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Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study

BACKGROUND: The primary stability of the acetabular cup (AC) implant is an important determinant for the long term success of cementless hip surgery. However, it remains difficult to assess the AC implant stability due to the complex nature of the bone-implant interface. A compromise should be found...

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Autores principales: Michel, Adrien, Bosc, Romain, Meningaud, Jean-Paul, Hernigou, Philippe, Haiat, Guillaume
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125605/
https://www.ncbi.nlm.nih.gov/pubmed/27893757
http://dx.doi.org/10.1371/journal.pone.0166778
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author Michel, Adrien
Bosc, Romain
Meningaud, Jean-Paul
Hernigou, Philippe
Haiat, Guillaume
author_facet Michel, Adrien
Bosc, Romain
Meningaud, Jean-Paul
Hernigou, Philippe
Haiat, Guillaume
author_sort Michel, Adrien
collection PubMed
description BACKGROUND: The primary stability of the acetabular cup (AC) implant is an important determinant for the long term success of cementless hip surgery. However, it remains difficult to assess the AC implant stability due to the complex nature of the bone-implant interface. A compromise should be found when inserting the AC implant in order to obtain a sufficient implant stability without risking bone fracture. The aim of this study is to evaluate the potential of impact signals analyses to assess the primary stability of AC implants inserted in cadaveric specimens. METHODS: AC implants with various sizes were inserted in 12 cadaveric hips following the same protocol as the one employed in the clinic, leading to 86 different configurations. A hammer instrumented with a piezoelectric force sensor was then used to measure the variation of the force as a function of time produced during the impact between the hammer and the ancillary. Then, an indicator I was determined for each impact based on the impact momentum. For each configuration, twelve impacts were realized with the hammer, the value of the maximum amplitude being comprised between 2500 and 4500 N, which allows to determine an averaged value I(M) of the indicator for each configuration. The pull-out force F was measured using a tangential pull-out biomechanical test. RESULTS: A significant correlation (R(2) = 0.69) was found between I(M) and F when pooling all data, which indicates that information related to the AC implant biomechanical stability can be retrieved from the analysis of impact signals obtained in cadavers. CONCLUSION: These results open new paths in the development of a medical device that could be used in the future in the operative room to help orthopedic surgeons adapt the surgical protocol in a patient specific manner.
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spelling pubmed-51256052016-12-15 Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study Michel, Adrien Bosc, Romain Meningaud, Jean-Paul Hernigou, Philippe Haiat, Guillaume PLoS One Research Article BACKGROUND: The primary stability of the acetabular cup (AC) implant is an important determinant for the long term success of cementless hip surgery. However, it remains difficult to assess the AC implant stability due to the complex nature of the bone-implant interface. A compromise should be found when inserting the AC implant in order to obtain a sufficient implant stability without risking bone fracture. The aim of this study is to evaluate the potential of impact signals analyses to assess the primary stability of AC implants inserted in cadaveric specimens. METHODS: AC implants with various sizes were inserted in 12 cadaveric hips following the same protocol as the one employed in the clinic, leading to 86 different configurations. A hammer instrumented with a piezoelectric force sensor was then used to measure the variation of the force as a function of time produced during the impact between the hammer and the ancillary. Then, an indicator I was determined for each impact based on the impact momentum. For each configuration, twelve impacts were realized with the hammer, the value of the maximum amplitude being comprised between 2500 and 4500 N, which allows to determine an averaged value I(M) of the indicator for each configuration. The pull-out force F was measured using a tangential pull-out biomechanical test. RESULTS: A significant correlation (R(2) = 0.69) was found between I(M) and F when pooling all data, which indicates that information related to the AC implant biomechanical stability can be retrieved from the analysis of impact signals obtained in cadavers. CONCLUSION: These results open new paths in the development of a medical device that could be used in the future in the operative room to help orthopedic surgeons adapt the surgical protocol in a patient specific manner. Public Library of Science 2016-11-28 /pmc/articles/PMC5125605/ /pubmed/27893757 http://dx.doi.org/10.1371/journal.pone.0166778 Text en © 2016 Michel et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Michel, Adrien
Bosc, Romain
Meningaud, Jean-Paul
Hernigou, Philippe
Haiat, Guillaume
Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study
title Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study
title_full Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study
title_fullStr Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study
title_full_unstemmed Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study
title_short Assessing the Acetabular Cup Implant Primary Stability by Impact Analyses: A Cadaveric Study
title_sort assessing the acetabular cup implant primary stability by impact analyses: a cadaveric study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125605/
https://www.ncbi.nlm.nih.gov/pubmed/27893757
http://dx.doi.org/10.1371/journal.pone.0166778
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