A hierarchy of computationally derived surgical and patient influences on metal on metal press-fit acetabular cup failure

Abstract The impact of anatomical variation and surgical error on excessive wear and loosening of the acetabular component of large diameter metal-on-metal hip arthroplasties was measured using a multi-factorial analysis through 112 different simulations. Each surgical scenario was subject to eight...

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Bibliographic Details
Published in:Journal of biomechanics 2012-06, Vol.45 (9), p.1698-1704
Main Authors: Clarke, S.G, Phillips, A.T.M, Bull, A.M.J, Cobb, J.P
Format: Article
Language:English
Subjects:
Acetabulum - surgery
Adult
Aged
Arthroplasty, Replacement, Hip - adverse effects
Biological and medical sciences
Cementless acetabular cup
Computer Simulation
Computerized, statistical medical data processing and models in biomedicine
Contact
Error analysis
Failure
Female
Finite Element Analysis
Hip replacement
Humans
Influence
Loosening
Male
Materials Testing
Medical Errors
Medical sciences
Metals
Middle Aged
Modelling
Models and simulation
Orthopaedic surgery
Orthopedic surgery
Patients
Personal relationships
Physical Medicine and Rehabilitation
Prosthesis Failure
Studies
Success
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgical implants
Wear
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Summary:Abstract The impact of anatomical variation and surgical error on excessive wear and loosening of the acetabular component of large diameter metal-on-metal hip arthroplasties was measured using a multi-factorial analysis through 112 different simulations. Each surgical scenario was subject to eight different daily loading activities using finite element analysis. Excessive wear appears to be predominantly dependent on cup orientation, with inclination error having a higher influence than version error, according to the study findings. Acetabular cup loosening, as inferred from initial implant stability, appears to depend predominantly on factors concerning the area of cup–bone contact, specifically the level of cup seating achieved and the individual patient's anatomy. The extent of press fit obtained at time of surgery did not appear to influence either mechanism of failure in this study.
ISSN:0021-9290
1873-2380
DOI:10.1016/j.jbiomech.2012.03.026