In revision total hip arthroplasty, until today, orthopaedic surgeons are missing evidence-based guidelines on cementless acetabular cup fixation.
5 finite element models were generated featuring the following anchorage strategies: 1 short peg, 1 long peg, 2 long screws, 3 short screws and zero anchoring components for reference. The micromotions at the implant-bone interface were analyzed for 3 different loadcases, “Seated leg-crossing” (joint force 940 N, impingement force 750 N), “Normal gait” (joint force 1820 N), and “Stumbling” (joint force 4520 N).
Within the same loadcase, percentages of interface area below 28 µm are nearly identical in all anchorage strategies. The average percentage of interface area below 28 µm is 31% for “Seated leg-crossing”, 17% for “Normal gait”, and 11% for “Stumbling”. Maximal von Mises stresses in “Normal gait”, for example, reach 12 MPa in the short peg, 48 MPa in the long peg, 15 MPa in 1 of the 2 long screws, and 85 MPa in 1 of the 3 short screws.
Common orthopaedic practice, to use peg or screw fixation alternatively according to bone availability or other clinical aspects, can be confirmed. The short peg may be a good alternative to the long peg with regard to the preservation of bone stock. However, the current study implies that the extent of potential osseointegration depends less on the chosen anchorage strategy but strongly on postoperative loading conditions. Total hip patients should be instructed on adequate postoperative activities.
Hip Int 2016; 26(6): 591 - 597
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsChristian Voigt, Andreas Schaller, Carsten Klöhn, Roger Scholz
- • Accepted on 30/03/2016
- • Available online on 15/10/2016
- • Published in print on 10/11/2016
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- Voigt, Christian [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Schaller, Andreas [PubMed] [Google Scholar] 1
- Klöhn, Carsten [PubMed] [Google Scholar] 2
- Scholz, Roger [PubMed] [Google Scholar] 1
Department of Orthopaedic, Trauma and Plastic Surgery, Laboratory for Biomechanics, Leipzig University, Leipzig - Germany
Faculty of Mechanical and Power Engineering, Leipzig University of Applied Sciences (HTWK), Leipzig - Germany