  
Vol 25 (06) ◽  
pp. 511-517 ◽  
Author(s):  
A. Autefage ◽  
T. Dembour ◽  
J.-L. Chancrin ◽  
P. Guillaumot
Keyword(s):  
Aseptic Loosening ◽  
Acetabular Component ◽  
Acetabular Fracture ◽  
Hip Prosthesis ◽  
Perioperative Complications ◽  
Greater Trochanter ◽  
Dual Mobility ◽  
Total Hip ◽  
Trochanter Fracture

SummaryObjectives: To report the clinical and radiographic outcome of a canine total hip prosthesis with a dual mobility acetabular component, with a minimum of six months follow-up.Methods: The outcome of dogs that underwent primary cemented unilateral dual mobility hip prosthesis surgery by one of the authors for hip dysplasia or trauma, and which had a minimum of six months clinical and radiologic follow-up, was evaluated.Results: Fifty dogs were included in the study. Follow-up ranged from six to 38 months (mean 14.4 months). Perioperative complications were acetabular collapse (n = 1) and greater trochanter fracture (n = 1), both of which were successfully managed perioperatively. Postoperative complications were aseptic loosening of the acetabular component (n = 2; both surgically revised), implant sepsis (n = 3; all explanted), acetabular fracture (n = 1; conservatively managed), greater trochanter fracture (n = 1; conservatively managed) and sciatic neurapraxia (n = 1). No cases of postoperative luxation or femoral implant aseptic loosening were encountered. Outcome was poor for three cases (3 implant sepsis), fair for three cases (including 1 acetabular component loosening and 1 acetabular fracture), and good or excellent for 44 cases (88%).Clinical significance: There were not any cases of postoperative coxofemoral luxation observed in this series of 50 dogs with dual mobility hip prosthesis. Studies with more patients and longer follow-up are needed to confirm the satisfactory results observed to date with this implant.

scholarly journals Usefulness of Intraoperative C-Arm Image Intensifier in Reducing Errors of Acetabular Component During Primary Total Hip Arthroplasty: An Application of Widmer’s Method

2021 ◽  
Author(s):  
Joo-Hyoun Song ◽  
Yong-Sik Kim ◽  
Soon-Yong Kwon ◽  
Young-Wook Lim ◽  
Jiyoung Jung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Intraoperative Imaging ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Target Zone ◽  
Total Hip ◽  
3D Computed Tomography

Abstract Background: Acetabular prosthesis positioning in total hip arthroplasty (THA) is crucial in reducing the risk of dislocation. There has been minimal research on the proper way to put the acetabular components into the safe zone intraoperatively. Assessment of version by intraoperative imaging intensifier is very valuable. The value of Widmer’s method, using the intraoperative C-arm available to determine cup anteversion was assessed.Methods: 101 hips in 91 patients who underwent primary THA were eligible for inclusion. Utilizing intraoperative C-arm images, measurement was performed using the technique described by Widmer. The values obtained using 3D computed tomography postoperatively, which determined the anteversion of the acetabular component, were regarded as the reference standard.Results: The method of Widmer obtained values similar to those obtained using 3D computed tomography and was considered accurate (n.s.). All 101 hips were positioned in the set target zone. Among the 101 hips, the cup position in nine hips (8.9%) was changed. The dislocation rate in our study was 1.0% with all dislocations occurring in hips placed in the target zone. The mean Harris hip score after THA in one year was 94.2 (82-98).Conclusions: The method of Widmer was accurate using intraoperative imaging intensifier for the measurement of the anteversion of the acetabular component during THA, with reference to the anteversion obtained from the 3D computed tomography. Also, utilizing intraoperative C-arm imaging was very useful because it allowed for correction of the position of the acetabular cup.

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