The effect of dorsal rim loss on the initial stability of the BioMedtrix cementless acetabular cup

Springer Science and Business Media LLC - Tập 11 - Trang 1-7 - 2015
Meredith L Montgomery1, Stanley E Kim1, Jonathan Dyce2, Antonio Pozzi1
1From the Comparative Orthopaedics Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, USA
2The Ohio State University Veterinary Medical Center, Columbus, USA

Tóm tắt

Loss of dorsal acetabular rim (DAR) is a common sequela to canine hip dysplasia. The purpose of this study is to evaluate the effect of DAR loss on the initial stability of the cementless (BFX) acetabular cup. BFX cups were implanted into foam blocks reamed to resemble acetabulae with simulated 0, 25, 50, and 75% DAR loss. Models were tested in edge loading of the lateral surface of the cup with an indenter, and in centered loading with an articulated femoral prosthesis. Additionally, cups were implanted into paired cadaveric canine hemipelves with either no DAR depletion, or removal of 50% of the DAR, and acutely loaded to failure with an articulated femoral prosthesis. Mean load measured at 1 mm cup displacement during edge loading was not significantly different in foam blocks with loss of 0, 25, 50, and 75% DAR (360 ± 124 N, 352 ± 42 N, 330 ± 81 N, 288 ± 43 N, respectively; P = 0.425). Mean load to failure with centered loads was greatest in blocks with 0% DAR loss (2828 ± 208 N; P < 0.001), but was not significantly different between 25, 50, and 75% DAR loss (2270 ± 301 N, 1924 ± 157 N, 1745 ± 118 N). In cadaveric testing, neither mean load to failure (P = 0.067), stiffness (P = 0.707), nor energy (P = 0.228) were significantly different in control hemipelves and those with 50% depletion of the DAR. Failure in all acetabulae occurred due to acetabular bone fracture at forces in supraphysiologic ranges. BFX cup stability under normal physiologic loads does not appear to be compromised in acetabulae with up to 50% DAR loss.

Tài liệu tham khảo

Marcellin-Little DJ, DeYoung BA, Doyens DH, DeYoung DJ. Canine uncemented porous-coated anatomic total hip arthroplasty: results of a long-term prospective evaluation of 50 consecutive cases. Vet Surg. 1999;28(1):10–20. Remedios AM, Fries CL. Treatment of canine hip dysplasia: a review. Can Vet J La Revue Veterinaire Canadienne. 1995;36(8):503–9. Moores AL, Moores AP, Brodbelt DC, Owen MR, Draper ER. Regional load bearing of the canine acetabulum. J Biomech. 2007;40(16):3732–7. Page AE, Allan C, Jasty M, Harrigan TP, Bragdon CR, Harris WH. Determination of loading parameters in the canine hip in vivo. J Biomech. 1993;26(4–5):571–9. Hunter S, Dyce J, Butkus L, Olmstead ML. Acetabular cup displacement after polyethylene-cement interface failure: a complication of total hip replacement in seven dogs. Vet Comp Orthopaed. 2003;16(2):99–104. Pooya HA, Schulz KS, Wisner ER, Montavon P, Jackson J. Short-term evaluation of dorsal acetabular augmentation in 10 canine total hip replacements. Vet Surg. 2003;32(2):142–52. Fitzpatrick N, Bielecki M, Yeadon R, Hamilton M. Total hip replacement with dorsal acetabular rim augmentation using the SOP(TM) implant and polymethylmethacrylate cement in seven dogs with dorsal acetabular rim deficiency. Vet Surg. 2012;41(1):168–79. Vezzoni L, Montinaro V, Vezzoni A. Use of a revision cup for treatment of Zurich cementless acetabular cup loosening. Surgical technique and clinical application in 31 cases. Vet Comp Orthop Traumatol. 2013;26(5):408–15. Hsu JT, Lin DJ. Effects of screw eccentricity on the initial stability of the acetabular cup in artificial foam bone of different qualities. Artif Organs. 2010;34(1):E10–16. Huber WO, Noble PC. Effect of design on the initial stability of press-fit cups in the presence of acetabular rim defects: experimental evaluation of the effect of adding circumferential fins. Int Orthop. 2014;38(4):725–31. Dyce J, Wisner ER, Schrader SC, Wang Q, Olmstead ML. Radiographic evaluation of acetabular component position in dogs. Vet Surg. 2001;30(1):28–39. Baleani M, Fognani R, Toni A. Initial stability of a cementless acetabular cup design: experimental investigation on the effect of adding fins to the rim of the cup. Artif Organs. 2001;25(8):664–9. Shahar R, Banks-Sills L. Biomechanical analysis of the canine hind limb: calculation of forces during three-legged stance. Vet J. 2002;163(3):240–50. Skurla CP, James SP. Postmortem retrieved canine THR: femoral and acetabular component interaction. Biomed Sci Instrum. 2004;40:255–60. Adler E, Stuchin SA, Kummer FJ. Stability of press-fit acetabular cups. J Arthroplasty. 1992;7(3):295–301. Deyoung DJ, Deyoung BA, Aberman HA, Kenna RV, Hungerford DS. Implantation of an uncemented total hip-prosthesis - technique and initial results of 100 arthroplasties. Vet Surg. 1992;21(3):168–77. Margalit KA, Hayashi K, Jackson J, Kim SY, Garcia TC, Wiggans KT, et al. Biomechanical evaluation of acetabular cup implantation in cementless total hip arthroplasty. Vet Surg. 2010;39(7):818–23. Torres BT, Chambers JN, Budsberg SC. Successful cementless cup reimplantation using cortical bone graft augmentation after an acetabular fracture and cup displacement. Vet Surg. 2009;38(1):87–91.