factors in THR for INDIGO.pdf (877.44 kB)
Factors Influencing Initial Cup Stability in Total Hip Arthroplasty
journal contribution
posted on 2015-03-02, 00:00 authored by Farid Amirouche, G. Solitro, S. Broviak, M. Gonzalez, W. Goldstein, R. BarmadaBackground: One of the main goals in total hip replacement is to preserve the integrity of the hip
kinematics, by well positioning the cup and to make sure its initial stability is congruent and
attained. Achieving the latter is not trivial.
Methods: A finite element model of the cup-bone interface simulating a realistic insertion and
analysis of different scenarios of cup penetration, insertion, under reaming and loading is
investigated to determine certain measurable factors sensitivity to stress-strain outcome. The
insertion force during hammering and its relation to the cup penetration during implantation is also
investigated with the goal of determining the initial stability of the acetabular cup during total hip
arthroplasty. The mathematical model was run in various configurations to simulate 1 and 2 mm
of under-reaming at various imposed insertion distances to mimic hammering and insertion of cup
insertion into the pelvis. Surface contact and micromotion at the cup-bone interface were evaluated
operative loading conditions.
Findings: The results suggest a direct correlation between under-reaming and insertion force used
to insert the acetabular cup on the micromotion and fixation at the cup-bone interface.
Interpretation: while increased under-reaming and insertion force result in an increase amount of
stability at the interface, approximately the same percentage of surface contact and micromotion
reduction can be achieved with less insertion force. We need to exercise caution to determine the
optimal configuration which achieves a good conformity without approaching the yield strength
for bone.
Funding
None given
History
Publisher Statement
This is the author’s version of a work that was accepted for publication in Clinical Biomechanics. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Clinical Biomechanics,Dec.29(10) 2014 DOI: 10.1016/j.clinbiomech.2014.09.006Publisher
Elsevier Inc.issn
0268-0033Issue date
2014-12-29Usage metrics
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