After total hip arthroplasty, impingement of implant components may occur during every-day patient activities causing increased shear stresses at the acetabular implant-bone interface. In the literature, impingement related lever-out moments were noted for a number of acetabular components. But there is little information about pelvic load transfer. The aim of the current study was to measure the three-dimensional strain distribution at the macrostructured hemispherical interface and in the periphery of a standard acetabular press-fit cup in an experimental implant-bone substitute model. An experimental setup was developed to simulate impingement loading via a lever arm representing the femoral component and the lower limb. In one experimental setup 12 strain gauges were embedded at predefined positions in the periphery of the acetabular cup implant inside a tray, using polyurethane composite resin as a bone substitute material. By incremental rotation of the implant tray in steps of 10 and 30 deg, respectively, the strains were measured at evenly distributed positions. With the described method 288 genuine strain values were measured in the periphery of an embedded acetabular cup implant in one experimental setup. In two additional setups the strains were evaluated at different distances from the implant interface. Both in radial and meridional interface directions strain magnitudes reach their peak near the rim of the cup below the impingement site. Values of equatorial strains vary near zero and reach their peaks near the rim of the cup on either side and in some distance from the impingement site. Interestingly, the maximum of averaged radial strains does not occur, as expected, close to the interface but at an interface offset of 5.6 mm. With the described experimental setup it is now possible to measure and display the three-dimensional strain distribution in the interface and the periphery of an embedded acetabular cup implant. The current study provides the first experimental proof of the high local stresses gradients in the direct vicinity of the impingement site. The results of the current study help for a better understanding of the impingement mechanism and its impact on acetabular cup stability.
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http://dx.doi.org/10.1115/1.4005686 | DOI Listing |
Iowa Orthop J
January 2025
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Background: Dislocation remains a common complication following total hip arthroplasty (THA). Previous literature has shown that the femoral head-to-neck ratio is essential in hip motion, function, and stability. While large femoral heads and dual mobility bearings have been developed to improve stability, it remains unknown if the ratio between femoral head size to acetabular cup size also plays a role in stability.
View Article and Find Full Text PDFInsights Imaging
January 2025
Department of Radiology, Radiation Oncology and Medical Physics Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Objective: To determine the feasibility, yield, and safety of fluoroscopic-guided aspiration of the acutely dislocated total hip arthroplasty (AD-THA).
Materials And Methods: IRB-approved, retrospective review of fluoroscopic-guided aspirations of AD-THA (January 2005-December 2023) was performed. Data from electronic charts and fluoroscopy images/reports were obtained.
Hip Int
January 2025
Orthopaedic Clinic Lucerne, Lucerne, Switzerland.
Introduction: The RM Pressfit vitamys is an uncemented, titanium particle-coated, isoelastic monoblock cup made of vitamin E blended highly cross-linked polyethylene. We addressed the following questions: (1) What are the clinical and (2) radiographic outcomes 10 years after implantation? (3) What is the revision rate?
Methods: In this prospective observational study in a tertiary care centre we investigated all consecutive cases of total hip replacement with the RM Pressfit vitamys cup between September 2009 and November 2011. It was implanted in 162 hips, 49.
Arthroplasty
January 2025
Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, 00162, Rome, Italy.
Background: Proper positioning of a total hip arthroplasty (THA) plays a crucial role in the success and long-term survivorship of the implant. Cup positioning within the Lewinnek Safe Zone (LSZ) does not, however, avoid implant dislocation. Thus, the concept of a functional cup position has been introduced.
View Article and Find Full Text PDFExpert Rev Med Devices
January 2025
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Introduction: There is a worldwide trend toward 'revisiting' cemented total hip arthroplasty (THA). In Japan, however, cemented THAs accounts for 11%, and the percentage of cemented hemiarthroplasty is estimated to be less than 10%. This review was designed to reconsider the option of cemented THA and to encourage policy changes in Japan to support the best possible care for patients.
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