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J Clin Med. 2021 Sep 04;10(17). doi: 10.3390/jcm10174002.

Primary Stability in Hip Revision Arthroplasty: Comparison of the Stability of Cementless Fixed Augments on a Modular Acetabular Cage System with and without Cranial Straps.

Journal of clinical medicine

Max Jaenisch, Hendrik Kohlhof, Dieter Christian Wirtz, Frank Alexander Schildberg, Nicholas A Beckmann, Jan Philippe Kretzer, Mareike Schonhoff, Sebastian Jäger

Affiliations

  1. Department for Orthopaedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany.
  2. Laboratory of Biomechanics and Implant Research, Clinic for Orthopaedics and Trauam Surgery, Heidelberg University Hospital, 69118 Heidelberg, Germany.

PMID: 34501450 PMCID: PMC8432542 DOI: 10.3390/jcm10174002

Abstract

The goal of this study is to evaluate the primary stability of a cementless augment-and-modular-cage system with and without the addition of cranial straps in a standardized in vitro setting. As the surrogate parameter for the evaluation of primary stability, the measurement of relative motion between the implant components themselves and the bone will be used. Acetabular revision components with a trabecular titanium augment in combination with a large fourth-generation composite left hemipelvis were assembled. These constructs were divided into two groups with (S) and without cranial straps (nS). A total of 1000 cycles was applied at each of three load levels. Relative movements (RM) between the components were measured. Load levels display a significant effect on the amount of RM at all interfaces except between shell/augment. The group assignment appears to have an effect on RM due to significantly differing means at all interfaces. Between bone/shell RM increased as load increased. NS displayed significantly more RM than S. Between shell/augment RM remained constant as load increased. Between shell/cup S showed more RM than nS while both groups' RM increased with load. We conclude a significant increase of primary stability between the shell and the bone through the addition of cranial straps. Relative motion between components (shell/cup) increases through the addition of cranial straps. A clinical impact of this finding is uncertain and requires further investigation. Finally, the cementless fixation of the augment against the rim-portion of the shell appears stable and compares favorably to prior investigation of different fixation techniques.

Keywords: arthroplasty; augment; cementless; cranial strap; hip; modular; revision

References

  1. Behav Res Methods. 2009 Nov;41(4):1149-60 - PubMed
  2. Iowa Orthop J. 2015;35:99-107 - PubMed
  3. J Arthroplasty. 1994 Feb;9(1):33-44 - PubMed
  4. J Biomech. 2016 Feb 29;49(4):537-42 - PubMed
  5. J Bone Joint Surg Br. 2011 Mar;93(3):293-7 - PubMed
  6. Arch Orthop Trauma Surg. 2014 Aug;134(8):1167-73 - PubMed
  7. Z Orthop Unfall. 2020 Aug;158(4):369-382 - PubMed
  8. J Arthroplasty. 1991 Dec;6(4):295-300 - PubMed
  9. Clin Orthop Relat Res. 2016 Feb;474(2):432-40 - PubMed
  10. Arch Orthop Trauma Surg. 2020 Jun;140(6):815-825 - PubMed
  11. J Biomech. 2001 Jul;34(7):859-71 - PubMed
  12. J Bone Joint Surg Br. 1996 Mar;78(2):270-5 - PubMed
  13. J Arthroplasty. 1993 Aug;8(4):341-6 - PubMed
  14. Orthopedics. 2017 Jan 1;40(1):e195-e198 - PubMed
  15. Int Orthop. 2013 Apr;37(4):605-10 - PubMed
  16. Clin Orthop Relat Res. 1986 Jul;(208):108-13 - PubMed
  17. Bone Joint Res. 2018 May 5;7(4):282-288 - PubMed
  18. Health Policy. 2018 May;122(5):548-557 - PubMed
  19. Orthopedics. 2014 Jul;37(7):e637-43 - PubMed
  20. J Bone Joint Surg Br. 1994 Jul;76(4):568-74 - PubMed
  21. Hip Int. 2016 May 16;26(3):307-9 - PubMed
  22. PLoS One. 2016 May 19;11(5):e0155612 - PubMed
  23. J Arthroplasty. 2017 May;32(5):1679-1683 - PubMed
  24. Bone Joint J. 2013 Feb;95-B(2):166-72 - PubMed
  25. Int Orthop. 2018 Aug;42(8):1811-1818 - PubMed
  26. Clin Orthop Relat Res. 1992 Dec;(285):129-39 - PubMed
  27. J Bone Joint Surg Am. 1990 Dec;72(10):1536-40 - PubMed
  28. Int Orthop. 2019 Oct;43(10):2269-2278 - PubMed
  29. Biomed Mater Eng. 2010;20(2):65-75 - PubMed
  30. Clin Orthop Relat Res. 1992 Dec;(285):13-29 - PubMed

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