Is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models?
Abstract Background In revision surgery with significant segmental acetabular defects, adequate implant selection and fixation methods are critical in determining successful bony ingrowth. Commercially available total hip prosthesis manufacturers generally offer additional multi-hole options of acet...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-05-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03845-y |
| _version_ | 1827948052336345088 |
|---|---|
| author | Ho-Jin Nam Young-Wook Lim Woo-Lam Jo Ji Hoon Bahk Soon-Yong Kwon Hyung Chul Park Saad Mohammed AlShammari |
| author_facet | Ho-Jin Nam Young-Wook Lim Woo-Lam Jo Ji Hoon Bahk Soon-Yong Kwon Hyung Chul Park Saad Mohammed AlShammari |
| author_sort | Ho-Jin Nam |
| collection | DOAJ |
| description | Abstract Background In revision surgery with significant segmental acetabular defects, adequate implant selection and fixation methods are critical in determining successful bony ingrowth. Commercially available total hip prosthesis manufacturers generally offer additional multi-hole options of acetabular shells with identical designs for use in revision THAs where screw holes configurations vary from product to product. This study aims to compare the mechanical stability of the two types of acetabular screw constructs for the fixation of acetabular components: spread-out and pelvic brim-focused configurations. Methods We prepared 40 synthetic bone models of the male pelvis. In half of the samples with acetabular defects, identical curvilinear bone defects were manually created using an oscillating electrical saw. On the right side, multi-hole-cups in which the direction of the screw holes are centered on the pelvic brim (brim-focused) and, on the left side, multi-hole-cups with the direction of the screw hole spread throughout the acetabulum (spread-out) were implanted into the pelvic synthetic bones. Coronal lever-out and axial torsion tests were performed with a testing machine, measuring load versus displacement. Results The average torsional strengths were significantly higher in the spread-out group over the brim-focused group regardless of the presence of the segmental defect of the acetabulum (p < 0.001). But for the lever-out strength, the spread-out group exhibited significantly higher average strength over the brim-focused group for the intact acetabulum (p = 0.004), whereas the results were reversed in the brim-focused group when the defects were generated (p < 0.001). The presence of acetabular defects reduced the average torsional strengths of the two groups by 68.66% versus 70.86%. In comparison, the decrease in the average lever-out strength was less significant for the brim-focused group than the spread-out group (19.87% vs. 34.25%) (p < 0.001). Conclusion Constructs of multi-hole acetabular cups with the spread-out screw holes configuration exhibited statistically better axial torsional strength and coronal lever-out strength. With the presence of posterior segmental bone defects, the spread-out constructs demonstrated significantly better tolerance to axial torsional strength. Still, they exhibited inverted results of higher lever-out strength in the pelvic brim-focused constructs. |
| first_indexed | 2024-04-09T12:48:19Z |
| format | Article |
| id | doaj.art-5ac785c94f46482697b5cc4803e5e2a6 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T12:48:19Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-5ac785c94f46482697b5cc4803e5e2a62023-05-14T11:22:31ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-05-011811910.1186/s13018-023-03845-yIs the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models?Ho-Jin Nam0Young-Wook Lim1Woo-Lam Jo2Ji Hoon Bahk3Soon-Yong Kwon4Hyung Chul Park5Saad Mohammed AlShammari6Asan Catholic Orthopedic ClinicDepartment of Orthopaedic Surgery, School of Medicine, Seoul St. Mary’s Hospital, The Catholic University of KoreaDepartment of Orthopaedic Surgery, School of Medicine, Seoul St. Mary’s Hospital, The Catholic University of KoreaDepartment of Orthopaedic Surgery, School of Medicine, Bucheon St. Mary’s Hospital, The Catholic University of KoreaDepartment of Orthopaedic Surgery, School of Medicine, Seoul St. Mary’s Hospital, The Catholic University of KoreaDepartment of Orthopaedic Surgery, School of Medicine, Seoul St. Mary’s Hospital, The Catholic University of KoreaDepartment of Orthopaedic Surgery, King Abdulaziz Air Base Hospital, Ministry of Defence, 75M2+R7R, King Abdel Aziz Air BaseAbstract Background In revision surgery with significant segmental acetabular defects, adequate implant selection and fixation methods are critical in determining successful bony ingrowth. Commercially available total hip prosthesis manufacturers generally offer additional multi-hole options of acetabular shells with identical designs for use in revision THAs where screw holes configurations vary from product to product. This study aims to compare the mechanical stability of the two types of acetabular screw constructs for the fixation of acetabular components: spread-out and pelvic brim-focused configurations. Methods We prepared 40 synthetic bone models of the male pelvis. In half of the samples with acetabular defects, identical curvilinear bone defects were manually created using an oscillating electrical saw. On the right side, multi-hole-cups in which the direction of the screw holes are centered on the pelvic brim (brim-focused) and, on the left side, multi-hole-cups with the direction of the screw hole spread throughout the acetabulum (spread-out) were implanted into the pelvic synthetic bones. Coronal lever-out and axial torsion tests were performed with a testing machine, measuring load versus displacement. Results The average torsional strengths were significantly higher in the spread-out group over the brim-focused group regardless of the presence of the segmental defect of the acetabulum (p < 0.001). But for the lever-out strength, the spread-out group exhibited significantly higher average strength over the brim-focused group for the intact acetabulum (p = 0.004), whereas the results were reversed in the brim-focused group when the defects were generated (p < 0.001). The presence of acetabular defects reduced the average torsional strengths of the two groups by 68.66% versus 70.86%. In comparison, the decrease in the average lever-out strength was less significant for the brim-focused group than the spread-out group (19.87% vs. 34.25%) (p < 0.001). Conclusion Constructs of multi-hole acetabular cups with the spread-out screw holes configuration exhibited statistically better axial torsional strength and coronal lever-out strength. With the presence of posterior segmental bone defects, the spread-out constructs demonstrated significantly better tolerance to axial torsional strength. Still, they exhibited inverted results of higher lever-out strength in the pelvic brim-focused constructs.https://doi.org/10.1186/s13018-023-03845-yConstruct stabilityRevision hip surgeryTorsional strengthLever-out strength |
| spellingShingle | Ho-Jin Nam Young-Wook Lim Woo-Lam Jo Ji Hoon Bahk Soon-Yong Kwon Hyung Chul Park Saad Mohammed AlShammari Is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models? Journal of Orthopaedic Surgery and Research Construct stability Revision hip surgery Torsional strength Lever-out strength |
| title | Is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models? |
| title_full | Is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models? |
| title_fullStr | Is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models? |
| title_full_unstemmed | Is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models? |
| title_short | Is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models? |
| title_sort | is the construct stability of the acetabular cup affected by the acetabular screw configuration in bone defect models |
| topic | Construct stability Revision hip surgery Torsional strength Lever-out strength |
| url | https://doi.org/10.1186/s13018-023-03845-y |
| work_keys_str_mv | AT hojinnam istheconstructstabilityoftheacetabularcupaffectedbytheacetabularscrewconfigurationinbonedefectmodels AT youngwooklim istheconstructstabilityoftheacetabularcupaffectedbytheacetabularscrewconfigurationinbonedefectmodels AT woolamjo istheconstructstabilityoftheacetabularcupaffectedbytheacetabularscrewconfigurationinbonedefectmodels AT jihoonbahk istheconstructstabilityoftheacetabularcupaffectedbytheacetabularscrewconfigurationinbonedefectmodels AT soonyongkwon istheconstructstabilityoftheacetabularcupaffectedbytheacetabularscrewconfigurationinbonedefectmodels AT hyungchulpark istheconstructstabilityoftheacetabularcupaffectedbytheacetabularscrewconfigurationinbonedefectmodels AT saadmohammedalshammari istheconstructstabilityoftheacetabularcupaffectedbytheacetabularscrewconfigurationinbonedefectmodels |