Статті в журналах: "Acetabular liner"

1

Yeroushalmi, David, Katherine A. Lygrisse, Mohamad Sharan, Nolan A. Maher, Joseph D. Zuckerman, and Ran Schwarzkopf. "Mid- to Long-Term Survivorship Analysis of a Second-Generation Highly Cross-Linked Polyethylene in Total Hip Arthroplasty." Journal of Hip Surgery 4, no. 03 (July 20, 2020): 124–28. http://dx.doi.org/10.1055/s-0040-1714292.

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AbstractThe emergence of highly cross-linked polyethylene (HCLPE) has drastically improved survivorship of implants used in total hip arthroplasty (THA), as demonstrated by midterm outcomes. However, there is limited data evaluating long-term outcomes and wear rates of these liners. Therefore, the aim of this study is to evaluate the longest-to-date follow-up of a specific second-generation HCLPE liner, the progression of wear rate, and its relation to acetabular cup positioning. A retrospective study was conducted on patients who underwent THA between January 2001 and December 2005 using a specific second-generation HCLPE liner. Annual liner wear rate (mm/year) was calculated in this group as well as acetabular positioning through abduction angle (degrees). Failures and reason for failures such as periprosthetic fracture, dislocation, and osteolysis were noted when applicable. Forty hips of 35 patients were included in this study with a clinical and radiographic follow-up of 13.4 ± 2.2 years (range: 10.0–16.7 years). Linear and volumetric wear rates were calculated to be 0.037 ± 0.020 mm/year and 22.94 ± 12.07 mm3/year, respectively. No radiographic femoral or acetabular osteolysis was observed in any of the cases. One patient required revision due to complications unrelated to the liner. No significant relationship could be established for acetabular component abduction angle and linear wear rate (p = 0.690, Spearman's rho = 0.03). Our study demonstrates comparable liner wear rates to that of other second-generation HCLPE liners in long-term follow-up. The XLPE liner continues to exhibit minimal progression of linear wear when compared with previous midterm studies and maintains a low rate of postoperative complications requiring revision THA surgery. Further studies are warranted to assess long-term wear and survivorship between this specific liner and comparable HCLPE models.

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Napier, Richard J., Owen Diamond, Chris K. J. O'Neill, Seamus O'Brien, and David E. Beverland. "The Incidence of Dissociated Liners in 4,751 Consecutive Total Hip Arthroplasties Using Pinnacle Polyethylene Acetabular Liners." HIP International 27, no. 6 (June 14, 2017): 537–45. http://dx.doi.org/10.5301/hipint.5000512.

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Introduction Acetabular liner dissociation is a complication exclusive to modular designs. We present a single surgeon series of 8 polyethylene liner dissociations with the Pinnacle Acetabular System (DePuy Orthopaedics) from over 4,750 cases. We also present a review of the literature and data from the UK National Joint Registry (NJR) on dissociation in total hip arthroplasty (THA). Methods The Pinnacle Acetabular System has been used exclusively by the senior author since April 2003, and to date 5,882 have been implanted (837 ceramic liners, 4,751 polyethylene liners (1,606 Enduron/3,145 Marathon) and 294 metal liners). We reviewed all cases of liner dissociation from this cohort to determine an overall incidence with polyethylene liners, identify associated risk factors, and report the outcome following revision surgery. Results Our incidence of this complication is 8 out of 4,751 cases (0.17%). Review of these cases and the literature suggests that femoral neck impingement against the polyethylene liner and/or edge loading may produce fatigue failure of the locking mechanism and subsequent dissociation. Conclusions Ensuring correct liner seating/locking, minimising impingement, achieving appropriate component version and avoiding radiographic cup inclinations >50° should minimise the risk of liner dissociation. Any new noise or squeaking from a polyethylene liner should undergo radiographic investigation to exclude dissociation. We recommend managing late cases of liner dissociation with revision of the acetabular shell if the cup orientation could be improved or if there is any damage to the liner-locking groove, to reduce the risk of recurrence.

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Lombardi, Adolph V., and Keith R. Berend. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 5 (May 2008): 243–48. http://dx.doi.org/10.5435/00124635-200805000-00002.

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Keggi, John M., Robert E. Kennon, Lee E. Rubin, and Kristaps J. Keggi. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 8 (August 2008): 495. http://dx.doi.org/10.5435/00124635-200808000-00009.

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Lombardi, Adolph V. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 8 (August 2008): 496. http://dx.doi.org/10.5435/00124635-200808000-00010.

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Keggi, John M., Robert E. Kennon, Lee E. Rubin, Kristaps J. Keggi, and Adolph V. Lombardi. "Isolated Acetabular Liner Exchange." Journal of the American Academy of Orthopaedic Surgeons 16, no. 9 (September 2008): 495–96. http://dx.doi.org/10.5435/00124635-200809000-00001.

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Ismail, Rifky, Sugiyanto Sugiyanto, Henry Kristianto, Eko Saputra, and Jamari Jamari. "Pemodelan Metode Elemen Hingga Kontak Femoral Head dengan Acetabular Liner pada Sendi Panggul Buatan dengan Variasi Diameter Celah pada Acetabular Liner." ROTASI 19, no. 3 (September 16, 2017): 139. http://dx.doi.org/10.14710/rotasi.19.3.139-146.

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Sendi panggul buatan (artificial hip joint) memiliki beberapa komponen utama, yaitu stem, femoral head dan acetabular shell yang terbuat dari material logam dan acetabular liner yang terbuat dari komponen polimer dengan jenis UHWMPE (ultra-high-molecular-weight polyethylene). Pada desain sendi panggul buatan, yang diproduksi oleh UNDIP terdapat alternatif desain permesinan komponen acetabular liner yang memiliki celah pada titik pusat acetabular liner-nya. Untuk menguji alternatif desain ini, perlu dilakukan penelitian untuk mengetahui efek dari celah yang terdapat pada pusat acetabular liner terhadap distribusi contact pressure dan tegangan von Mises. Penelitian ini dilakukan dengan tujuan mengetahui pengaruh dari variasi diameter celah yang terdapat pada acetabular liner sendi panggul buatan produk UNDIP terhadap tekanan kontak dan tegangan von Mises. Penelitian dilakukan menggunakan metode elemen hingga dengan software ABAQUS. Femoral head dimodelkan menggunakan material stainless steel AISI 316L dan acetabular liner dimodelkan menggunakan material UHMWPE. Beban yang diberikan pada kontak femoral head dan acetabular liner ini dimodelkan sebesar 5 N menuju titik pusat acetabular liner dengan variasi diameter celah: 0,5 mm, 1 mm, 1,5 mm, 2 mm, 2,5 mm dan 3 mm.. Jumlah elemen yang digunakan sebanyak 9000 buah setelah dikonfirmasi validitas penentuan mesh. Hasil simulasi menunjukkan bahwa terdapat konsentrasi tegangan pada tepi celah yang ditandai dengan tinggiya contact pressure dan tegangan von Mises. Nilai tertinggi kedua luaran ini terlihat pada diameter celah sebesar 2 mm yang nilai maksimumnya mencapai 4 kali dari besar contact pressure dan tegangan von Mises pada diameter celah yang lain. Fenomena ini diperkirakan disebabkan karena tepi dari celah berimpit dengan tepi dari jari-jari kontak yang terbentuk pada sistem kontak mekanik femoral head dan acetabular liner. Adanya kenaikan yang dramatis ini dapat mengakibatkan naiknya keausan (wear) dan munculnya kemungkinan terjadinya deformasi plastis yang lebih besar pada liner. Rekomendasi yang diberikan pada pemberian celah ini adalah sebaiknya dihindari untuk mengurangi terjadinya wear dan deformasi plastis yang terlalu besar. Dalam kondisi celah tidak dapat dihindari maka diameter celah tidak lebih dari 14% dari diameter femoral head

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Andersen, Annette Vest, Anne Grete Kjersgaard, and Søren Solgaard. "Trilogy-Constrained Acetabular Component for Recurrent Dislocation." ISRN Orthopedics 2013 (January 10, 2013): 1–4. http://dx.doi.org/10.1155/2013/629201.

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32 patients received a Trilogy- or Trilogy-Longevity-constrained acetabular liner for recurrent dislocations after total hip replacement. The constrained liner was inserted into a well-fixed Trilogy acetabular shell with snap fit. At 1.8-year followup (range 3–63 months), 4 patients had suffered further dislocation(s) (12%), and one patient had revision surgery for a loosened acetabular shell. Radiologic evaluation detected no definitively loose components, but one patient with progressing radiolucent lines around the femoral component and one patient with an acetabular cyst were found, as well as a patient with a loose locking ring (but otherwise no failure). The nineteen patients who were available for the present followup had a mean Harris Hip Score of 81. The constrained liner is an effective method of dealing with recurrent dislocations in well-fixed components.

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9

Jiranek, William A. "Acetabular Liner Fixation by Cement." Clinical Orthopaedics & Related Research 417 (December 2003): 217–23. http://dx.doi.org/10.1097/01.blo.0000096805.78689.8b.

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10

Parkar, Asif A. H., Mohamed Sukeik, Ahmed El-Bakoury, and James Powell. "Acetabular liner dissociation: A case report and review of the literature." SICOT-J 5 (2019): 31. http://dx.doi.org/10.1051/sicotj/2019025.

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Dissociation of the polyethylene liner from the acetabular shell is a rare but catastrophic complication of total hip arthroplasty (THA). There have been reports of polyethylene liner dissociation (PLD) as well as ceramic liner dissociation (CLD) in the literature. Amongst the commonly used implants, liner dissociation has been reported with the Pinnacle (DePuy), Harris–Galante (Zimmer) and Trident (Stryker) acetabular components. To the best of our knowledge, this is the first case report of PLD in an R3 (Smith & Nephew) acetabular component. This case report highlights the implant choice for treatment of the liner dissociation and the role of constrained implants in such cases.

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11

Fransen, Bas L., Francisco J. Bengoa, Michael E. Neufeld, Gerard A. Sheridan, Donald S. Garbuz, and Lisa C. Howard. "Thin highly cross-linked polyethylene liners combined with large femoral heads in primary total hip arthroplasty show excellent survival and low wear rates at a mean follow-up of 12.8 years." Bone & Joint Journal 105-B, no. 1 (January 1, 2023): 29–34. http://dx.doi.org/10.1302/0301-620x.105b1.bjj-2022-0812.r1.

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Aims Several short- and mid-term studies have shown minimal liner wear of highly cross-linked polyethylene (HXLPE) in total hip arthroplasty (THA), but the safety of using thinner HXLPE liners to maximize femoral head size remains uncertain. The objective of this study was to analyze clinical survival and radiological wear rates of patients with HXLPE liners, a 36 mm femoral head, and a small acetabular component with a minimum of ten years’ follow-up. Methods We retrospectively identified 55 patients who underwent primary THA performed at a single centre, using HXLPE liners with 36 mm cobalt-chrome heads in acetabular components with an outer diameter of 52 mm or smaller. Patient demographic details, implant details, death, and all-cause revisions were recorded. Cox regression and Kaplan-Meier survival was used to determine all-cause and liner-specific revision. Of these 55 patients, 22 had a minimum radiological follow-up of seven years and were assessed radiologically for linear and volumetric wear. Results Overall survival rate for all-cause revision was 94.5% (95% confidence interval (CI) 81.7% to 97.2%) at a mean follow-up of 12.8 years (10.9 to 18.7). Three patients were revised, none for liner wear, fracture, or dissociation. A total of 22 patients were included in the radiological analysis (mean follow-up 9.9 years (7.5 to 13.7)). Mean linear liner wear was 0.085 mm (95% CI -0.086 to 0.257) and the volumetric wear rate was 11.097 mm3/year (95% CI -6.5 to 28.7). Conclusion Using HXLPE liners with 36 mm heads in 52 mm acetabular components or smaller is safe, with excellent survival and low rates of linear and volumetric wear at medium-term follow-up. Patients did not require revision surgery for liner complications such as fracture, dissociation, or wear. Our results suggest that the advantages of using larger heads outweigh the potential risks of using thin HXLPE liners. Cite this article: Bone Joint J 2023;105-B(1):29–34.

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Hill, Daniel S., Kuntal Patel, and Deepak Herlekar. "Early Catastrophic Failure of a PINNACLE MARATHON® Polyethylene Acetabular Liner: A Report of a Malpositioned PINNACLE DUOFIX HA® Acetabular Shell Resulting in Point Loading and Accelerated Wear." HIP International 26, no. 6 (October 11, 2016): e52-e55. http://dx.doi.org/10.5301/hipint.5000447.

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Background Highly cross-linked polyethylene in total hip arthroplasty (THA) has been shown to decrease wear rate compared with a conventional polyethylene liner. However, it has also been reported that the manufacturing processes can cause early failure of the implant. Case We describe early catastrophic failure at <4 years following primary THA surgery of a PINNACLE MARATHON® polyethylene acetabular liner resulting from a malaligned PINNACLE DUOFIX HA® acetabular shell with resultant point loading. Radiographs revealed a malaligned acetabular shell and superior subluxation of the femoral head out of the liner. At revision surgery operative findings revealed that the acetabular shell alignment was in of 50° of anteversion and 70° of inclination. Significant metallosis in the surrounding tissues was observed. Conclusions We conclude that a malpositioned acetabular shell resulting in point loading and abnormal contact stresses was the mechanism of failure. Our case highlights the importance of achieving correct acetabular component alignment in total hip arthroplasty.

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13

Jamari, J., A. Hidayat, Eko Saputra, Iwan Budiwan Anwar, Rifky Ismail, and Emile van der Heide. "The Effect of the Wall Thickness on Wear of an UHMWPE Acetabular Liner." Advanced Materials Research 1123 (August 2015): 196–200. http://dx.doi.org/10.4028/www.scientific.net/amr.1123.196.

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A larger diameter of femoral head of artificial hip joint (AHJ) is commonly recommended for increasing range of motion (RoM) and for avoiding dislocation. Unfortunately, increasing that diameter will reduce the material liner thickness of the acetabular component. The behaviour of the AHJ contact system with thickness variation of the Ultra High Molecular Weight Polyethylene (UHMWPE) acetabular liner was studied numerically and experimentally. Finite element analysis was employed for calculating contact stresses and the wear volume was measured experimentally. Numerical results show higher contact stresses with decreasing liner wall thickness. Yet, the experimental results suggest that wear decreases as well with decreasing wall thickness. These findings are important in designing an optimised acetabular liner for larger RoM.

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Keohane, David, Gerard A. Sheridan, James Harty, and Padhraig O'Loughlin. "Polyethylene liner dissociation in a DePuy pinnacle cup with a manufacturer analysis of the failed component." BMJ Case Reports 14, no. 2 (February 2021): e238333. http://dx.doi.org/10.1136/bcr-2020-238333.

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A 74-year-old patient presented to the emergency department with acute atraumatic hip pain 9 years after her primary left total hip arthroplasty (THA). Plain radiographic imaging demonstrated lateralisation of the femoral head within the acetabular shell—indicating an issue with the polyethylene liner. The patient required revision of the acetabular component and the femoral head, as well as a new polyethylene liner. A detailed analysis of the components removed was performed by DePuy Synthes Engineering. Between 2009 and 2020, 8 publications have documented 52 cases of liner dissociation with the Pinnacle acetabular component and Marathon polyethylene liner. Various theories have been proposed in the literature as all of these components appear to fail in the same way, with shearing of the locking tabs in the polyethylene liner. In spite of a manufacturer analysis of the components, no root cause was identified as to why the polyethylene liner failed.

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Krull, Paula, Arnd Steinbrück, Alexander W. Grimberg, Oliver Melsheimer, Michael Morlock, and Carsten Perka. "Modified acetabular component liner designs are not superior to standard liners at reducing the risk of revision." Bone & Joint Journal 104-B, no. 7 (July 1, 2022): 801–10. http://dx.doi.org/10.1302/0301-620x.104b7.bjj-2021-1791.r1.

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Aims Registry studies on modified acetabular polyethylene (PE) liner designs are limited. We investigated the influence of standard and modified PE acetabular liner designs on the revision rate for mechanical complications in primary cementless total hip arthroplasty (THA). Methods We analyzed 151,096 primary cementless THAs from the German Arthroplasty Registry (EPRD) between November 2012 and November 2020. Cumulative incidence of revision for mechanical complications for standard and four modified PE liners (lipped, offset, angulated/offset, and angulated) was determined using competing risk analysis at one and seven years. Confounders were investigated with a Cox proportional-hazards model. Results Median follow-up was 868 days (interquartile range 418 to 1,364). The offset liner design reduced the risk of revision (hazard ratio (HR) 0.68 (95% confidence interval (CI) 0.50 to 0.92)), while the angulated/offset liner increased the risk of revision for mechanical failure (HR 1.81 (95% CI 1.38 to 2.36)). The cumulative incidence of revision was lowest for the offset liner at one and seven years (1.0% (95% CI 0.7 to 1.3) and 1.8% (95% CI 1.0 to 3.0)). No difference was found between standard, lipped, and angulated liner designs. Higher age at index primary THA and an Elixhauser Comorbidity Index greater than 0 increased the revision risk in the first year after surgery. Implantation of a higher proportion of a single design of liner in a hospital reduced revision risk slightly but significantly (p = 0.001). Conclusion The use of standard acetabular component liners remains a good choice in primary uncemented THA, as most modified liner designs were not associated with a reduced risk of revision for mechanical failure. Offset liner designs were found to be beneficial and angulated/offset liner designs were associated with higher risks of revision. Cite this article: Bone Joint J 2022;104-B(7):801–810.

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Lestari, Wahyu Dwi, Luluk Edahwati, Tria Puspa Sari, Ndaru Adyono, and Novel Karaman. "SEM Analysis of UHMWPE for Biomedical Application." Biomedical and Mechanical Engineering Journal (BIOMEJ) 1, no. 1 (April 14, 2021): 5. http://dx.doi.org/10.33005/biomej.v1i1.23.

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The objective of this study is to investigate the wear mechanism of UHMWPE acetabular liner. There were three samples of acetabular liner with variations without crosslink, with crosslink doses of 50 kGy and 100 kGy which were subjected to a wear testing process. The wear test was carried out using a Tribometer wear testing machine with a total of 30,000 cycles and a load of 800N. Microstructure analysis was performed using scanning electron microscopy (SEM). The results show that the surface of the UHMWPE acetabular liner with the crosslink treatment is smoother than the untreated one. This shows that UHMWPE with crosslink treatment has a lower wear rate, where the greater the crosslink dose the lower the wear rate. The wear mechanism that occurs in this study is the third body abrasion which leads to adhesive wear.

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W D Lestari, L Edahwati, R D Issafira, W Saputro, A K Faizin, N Adyono, and T P Sari. "Manufacturing Acetabular Liner UHMWPE using CNC Milling." Biomedical and Mechanical Engineering Journal (BIOMEJ) 1, no. 2 (October 19, 2021): 12–16. http://dx.doi.org/10.33005/biomej.v1i2.35.

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Ultra High Molecular Weight Polyethylene (UHMWPE) is a biomedical polymer that is useful in the orthopedic field as a bearing component in artificial hip joints. In general, these polymers pair up and rub against each other with metallic biomaterials, namely 316L stainless steel, cobalt chromium (CoCr) and titanium, which can cause material wear problems. One way to increase the wear resistance of UHMWPE is through the manufacturing process. The purpose of this research is to manufacture acetabular liner products using a CNC milling machine to obtain high surface quality and dimensional accuracy. The CNC milling machine used is the type of YCM 1020 EV 20. The manufactured specimen is then measured for roughness and dimensional accuracy. Based on the measurement results, it is found that the acetabular liner specimens from the CNC milling process are still in accordance with the standard ASTM standard (F 2033-12).

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Callaghan, John J., Steve S. Liu, and Nathan M. Schularick. "Shell Retention with a Cemented Acetabular Liner." Orthopedics 32, no. 9 (September 1, 2009): 673–75. http://dx.doi.org/10.3928/01477447-20090728-17.

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Shigemura, Tomonori, Shunji Kishida, Junichin Akamura, Munenori Takeshita, Makoto Takazawa, and Yoshitadah Arada. "Acetabular Liner Revision Using an Anterolateral Approach." Orthopedics 35, no. 4 (April 1, 2012): e570-e573. http://dx.doi.org/10.3928/01477447-20120327-36.

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Haft, Geoffrey F., Anneliese D. Heiner, John J. Callaghan, Lawrence D. Dorr, Zhinian Wan, William Long, Donald B. Longjohn, and Thomas D. Brown. "Polyethylene liner cementation into fixed acetabular shells." Journal of Arthroplasty 17, no. 4 (June 2002): 167–70. http://dx.doi.org/10.1054/arth.2002.32465.

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Gwynne-Jones, David P., and Adeel Memon. "Acetabular Liner Dissociation: A Comparative Study of Two Contemporary Uncemented Acetabular Components." Arthroplasty Today 6, no. 3 (September 2020): 354–59. http://dx.doi.org/10.1016/j.artd.2020.04.016.

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Vogel, Danny, Matthias Klimek, Michael Saemann, and Rainer Bader. "Influence of the Acetabular Cup Material on the Shell Deformation and Strain Distribution in the Adjacent Bone—A Finite Element Analysis." Materials 13, no. 6 (March 18, 2020): 1372. http://dx.doi.org/10.3390/ma13061372.

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In total hip arthroplasty, excessive acetabular cup deformations and altered strain distribution in the adjacent bone are potential risk factors for implant loosening. Materials with reduced stiffness might alter the strain distribution less, whereas shell and liner deformations might increase. The purpose of our current computational study was to evaluate whether carbon fiber-reinforced poly-ether-ether-ketones with a Young´s modulus of 15 GPa (CFR-PEEK-15) and 23 GPa (CFR-PEEK-23) might be an alternative shell material compared to titanium in terms of shell and liner deformation, as well as strain distribution in the adjacent bone. Using a finite element analysis, the press-fit implantation of modular acetabular cups with shells made of titanium, CFR-PEEK-15 and CFR-PEEK-23 in a human hemi-pelvis model was simulated. Liners made of ceramic and polyethylene were simulated. Radial shell and liner deformations as well as strain distributions were analyzed. The shells made of CFR-PEEK-15 were deformed most (266.7 µm), followed by CFR-PEEK-23 (136.5 µm) and titanium (54.0 µm). Subsequently, the ceramic liners were radially deformed by up to 4.4 µm and the polyethylene liners up to 184.7 µm. The shell materials slightly influenced the strain distribution in the adjacent bone with CFR-PEEK, resulting in less strain in critical regions (<400 µm/m or >3000 µm/m) and more strain in bone building or sustaining regions (400 to 3000 µm/m), while the liner material only had a minor impact. The superior biomechanical properties of the acetabular shells made of CFR-PEEK could not be determined in our present study.

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González-Bravo, Carlos, Miguel A. Ortega, Julia Buján, Basilio de la Torre, and Loreto Barrios. "Wear Risk Prevention and Reduction in Total Hip Arthroplasty. A Personalized Study Comparing Cement and Cementless Fixation Techniques Employing Finite Element Analysis." Journal of Personalized Medicine 11, no. 8 (August 10, 2021): 780. http://dx.doi.org/10.3390/jpm11080780.

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The wear rate on Total Hip Arthroplasty (THA) entails a heavy burden for patients. This becomes more relevant with increased wear risk and its consequences such as osteolysis. In addition, osteolysis has been described in cemented and uncemented acetabular implants, and nowadays, controversy remains as to whether or not to cement the acetabular component. A personalized theoretical study was carried out to investigate which parameters have an influence on wear risk and to determine the best fixation method. Liner wear risk was assessed for two different types of fixation (cemented vs uncemented) through Finite Elements Analysis (FEA). The intraoperative variables used to determine the wear risk (cervical-diaphyseal angle, Center of Rotation positioning -COR-, head material, head size, and liner thickness) are vital parameters in surgical planning. Two types of tridimensional liner models of Ultra High Molecular Weight Polyethene (UHMWPE) were simulated through finite element analysis (FEA—over 216 cases were the core of this research). A significant relationship was found between the cervical-diaphyseal angle and wear risk (p < 0.0001), especially in valgus morphology. The acetabular fixation technique (p < 0.0001) and liner thickness (p < 0.0001) showed a significant relationship with wear risk. According to our study, using a cemented fixation with a thick liner in the right center of rotation appears to be the proper stratagy for preventing polyethylene liner wear.

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Lie, S. A., G. Hallan, O. Furnes, L. I. Havelin, and L. B. Engesæter. "Isolated acetabular liner exchange compared with complete acetabular component revision in revision of primary uncemented acetabular components." Journal of Bone and Joint Surgery. British volume 89-B, no. 5 (May 2007): 591–94. http://dx.doi.org/10.1302/0301-620x.89b5.18623.

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Mouri, Kanto, and Tatsuro Karita. "Short-term clinical and radiographic outcomes of total hip arthroplasty with PMPC-grafted highly cross-linked polyethylene liners against 32-mm femoral heads." Journal of Artificial Organs 24, no. 2 (January 15, 2021): 234–42. http://dx.doi.org/10.1007/s10047-020-01246-0.

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AbstractWe evaluated the clinical and radiographic outcomes of femoral head penetration and total hip arthroplasties with untreated and poly (2-methacryloyloxyethyl phosphorylcholine) (PMPC)-grafted highly cross-linked polyethylene (HXLPE) acetabular liners against 26-, 28-, and 32-mm cobalt–chromium alloy femoral heads 3 years after the index surgery. Three combinations of the articulating surfaces were evaluated in the present study: untreated or PMPC-grafted HXLPE liner against 26- or 28-mm femoral heads (n = 16, 24) [control (26 or 28 mm) and PMPC (26 or 28 mm)] and PMPC-grafted HXLPE liner against 32-mm femoral heads (n = 64) [PMPC (32 mm)]. The clinical outcomes improved at 3 years postoperatively for the groups. No periprosthetic osteolysis or acetabular component migration was detected, and no revision surgery was performed among the groups. The steady-state wear rate of the PMPC (26 or 28 mm) group (0.021 mm/year) was lower than that of the control (26 or 28 mm) group (− 0.015 mm/year); the steady-state wear was under the clinical threshold. In contrast, the steady-state wear rate of the PMPC (32 mm) group (-0.006 mm/year) showed no significant difference when compared to that of the PMPC (26 or 28 mm) group (p < 0.01). The results obtained in the present study clearly demonstrate that PMPC-grafting onto an HXLPE surface improved the wear resistance of acetabular liners, even when coupled with larger femoral heads. Although further follow-up evaluations are required, PMPC-grafted HXLPE acetabular liners may be a promising approach to extend the longevity of artificial joints.

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Cho, Myung-Rae, Chung-Mu Jun, Kyung-Tae Kim, Suk Kyun Song, and Won-Kee Choi. "Results of primary THA using 36 mm femoral heads on first-generation highly cross-linked polyethylene in patients less than 60 years of age: Minimum 10-year follow-ups." Journal of Orthopaedic Surgery 28, no. 1 (January 1, 2020): 230949901989644. http://dx.doi.org/10.1177/2309499019896448.

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Purpose: Long-term results of total hip arthroplasty (THA) using highly cross-linked polyethylene (HXLPE) and metal femoral head with more than 10 years of follow-up have already been reported. However, most studies included results with a head size of 28 mm that could affect wear rates. The aim of this study was to evaluate the results of 36-mm metallic femoral heads on first-generation HXLPE in patients less than 60 years of age with a minimum follow-up of 10 years. Methods: Retrospective analysis included 54 cases from 47 patients. The mean age at the time of surgery was 47.22 years and the mean follow-up period was 131.04 months. Porous-coated cementless acetabular cups (Trilolgy®; Zimmer Inc., Warsaw, Indiana, USA) and HXLPE acetabular liners (Longevity®; Zimmer Inc.) were used for all cases. Acetabular cup abduction angles, anteversion angles, and wear rates of liner were measured using polyWare pro 3D distal version 5.10. Results: The average modified Harris hip score at the final follow-up was 88.48 (range 80–96). Average Merle d’Aubigne and Postel score was 15.57 (range 14–18). There was no acetabular cup or femoral stem failing due to aseptic loosening. The average steady-state wear rate determined using radiographs taken at 1 year postoperatively and at the latest follow-up was 0.053 ± 0.025 mm/year. There were no statistically significant differences in liner wear rate with respect to age, variety of the femoral stem, or liner thickness. Conclusion: Results of THA with 36-mm metallic femoral heads on first-generation HXLPE in patients less than 60 years of age were satisfactory.

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Boulay, Christophe, Gérard Bollini, Jean Legaye, Christine Tardieu, Dominique Prat-Pradal, Brigitte Chabrol, Jean-Luc Jouve, Ginette Duval-Beaupère, and Jacques Pélissier. "Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study." Anatomy Research International 2014 (March 18, 2014): 1–9. http://dx.doi.org/10.1155/2014/594650.

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Acetabular cup orientation (inclination and anteversion) is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter) emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter) could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society) providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter) could determine the safe range of pelvis tilt (positional parameter) for an individual and not a group.

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Kawano, Shunsuke, Motoki Sonohata, Masaru Kitajima, and Masaaki Mawatari. "Highly Cross-linked Polyethylene Liner Dissociation from a Cement-less Modular Acetabular Shell: Two Case Reports." Open Orthopaedics Journal 10, no. 1 (December 26, 2016): 732–40. http://dx.doi.org/10.2174/1874325001610010732.

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Liner dissociation of polyethylene from a cementless acetabular socket following total hip arthroplasty (THA) is a rare complication. Cross-linked polyethylene liner dissociation from AMS-HA shell (KYOCERA Med, Osaka, Japan) occurred in 2 out of the 4153 (0.04%) cases approximately 10 years after undergoing surgery at our institute. First case was an 80-year-old female who underwent right THA along with subtrochanteric femoral shortening osteotomy due to complete dislocation hip, and second case was a 72-year-old male, who underwent right THA due to coxarthrosis. A 26 mm femoral head and CPE liner were used in both cases and the inclination degree of the acetabular socket was within 50Â°.There was no implant loosening in both cases. There was partial damage in the elevated rim on the alternative side and scratches on the back side in the both extracted CPE liner. It was surmised that liner dissociation was caused due to a problem in the liner fixing format of the push in type of the present model.

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Guillaumot, Pierre, Jean-Luc Chancrin, and Bertrand Vedrine. "Dislocation of a dual mobility total hip replacement following fracture of the polyethylene liner." Veterinary and Comparative Orthopaedics and Traumatology 29, no. 03 (May 2016): 259–64. http://dx.doi.org/10.3415/vcot-15-01-0016.

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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.

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Gascoyne, Trevor C., Martin J. Petrak, Thomas R. Turgeon, and Eric R. Bohm. "Wear of a sequentially annealed polyethylene acetabular liner." Acta Orthopaedica 85, no. 5 (August 20, 2014): 470–73. http://dx.doi.org/10.3109/17453674.2014.949044.

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31

Mesko, J. Wesley. "Acute Liner Disassociation of a Pinnacle Acetabular Component." Journal of Arthroplasty 24, no. 5 (August 2009): 815–18. http://dx.doi.org/10.1016/j.arth.2008.03.010.

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Blakey, Caroline M., Leela C. Biant, Thomas G. Kavanagh, and Richard E. Field. "Failure of Cement-in-Shell Acetabular Liner Exchange." HIP International 20, no. 1 (January 2010): 120–22. http://dx.doi.org/10.1177/112070001002000118.

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Archibeck, Michael J., Tamara Cummins, Daniel W. Junick, and Richard E. White. "Acetabular Loosening Using an Extended Offset Polyethylene Liner." Clinical Orthopaedics and Related Research 467, no. 1 (September 10, 2008): 188–93. http://dx.doi.org/10.1007/s11999-008-0479-x.

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34

Dammerer, D., F. Schneider, T. Renkawitz, D. Putzer, M. Bogensperger, and R. Biedermann. "High risk of hip dislocation following polyethylene liner exchange in total hip arthroplasty—is cup revision necessary?" Archives of Orthopaedic and Trauma Surgery 140, no. 11 (September 19, 2020): 1837–45. http://dx.doi.org/10.1007/s00402-020-03603-3.

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Abstract Purpose Polyethylene (PE) wear remains a common reason for revision surgery following total hip arthroplasty (THA). An established treatment method is isolated liner exchange in a well-fixed acetabular cup and entails a known high risk of hip dislocation after revision surgery. The purpose of this retrospective study was to determine the rate of hip dislocation after liner exchange. Methods Patients were included if (1) the PE liner was removable, (2) the acetabular shell was stable with acceptable orientation, (3) no osteolysis around the acetabular cup was found and (4) no dislocation of the THA occurred before revision surgery. We reviewed medical histories and performed radiological measurements using Einzel-Bild-Röntgen-Analyse (EBRA) software. EBRA measurements and statistical investigations were performed by two independent investigators. Results A total of 82 patients were included in our study. Mean follow-up was six (range: 3.6–9.9) years. In 13 (15.8%) patients THA dislocations occurred at a mean postoperative period of 20.2 (range: 1–44) weeks after revising the PE liner. This is equivalent to an absolute risk increase of 16% after revision surgery, which results in a number needed to harm of 6. This means that every sixth patient with isolated liner exchange can expect to experience dislocation due to wear. Conclusion In conclusion, isolated exchange of the polyethylene liner because of wear showed a high risk of dislocation and further cup revision. Our results suggest that the threshold for revising well-fixed components in the case of liner wear should be lowered. Trial Registration number and date of registration Number: 20140710-1012 and Date: 2016-03-09.

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Ravikant, Vinod Kumar Mittal, and Dr. Vikas Gupta. "Dry and Wet Lubrication Analysis for Multi-Material Hip Assembly." International Journal of Automotive and Mechanical Engineering 19, no. 1 (May 10, 2022): 9606–22. http://dx.doi.org/10.15282/ijame.19.1.2022.22.0741.

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Hip joint repair/replacement is one of the most thriving orthopedic surgical procedures in the human body. The group of patients undergoing hip replacement considerably includes young and physically active persons with varying movements thus requiring longer product life and ease of maintenance. Perfect lubrication in hip assembly ensures a low wear rate and better product life. The present work focuses on dry and wet lubrication analysis of complete implant assembly instead of an individual part. The assembly consists of a stem, head, liner and cup, each made of different materials like a ceramic femoral head mounted over a metallic femoral stem with a polyethylene liner and a metallic acetabular cup. In this work, eight metal-materials are considered for stem/cup, three ceramic materials for the head and two polyethylene materials for the liner. The combinations of these materials are evaluated for various mechanical parameters. Dry (µ = 0.13) and wet (µ = 0.05) lubricating conditions between the liner and femoral head have been considered and their effects on the head, liner and cup have been evaluated for the optimization of Hip joint design. Fifty percent of re-surgery cases arise because of excessive wear out resulting in aseptic loosening of the femoral head and liner interface. Femoral head of size 28 mm diameter with 2 mm thick liner and 3 mm thick acetabular cup are modeled and are analyzed for axial pay load of 2.3 kN. The maximum von mises stress and total deformation for various material combinations of implant assembly have been compared to select the most suitable one for the arthroplasty implantation. The combination of CoCrMo – Ceramics – HXLPE – CoCrMo demonstrates minimum stress and deformation for all three parts i.e. femoral head, liner and acetabular cup under present loading and boundary conditions. ZTA is emerged as the preferred ceramic material for femoral head having a higher compressive strength.

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Sonohata, Motoki, Warit Waewsawangwong, and Stuart B. Goodman. "Successful Closed Reduction of a Dislocated Constrained Total Hip Arthroplasty: A Case Report and Literature Review." Open Orthopaedics Journal 6, no. 1 (May 30, 2012): 211–14. http://dx.doi.org/10.2174/1874325001206010211.

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Many surgeons use acetabular components with constrained polyethylene liners to improve stability after total hip arthroplasty in patients with a history of hip dislocation. Surgical treatment is generally thought to be the only available option for the dislocated constrained liner. The success rate and clinical results of closed reduction for such patients is unclear. This report presents a case of a successful closed reduction of a dislocated constrained liner. Few papers have so far addressed closed reduction of a dislocated constrained liner. Furthermore, previous studies reported a variety of components. Publication of additional successful and unsuccessful case reports is therefore needed to help establish the optimal treatment protocol for a dislocated constrained liner.

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Ansorge, C. H., M. Ohlmeier, T. M. Ballhause, T. Gehrke, M. Citak, and M. Lee. "Acetabular Reconstruction Using Multiple Porous Tantalum Augments: Three-Quarter Football Augment." Case Reports in Orthopedics 2022 (May 21, 2022): 1–5. http://dx.doi.org/10.1155/2022/7954052.

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Reconstruction of a large acetabular bone defect is a complex problem in revision hip arthroplasty. The authors report a novel method of reconstructing an uncontained acetabular defect (Paprosky type IIIb) using multiple tantalum augments. A 73-year-old female patient presented to our institution with a chronically dislocated primary left total hip arthroplasty with radiographs demonstrating migration of acetabular component and formation of pseudoarthrosis within the left ilium. Extensive arthrolysis and anatomic reconstruction of the acetabular bone defect were performed using the novel method of multiple tantalum augments. Postoperatively, recovery was initially complicated by multiple dislocations requiring an exchange to an elevated liner, however subsequently achieved good function.

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Tribe, H., S. Malek, J. Stammers, V. Ranawat, and JA Skinner. "Advanced wear of an Oxinium™ femoral head implant following polyethylene liner dislocation." Annals of The Royal College of Surgeons of England 95, no. 8 (November 2013): e4-e6. http://dx.doi.org/10.1308/rcsann.2013.95.8.e4.

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Oxinium™ (Smith & Nephew, Memphis, TN, US) has been used in hip arthroplasty since 2003. The surface coating is hard and provides low wear rates but if this surface coating is damaged, the soft metal core is at risk of accelerated wear. Previous reports have described accelerated wear following intra and postoperative hip dislocation. We report a case of advanced wear of an in situ Oxinium™ femoral head implant following a cracked acetabular liner. The liner had disengaged from the titanium shell, allowing the Oxinium™ head to articulate directly with the shell. The disengaged liner led to dislocation of the Oxinium™ head, with associated pronounced wear of the head and the acetabular cup. The patient had a successful revision procedure. We advise close follow-up of patients with Oxinium™ implants, especially if associated with dislocation and closed reduction.

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Divecha, Hiren M., Terence W. O'Neill, Mark Lunt, and Tim N. Board. "The effect of uncemented acetabular liner geometry and lip size on the risk of revision for instability or loosening." Bone & Joint Journal 103-B, no. 12 (December 1, 2021): 1774–82. http://dx.doi.org/10.1302/0301-620x.103b12.bjj-2021-0471.r1.

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Aims The aim of this study was to determine if uncemented acetabular polyethylene (PE) liner geometry, and lip size, influenced the risk of revision for instability or loosening. Methods A total of 202,511 primary total hip arthroplasties (THAs) with uncemented acetabular components were identified from the National Joint Registry (NJR) dataset between 2003 and 2017. The effect of liner geometry on the risk of revision for instability or loosening was investigated using competing risk regression analyses adjusting for age, sex, American Society of Anesthesiologists grade, indication, side, institution type, surgeon grade, surgical approach, head size, and polyethylene crosslinking. Stratified analyses by surgical approach were performed, including pairwise comparisons of liner geometries. Results The distribution of liner geometries were neutral (39.4%; 79,822), 10° (34.5%; 69,894), 15° (21.6%; 43,722), offset reorientating (2.8%; 5705), offset neutral (0.9%; 1,767), and 20° (0.8%; 1,601). There were 690 (0.34%) revisions for instability. Compared to neutral liners, the adjusted subhazard ratios of revision for instability were: 10°, 0.64 (p < 0.001); 15°, 0.48 (p < 0.001); and offset reorientating, 1.6 (p = 0.010). No association was found with other geometries. 10° and 15° liners had a time-dependent lower risk of revision for instability within the first 1.2 years. In posterior approaches, 10° and 15° liners had a lower risk of revision for instability, with no significant difference between them. The protective effect of lipped over neutral liners was not observed in laterally approached THAs. There were 604 (0.3%) revisions for loosening, but no association between liner geometry and revision for loosening was found. Conclusion This registry-based study confirms a lower risk of revision for instability in posterior approach THAs with 10° or 15° lipped liners compared to neutral liners, but no significant difference between these lip sizes. A higher revision risk is seen with offset reorientating liners. The benefit of lipped geometries against revision for instability was not seen in laterally approached THAs. Liner geometry does not seem to influence the risk of revision for loosening. Cite this article: Bone Joint J 2021;103-B(12):1774–1782.

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Abdelaziz Bassiony, Ayman, Saleh Gameel, and Ahmed Nageeb Mahmoud. "Acetabular distraction hip arthroplasty in neglected transverse and T-shape acetabular fractures : a different application." Acta Orthopaedica Belgica 87, no. 2 (June 30, 2021): 267–74. http://dx.doi.org/10.52628/87.2.10.

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Neglected acetabular fractures are often challenging to treat. The aim of this study is to highlight the technique of acetabular distraction with porous metal cup as a viable technique to address such complex cases. This is a prospective study of seven patients who had neglected acetabular fracture or fracture non-union that were managed with total hip arthroplasty using acetabular distraction and porous metal cup with cemented liner. The average age of the patients was 51 years (range 36-58 years). Average time of follow up was 18 months (range 12-36 months). Radiological results at latest follow up and by comparing serial radiographs showed that all cases had a well-fixed implant construct without evidence of loosening or malorientation. Average Harris hip score pre-operatively was 46, which improved to an average of 84 post-operatively. Our study shows that total hip replacement using acetabular distraction with porous metal cup provide early good results in reconstruction of acetabular bony deficiencies due to neglected acetabular fracture.

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Harvie, P., M. Kemp, and D. Whitwell. "The Trident Constrained Acetabular (Bipolar) Component for Recurrent Dislocation. New Mode of Liner Failure." HIP International 17, no. 4 (October 2007): 241–44. http://dx.doi.org/10.1177/112070000701700410.

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Recurrent dislocation after reconstructive hip surgery remains a challenging problem to treat. Constrained acetabular components can provide an excellent solution, in selected patients. Failure of constrained components may still occur despite excellent component implantation and occurs at the liner-shell and shell-bone interfaces usually as a result of trauma or aseptic loosening. We describe the failure of a Trident bipolar acetabular component at its bipolar/insert interface, a previously unreported mode of failure.

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Maguire Jr., Gerald Q., Marilyn E. Noz, Henrik Olivecrona, Michael P. Zeleznik, and Lars Weidenhielm. "A New Automated Way to Measure Polyethylene Wear in THA Using a High Resolution CT Scanner: Method and Analysis." Scientific World Journal 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/528407.

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As the most advantageous total hip arthroplasty (THA) operation is the first, timely replacement of only the liner is socially and economically important because the utilization of THA is increasing as younger and more active patients are receiving implants and they are living longer. Automatic algorithms were developed to infer liner wear by estimating the separation between the acetabular cup and femoral component head given a computed tomography (CT) volume. Two series of CT volumes of a hip phantom were acquired with the femoral component head placed at 14 different positions relative to the acetabular cup. The mean and standard deviation (SD) of the diameter of the acetabular cup and femoral component head, in addition to the range of error in the expected wear values and the repeatability of all the measurements, were calculated. The algorithms resulted in a mean (±SD) for the diameter of the acetabular cup of 54.21 (±0.011) mm and for the femoral component head of 22.09 (±0.02) mm. The wear error was ±0.1 mm and the repeatability was 0.077 mm. This approach is applicable clinically as it utilizes readily available computed tomography imaging systems and requires only five minutes of human interaction.

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Takasago, Tomoya, Tomohiro Goto, Keizo Wada, Daisuke Hamada, Toshiyuki Iwame, Tetsuya Matsuura, Akihiro Nagamachi, and Koichi Sairyo. "Metallosis after Exchange of the Femoral Head and Liner following Ceramic Acetabular Liner Dissociation in Total Hip Arthroplasty with a Modular Layered Acetabular Component." Case Reports in Orthopedics 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/5301451.

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Анотація:

The type of bearing material that should be used in revision surgery after the failure of ceramic-on-ceramic total hip arthroplasty (THA) remains controversial. In the case of ceramic fracture, the residual ceramic particles can cause consequent metallosis when metal implants are used for revision THA. On the other hand, in the case of THA failure without ceramic fracture, revision THA with a metal femoral head provides satisfactory results. We report an unusual case of progressive osteolysis due to metallosis that developed after revision THA for ceramic liner dissociation without a liner fracture performed using a metal femoral head and polyethylene liner. The residual metal debris and abnormal pumping motion of the polyethylene liner due to the breakage of the locking system or the aspherical metal shell being abraded by the ceramic head seemed to be the cause of the progressive osteolysis.

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Saputra, Eko, Iwan Budiwan Anwar, J. Jamari, and Emile van der Heide. "A Bipolar Artificial Hip Joint Design for Contact Impingement Reduction." Advanced Materials Research 1123 (August 2015): 164–68. http://dx.doi.org/10.4028/www.scientific.net/amr.1123.164.

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The acetabular liner of an artificial hip joint (AHJ) is easily damaged locally in case of impingement, i.e. in case of contact of the liner wall with the stem neck, especially when it is made from relatively soft material such as ultra high molecular weight polyethylene (UHMWPE). Frequent impingement will severely damage the acetabular liner, requiring replacement of the AHJ. The aim of this study is to reduce AHJ impingement for specific combinations of flexion, internal rotation, and adduction of the thigh, by optimizing the design of the AHJ. The presented new design is based on modifying a conventional AHJ into a bipolar version with a higher free range of motion (RoM). Results show that the proposed design is able to prevent impingement for RoM. The latter range of motion corresponds well with the requirements of Shalat.

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Gill, Kathryn, Sarah L. Whitehouse, Matthew J. W. Hubble, and Matthew J. Wilson. "Short-Term Results with a Constrained Acetabular Liner in Patients at High Risk of Dislocation after Primary Total Hip Arthroplasty." HIP International 26, no. 6 (August 10, 2016): 580–84. http://dx.doi.org/10.5301/hipint.5000396.

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Background Dislocation following primary total hip arthroplasty (THA) is a complication with an incidence of 2%-5%. This study examines the clinical and radiological outcome of a constrained acetabular implant used in primary THA in high-risk patients to prevent dislocation. Methods 54 patients with 55 constrained implants for primary THA were reviewed clinically and radiologically. Oxford, Harris Hip and Charlson scores were recorded. Results 54 patients, with an average age of 83.2 years, were followed up at a mean of 44.9 (20-74) months. 38 had an hydroxyapatite- (HA) coated acetabular shell with a constrained insert and 17 had a cemented constrained implant. The median Charlson score at surgery was 5 (4-10). There were significant improvements in Oxford, Harris hip pain and function scores and Charnley pain after surgery. 2 patients had radiolucent lines on the most recent radiograph. Neither was symptomatic and the acetabular components had not migrated. 3 patients developed postoperative infection, 1 deep requiring a 2-stage revision. Of the 29 patients who died, 1 required revision 2 months following surgery for dislocation of the constrained liner. This patient died 26 months later from unrelated causes having had no further complications from her surgery. There have been no further revisions or reoperations for dislocation in any of the other cases. Conclusions The use of a constrained acetabular liner at primary THA in high risk patients for dislocation can successfully prevent this complication without increasing component loosening. In this series of 55 constrained implants we have a postoperative dislocation rate of 1.8%.

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Vogel, Danny, Christian Schulze, Henry Dempwolf, Daniel Kluess, and Rainer Bader. "Biomechanical behavior of modular acetabular cups made of poly-ether-ether-ketone: A finite element study." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 232, no. 10 (September 5, 2018): 1030–38. http://dx.doi.org/10.1177/0954411918797600.

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Анотація:

After total hip arthroplasty, stress-shielding is a potential risk factor for aseptic loosening of acetabular cups made of metals. This might be avoided by the use of acetabular cups made of implant materials with lower stiffness. The purpose of this numerical study was to determine whether a modular acetabular cup with a shell made of poly-ether-ether-ketone or poly-ether-ether-ketone reinforced with carbon fibers might be an alternative to conventional metallic shells. Therefore, the press-fit implantation of modular cups with shells made of different materials (Ti6Al4V, poly-ether-ether-ketone, and poly-ether-ether-ketone reinforced with carbon fibers) and varying liner materials (ceramics and ultra-high-molecular-weight polyethylene) into an artificial bone cavity was simulated using finite element analysis. The shell material had a major impact on the radial shell deformation determined at the rim of the shell, ranging from 17.9 µm for titanium over 92.2 µm for poly-ether-ether-ketone reinforced with carbon fibers up to 475.9 µm for poly-ether-ether-ketone. Larger radial liner deformations (up to 618.4 µm) occurred in combination with the shells made of poly-ether-ether-ketone compared to titanium and poly-ether-ether-ketone reinforced with carbon fibers. Hence, it can be stated that conventional poly-ether-ether-ketone is not a suitable shell material for modular acetabular cups. However, the radial shell deformation can be reduced if the poly-ether-ether-ketone reinforced with carbon fiber material is used, while deformation of ceramic liners is similar to the deformation in combination with titanium shells.

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47

Jamari, J., Eko Saputra, Iwan Budiwan Anwar, and Emile van der Heide. "Study of an Additional Layer of Cement Mantle Hip Joints for Reducing Cracks." Journal of Functional Biomaterials 10, no. 3 (September 6, 2019): 40. http://dx.doi.org/10.3390/jfb10030040.

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Анотація:

Failure of the cement mantle in total hip arthroplasty is not a simple phenomenon. Cracking, which can be caused by crack initiation and repeated loading, can cause loosening of the acetabular liner component. A previous study showed that addition of a metal layer between the liner and acetabular could reduce the stress at the contact surface of the cement mantle. This study elaborates on the performance of the additional layer. Several material properties of the layer were simulated using finite element analysis for maximum performance. A static contact analysis was used to simulate the stresses at the contact surface of the cement mantle. The results show that an additional layer of cobalt chrome produced the best performance.

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48

Glenn, Grayson T., Andrew E. Apple, Simon C. Mears, C. Lowry Barnes, Benjamin M. Stronach, Eric R. Siegel, and Jeffrey B. Stambough. "Articulating Hip Spacers with a Constrained Acetabular Liner: Effect of Acetabular Bone Loss and Cementation Quality." Antibiotics 12, no. 9 (August 30, 2023): 1384. http://dx.doi.org/10.3390/antibiotics12091384.

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Articulating hip spacers for periprosthetic joint infection (PJI) offer numerous advantages over static spacers such as improved patient mobilization, hip functionality, and soft tissue tension. Our study aimed to determine complication rates of a functional articulating spacer using a constrained liner to determine the role of acetabular cementation mantle and bone loss on the need for second-stage surgery. A retrospective review of 103 patients was performed and demographic information, spacer components and longevity, spacer-related complications, reinfection rates, and grade of bone loss and acetabular cement mantle quality were determined. There was no significant difference in spacer-related complications or reinfection rate between PJI and native hip infections. 33 of 103 patients (32.0%) elected to retain their spacers. Between patients who retained their initial spacer and those who underwent reimplantation surgery, there was not a significant difference in cement mantle grade (p = 0.52) or degree of bone loss (p = 0.78). Functional articulating antibiotic spacers with cemented constrained acetabular liners demonstrate promising early results in the treatment of periprosthetic and native hip infections. The rate of dislocation events was low. Further efforts to improve cement fixation may help decrease the need for second-stage reimplantation surgery.

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49

TANABE, Y., T. UCHIYAMA, H. YAMAOKA, and H. OHASHI. "LOAD TRANSMISSION THROUGH ARTIFICIAL HIP JOINTS DUE TO STRESS WAVE LOADING." International Journal of Modern Physics B 22, no. 09n11 (April 30, 2008): 1789–94. http://dx.doi.org/10.1142/s0217979208047420.

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Since wear of the polyethylene (Ultra High Molecular Weight Polyethylene or UHMWPE) acetabular cup is considered to be the main cause of loosening of the artificial hip joint, the cross-linked UHMWPE with high durability to wear has been developed. This paper deals with impact load transmission through the complex of an artificial hip joint consisting of a UHMWPE acetabular cup (or liner), a metallic femoral head and stem. Impact compressive tests on the complex were performed using the split-Hopkinson pressure bar apparatus. To investigate the effects of material (conventional or cross-linked UHMWPE), size and setting angle of the liner, and test temperature on force transmission, the impact load transmission ratio (ILTR) was experimentally determined. The ILTR decreased with an increase of the setting angle independent of material and size of the liner, and test temperature. The ILTR values at 37°C were larger than those at 24 °C and 60°C. The ILTR also appeared to be affected by the type of material as well as size of the liner.

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50

Pritchett, James W. "Hip resurfacing with a highly cross-linked polyethylene acetabular liner and a titanium nitride-coated femoral component." HIP International 28, no. 4 (May 7, 2018): 422–28. http://dx.doi.org/10.1177/1120700017752334.

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Aims: This study evaluated a specific hip resurfacing system to determine the: (1) function and complications, (2) implant survivorship, (3) acetabular bone conservation and joint biomechanics and (4) osteolysis and polyethylene wear. Methods: I performed 234 resurfacing procedures (192 patients) using a two-piece titanium acetabular component with a 4 mm highly cross-linked polyethylene liner and a cementless titanium nitride-coated titanium femoral component. Function was assessed with Harris Hip, WOMAC, SF-12, and UCLA scores. Radiography and CT scans were used to evaluate bone retention, component position, joint biomechanics, and osteolysis. Retrieved polyethylene liners were analyzed for wear. Results: Median follow-up was 8 years and patients averaged 48 years of age at surgery. The mean Harris Hip Score was 96 and all scores improved significantly. Kaplan-Meier survivorship was 97%. The mean medial acetabular thickness was 9 mm postoperatively versus 14 mm preoperatively ( p = 0.019). Femoral bone conservation (head:neck ratio) was 1.36 postoperatively versus 1.42 preoperatively ( p = 0.02). There was no polyethylene wear through or osteolysis. Eight polyethylene retrievals had a mean wear of 0.05 mm/yr. Conclusions: Resurfacing with a highly cross-linked polyethylene acetabular component and a titanium nitride-coated titanium cementless femoral component is a reliable and bone-conserving procedure at mid-term.

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