The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysis
Aims: Acetabular edge-loading was a cause of increased wear rates in metal-on-metal hip arthroplasties, ultimately contributing to their failure. Although such wear patterns have been regularly reported in retrieval analyses, this study aimed to determine their in vivo location and investigate their...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2021-10-01
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| Series: | Bone & Joint Research |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1010.BJR-2021-0132.R1 |
| _version_ | 1818724213107720192 |
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| author | Sean Bergiers Harry Hothi Johann Henckel Anna Di Laura Martín Belzunce John Skinner Alister Hart |
| author_facet | Sean Bergiers Harry Hothi Johann Henckel Anna Di Laura Martín Belzunce John Skinner Alister Hart |
| author_sort | Sean Bergiers |
| collection | DOAJ |
| description | Aims: Acetabular edge-loading was a cause of increased wear rates in metal-on-metal hip arthroplasties, ultimately contributing to their failure. Although such wear patterns have been regularly reported in retrieval analyses, this study aimed to determine their in vivo location and investigate their relationship with acetabular component positioning. Methods: 3D CT imaging was combined with a recently validated method of mapping bearing surface wear in retrieved hip implants. The asymmetrical stabilizing fins of Birmingham hip replacements (BHRs) allowed the co-registration of their acetabular wear maps and their computational models, segmented from CT scans. The in vivo location of edge-wear was measured within a standardized coordinate system, defined using the anterior pelvic plane. Results: Edge-wear was found predominantly along the superior acetabular edge in all cases, while its median location was 8° (interquartile range (IQR) -59° to 25°) within the anterosuperior quadrant. The deepest point of these scars had a median location of 16° (IQR -58° to 26°), which was statistically comparable to their centres (p = 0.496). Edge-wear was in closer proximity to the superior apex of the cups with greater angles of acetabular inclination, while a greater degree of anteversion influenced a more anteriorly centred scar. Conclusion: The anterosuperior location of edge-wear was comparable to the degradation patterns observed in acetabular cartilage, supporting previous findings that hip joint forces are directed anteriorly during a greater portion of walking gait. The further application of this novel method could improve the current definition of optimal and safe acetabular component positioning. |
| first_indexed | 2024-12-17T21:22:50Z |
| format | Article |
| id | doaj.art-b9b8a96b2fda42488e3193b26930a68d |
| institution | Directory Open Access Journal |
| issn | 2046-3758 |
| language | English |
| last_indexed | 2024-12-17T21:22:50Z |
| publishDate | 2021-10-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Research |
| spelling | doaj.art-b9b8a96b2fda42488e3193b26930a68d2022-12-21T21:32:08ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582021-10-01101063964910.1302/2046-3758.1010.BJR-2021-0132.R1The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysisSean Bergiers0Harry Hothi1Johann Henckel2Anna Di Laura3Martín Belzunce4John Skinner5Alister Hart6Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UKInstitute of Orthopaedics and Musculoskeletal Science, University College London, London, UKRoyal National Orthopaedic Hospital NHS Trust, Stanmore, UKInstitute of Orthopaedics and Musculoskeletal Science, University College London, London, UKRoyal National Orthopaedic Hospital NHS Trust, Stanmore, UKInstitute of Orthopaedics and Musculoskeletal Science, University College London, London, UKInstitute of Orthopaedics and Musculoskeletal Science, University College London, London, UKAims: Acetabular edge-loading was a cause of increased wear rates in metal-on-metal hip arthroplasties, ultimately contributing to their failure. Although such wear patterns have been regularly reported in retrieval analyses, this study aimed to determine their in vivo location and investigate their relationship with acetabular component positioning. Methods: 3D CT imaging was combined with a recently validated method of mapping bearing surface wear in retrieved hip implants. The asymmetrical stabilizing fins of Birmingham hip replacements (BHRs) allowed the co-registration of their acetabular wear maps and their computational models, segmented from CT scans. The in vivo location of edge-wear was measured within a standardized coordinate system, defined using the anterior pelvic plane. Results: Edge-wear was found predominantly along the superior acetabular edge in all cases, while its median location was 8° (interquartile range (IQR) -59° to 25°) within the anterosuperior quadrant. The deepest point of these scars had a median location of 16° (IQR -58° to 26°), which was statistically comparable to their centres (p = 0.496). Edge-wear was in closer proximity to the superior apex of the cups with greater angles of acetabular inclination, while a greater degree of anteversion influenced a more anteriorly centred scar. Conclusion: The anterosuperior location of edge-wear was comparable to the degradation patterns observed in acetabular cartilage, supporting previous findings that hip joint forces are directed anteriorly during a greater portion of walking gait. The further application of this novel method could improve the current definition of optimal and safe acetabular component positioning.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1010.BJR-2021-0132.R1wearretrieval analysiscthip arthroplastieship jointship implantsct scansacetabular component positioningmetal-on-metal hip arthroplastiesacetabular cartilageacetabular componentsacetabular cupssubluxation |
| spellingShingle | Sean Bergiers Harry Hothi Johann Henckel Anna Di Laura Martín Belzunce John Skinner Alister Hart The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysis Bone & Joint Research wear retrieval analysis ct hip arthroplasties hip joints hip implants ct scans acetabular component positioning metal-on-metal hip arthroplasties acetabular cartilage acetabular components acetabular cups subluxation |
| title | The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysis |
| title_full | The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysis |
| title_fullStr | The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysis |
| title_full_unstemmed | The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysis |
| title_short | The in vivo location of edge-wear in hip arthroplasties: combining pre-revision 3D CT imaging with retrieval analysis |
| title_sort | in vivo location of edge wear in hip arthroplasties combining pre revision 3d ct imaging with retrieval analysis |
| topic | wear retrieval analysis ct hip arthroplasties hip joints hip implants ct scans acetabular component positioning metal-on-metal hip arthroplasties acetabular cartilage acetabular components acetabular cups subluxation |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1010.BJR-2021-0132.R1 |
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