Impaction technique influences implant stability in low density bone model
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Published version
Author(s)
Doyle, Ruben
van Arkel, Richard
Muirhead-Allwood, Sarah
Jeffers, Jonathan
Type
Journal Article
Abstract
Aims: Cementless acetabular cups rely on press-fit fixation for initial stability. In certain cases initial stability is more difficult to obtain (such as during revision). No current study evaluates how a surgeon’s impaction technique (mallet mass, mallet velocity and number of strikes) may affect cup fixation. This study seeks to answer the following research questions:(1) How does impaction technique affect a) bone strain generation and deterioration (and hence implant stability); b) seating in different density bones? (2) Can an impaction technique be recommended to minimize risk of implant loosening while ensuring seating of the acetabular cup? Methods: A custom drop tower was used to simulate surgical strikes seating acetabular cups into synthetic bone. Strike velocity and drop mass were varied. Synthetic bone strain was measured using strain gauges and stability was assessed via push out tests. Polar gap was measured using optical trackers. Results: A phenomenon of strain deterioration was identified if an excessive number of strikes were used to seat a cup. This effect was most pronounced in low density bone at high strike velocities. Polar gap was reduced with increasing strike mass and velocity. Conclusions: A high mallet mass with low strike velocity resulted in satisfactory implant stability and polar gap while minimizing the risk of losing stability due to over-striking. Extreme caution not to over-strike must be exercised when using high velocity strikes in low density bone for any mallet
Date Issued
2020-07-01
Date Acceptance
2020-02-11
Citation
Bone & Joint Research, 2020, 9 (7)
ISSN
2046-3758
Publisher
The British Editorial Society of Bone & Joint Surgery
Journal / Book Title
Bone & Joint Research
Volume
9
Issue
7
Copyright Statement
© 2020 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/.
Sponsor
Engineering & Physical Science Research Council (EPSRC)
Wellcome Trust
Engineering & Physical Science Research Council (EPSRC)
Engineering & Physical Science Research Council (EPSRC)
Grant Number
EP/K027549/1
208858/Z/17/Z
EP/R042721/1
EP/S022546/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Cell & Tissue Engineering
Orthopedics
Cell Biology
Implant
Stability
Fixation
CEMENTLESS ACETABULAR CUP
PRESS-FIT
INITIAL STABILITY
HIP-ARTHROPLASTY
DEFORMATION
COMPONENT
INSERTION
FIXATION
MICROMOTION
STIFFNESS
Fixation
Implant
Stability
1103 Clinical Sciences
1106 Human Movement and Sports Sciences
Publication Status
Published
Date Publish Online
2020-07-23