• Title/Summary/Keyword: Acetabular cup

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A Study on Computer Aided Surgical Simulation Method for Total Hip Arthroplasty (컴퓨터 응용 인공고관절 모사 시술 방법 연구)

  • Kim Sang Hoo;Han Seung Moo
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.455-464
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    • 2004
  • Total hip arthroplasty(THA) considerably depends on high-experienced doctors because of high difficulty of the operation. Selection of acetabular cup's and femoral implant's position is closely related with success or failure of THA. Nevertheless the selection has usually depended on doctor's eye measurement, which makes the position accuracy of artificial joint lower after THA, often resulting in revision of THA. The present study determined a method to select accurately the position of acetabular cup and femoral implant through surgical simulation with 3D characteristic geometrical information of patient's pelvis and femur. We examined the change of femoral anteversion angle and neck-shaft angle accompanied by the change of acetabular cup's position and the insertion position of femoral implant. As result of analyzing geometrical information through different surgical simulations, we found that it was possible to select the accurate position of acetabular cup and femoral implant. It is expected to help doctors get experienced in THA operation through repetitive surgical simulations using the method suggested in the study.

3-D Finite Element Analysis of Acetabular Reconstruction of THR (인공고관절 전치환술에 있어서 비구 재건 술에 관한 3차원 유한요소해석)

  • Ryu, J.C.;Mun, M.S.;Kim, G.S.;Yoo, M.C.
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.11
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    • pp.34-38
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    • 1995
  • Using a 3-D finite element method (FEM), the biomechanical characteristics of a threaded truncated acetabular component and a porous coated hemispherical acetabular component were studied. The Von-Mises stress/strain patterns in the acetabulum reconstructed with these two different types of cementless acetabular cups were investigated. The geometry and dimensions of human hemi-pelvis used in the present shape modeling for finite element analysis were scanned with a 3-D laser scanner(TDS-9000, Cyberware, USA). The scanned data was numerically handled with a shape modelling software 'Pro-Engineer'. Using 19836, 16853 tetrahedral elements, respectively, the stress and displacement field of the acetabulum reconstructed with the two different types of the acetabular components were computed. While the hemi-sphere component was found to show a relatively similar stress/strain patterns to those in the normal hip, the results with the threaded cup showed a considerably different patterns from those in the normal condition. Several regions in cancellous bone near the threads and the edge of the truncated cup was found to be overstressed, especially in the superior-lateral part of the acetabulum. It was postulated that the excessive reaming-out of subchondral bone layer when the truncated cup was used can cause the presence of these overstressed regions of cancellous bone. This theoretical prediction for the implanted acetabulum appeared to consistent with the pathological observation of proximal/medial migration of the threaded truncated acetabular prostheses in the previous publications.

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Total Hip Replacement in a Jindo Dog with Dorsal Acetabular Rim Deficiency: a Case Report (등쪽 관골절구 결손을 가진 진도견의 인공 대퇴 관절 전치환술)

  • Heo, Su-Young;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.121-124
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    • 2014
  • A 7-year-old, intact female Jindo dog was presented for assessment of weight-bearing lameness of the right hindlimb. On physical examination, crepitus and pain was noted in the right coxofemoral joint upon extension. Radiographs revealed a craniodorsal luxation of the right coxofemoral joint and degenerative joint disease (DJD) of both coxofemoral joints. Total hip replacement (THR) was performed for the right coxofemoral joint. Intraoperatively, dorsal acetabular rim (DAR) deficiency was noted, which can be related to a high risk for acetabular cup implant dislocation. Deficiency of the dorsal acetabular rim realigned with the acetabular cup using universal locking plate (ULP) and polymethylmethacrylate (PMMA) bone cement. After surgery, the patient had an uneventful course and a successful outcome. The ROM and thigh girth were dramatically improved. There were no complications associated with prosthesis implants. Hip luxation with dorsal acetabular rim deficiency in a dog was successfully repaired with THR and dorsal acetabular rim augmentation using ULP and PMMA bone cement. This technique should be considered when conventional THR is precluded by dorsal acetabular rim deficiency.

A FEM Analysis for Acetabular Component with Negative Poisson's Ratio in Total Hip Arthroplasty

  • 최재봉
    • Computational Structural Engineering
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    • v.8 no.4
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    • pp.17-23
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    • 1995
  • Based on the present FEM study for negative Poisson's-ratio UHMWPE, the following conclusions seem expected. 1) Negative Poisson's-ratio UHMWPE transfers less stresses to the subchondral or peripheral iliac bone, compared to the conventional UHMWPE with Poission's-ratio. 2) Negative Poisson's-ratio cup reduces stresses in UHMWPE cup itself as well as metal backing, and subchondral bone. 3) The reduction in periacetabular mechanical stresses would significantly reduce the rate of fatigue failure and consequently reduce the incidence of aseptic loosening of the cup due to wear or bone resorption.

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Total Hip Arthroplasty with Cemented Dual Mobility Cup into a Fully Porous Multihole Cup with Variable Angle Locking Screws for Acetabular Fractures in the Frail Elderly

  • Mathias van den Broek;Kris Govaers
    • Hip & pelvis
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    • v.35 no.1
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    • pp.54-61
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    • 2023
  • Purpose: The purpose was to examine the clinical and radiological outcomes after surgical treatment of acetabular fractures with total hip arthroplasty with a dual mobility cup cemented into a porous multihole cup in the population of frail elderly patients. Materials and Methods: A retrospective review of 16 patients who underwent surgery (mean age, 76.7 years) with a mean follow-up period of 36.9 months was conducted. Following surgery, patients underwent postoperative follow-up at six weeks, three, six, and 12 months and clinical and radiological examinations were performed. Results: Classification of fractures was based on the Letournel classification. Following surgery, all patients were allowed weight-bearing as tolerated immediately postoperative. Fourteen patients showed maintenance of preoperative mobility status at one year. The mean Harris hip score was 64.8 (range, 34.7-82.8) and 80.0 (range, 60.8-93.8) at three months and one year, respectively. The mortality rate was 12.5% at one year (2/16). Complications included heterotopic ossification (2/16), deep venous thrombosis (1/16), heamatoma (1/16), and femoral revision due to a Vancouver B2 fracture (1/16). No case of deep infection, dislocation, or implant loosening was reported. Conclusion: Total hip arthroplasty using a dual mobility cup cemented into a porous multihole cup with locking screws resulted in a stable construct with a capacity for immediate weight-bearing as tolerated with rapid relief of pain. The findings of this study suggest that this procedure can be regarded as a safe method that has shown promising clinical and radiological outcomes for treatment of patients with medical frailty.

Total Hip Replacement for Treatment of Chronic Coxofemoral Joint Dislocation in 7 Dogs

  • Yoon, Jang-Won;Heo, Su-Young;Jeong, Seong-Mok;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.36 no.4
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    • pp.229-232
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    • 2019
  • Total Hip Replacement in a patient with chronic coxofemoral joint dislocation is a challenging problem because chronic coxofemoral joint dislocation causes severe morphological changes. These challenging factors make surgery more difficult and increase the possibility of postoperative complications including cup implant dislocation and prosthetic joint luxation. All patients were diagnosed having at least 2 months of coxofemoral joint dislocation. On physical examination, crepitus was noted in the coxofemoral joint. Radiographs revealed hip joint dislocation with mild to severe degenerative changes. Total hip replacement was planned for all patients. Dorsal acetabular rim deficiency in 3 cases was augmented using a locking plate and polymethylmethacrylate bone cement. All cases have shown difficulty in prosthetic joint reduction. Pectineus and rectus femoris muscle origin were released in all cases. At 12 months follow up, all patients showed satisfactory ambulation. The issues on perioperative prosthetic joint reduction and luxation due to chronic coxofemoral joint luxation with muscle contracture and dorsal acetabular rim deficiency can be resolved by muscle releasing and dorsal acetabular rim augmentation.

Simulation of tissue differentiation around acetabular cups: the effects of implant-bone relative displacement and polar gap

  • Mukherjee, Kaushik;Gupta, Sanjay
    • Advances in biomechanics and applications
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    • v.1 no.2
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    • pp.95-109
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    • 2014
  • Peri-acetabular bone ingrowth plays a crucial role in long-term stability of press-fit acetabular cups. A poor bone ingrowth often results in increased cup migration, leading to aseptic loosening of the implant. The rate of peri-prosthetic bone formation is also affected by the polar gap that may be introduced during implantation. Applying a mechano-regulatory tissue differentiation algorithm on a two-dimensional plane strain microscale model, representing implant-bone interface, the objectives of the study are to gain an insight into the process of peri-prosthetic tissue differentiation and to investigate its relationship with implant-bone relative displacement and size of the polar gap. Implant-bone relative displacement was found to have a considerable influence on bone healing and peri-acetabular bone ingrowth. An increase in implant-bone relative displacement from $20{\mu}m$ to $100{\mu}m$ resulted in an increase in fibrous tissue formation from 22% to 60% and reduction in bone formation from 70% to 38% within the polar gap. The increase in fibrous tissue formation and subsequent decrease in bone formation leads to weakening of the implant-bone interface strength. In comparison, the effect of polar gap on bone healing and peri-acetabular bone ingrowth was less pronounced. Polar gap up to 5 mm was found to be progressively filled with bone under favourable implant-bone relative displacements of $20{\mu}m$ along tangential and $20{\mu}m$ along normal directions. However, the average Young's modulus of the newly formed tissue layer reduced from 2200 MPa to 1200 MPa with an increase in polar gap from 0.5 mm to 5 mm, suggesting the formation of a low strength tissue for increased polar gap. Based on this study, it may be concluded that a polar gap less than 0.5 mm seems favourable for an increase in strength of the implant-bone interface.

Ceramic-Ceramic Wear Zirconia/Alumina Composites For The Application Of Total Hip Joint Implant (인공 고관절 골두용 세라믹 복합재료에 대한 세라믹-세라믹 접촉 마멸 특성 분석)

  • Kim H.;Lee K.Y.;Kim D. J.;Lee M. H.;Seo W. S.
    • Proceedings of the Korean Society of Tribologists and Lubrication Engineers Conference
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    • 2004.11a
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    • pp.355-361
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    • 2004
  • Ceramic femoral heads in the total hip replacement have been developed to reduce the polyethylene liner wear, Alumina and zirconia (3Y-TZP) having the excellent tribological properties are coupled against acetabular cups of polyethylene and are used in clinical application worldwide. However, alumina has a risk of catastrophic failure, and zirconia has the low temperature degradation in spite of enhanced fracture toughness. Recently, novel zirconia/alumina composite is very attractive due to the low temperature degradation (LTD)-free character and high fracture toughness. In the present study, we focus on the wear of ceramic on ceramic, which are able to be used as femoral heads and acetabular cups. Therefore, LTD-free zirconia/alumina composites with three compositions are made in a form of disk and cylinder, and the wear of the composites is performed on pin-on-disk type wear tester. The wear is conducted with or without lubricant. All the composites fabricated with the different composition show the good wear resistance.

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Pseudotumor and Subsequent Implant Loosening as a Complication of Revision Total Hip Arthroplasty with Ceramic-on-Metal Bearing: A Case Report

  • Naik, Lokesh Gudda;Shon, Won Yong;Clarke, I.C.;Moon, Jun-Gyu;Mukund, Piyush;Kim, Sang-Min
    • Hip & pelvis
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    • v.30 no.4
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    • pp.276-281
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    • 2018
  • Pseudotumors are not uncommon complications after total hip arthroplasty (THA) and may occur due to differences in bearing surfaces of the head and the liner ranging from soft to hard articulation. The most common causes of pseudotumors are foreign-body reaction, hypersensitivity and wear debris. The spectrum of pseudotumor presentation following THA varies greatly-from completely asymptomatic to clear implant failure. We report a case of pseudo-tumor formation with acetabular cup aseptic loosening after revision ceramic-on-metal hip arthroplasty. The patient described herein underwent pseudotumor excision and re-revision complex arthroplasty using a trabecular metal shell and buttress with ceramic-on-polyethylene THA. Surgeons should be aware of the possibility of a pseudotumor when dealing with revisions to help prevent rapid progression of cup loosening and implant failure, and should intervene early to avoid complex arthroplasty procedures.