Periprosthetic fracture and implant loosening are two of the major reasons for revision surgery of cementless implants. Optimal implant fixation with minimal bone damage is challenging in this procedure. This pilot study investigates whether vibratory implant insertion is gentler compared to consecutive single blows for acetabular component implantation in a surrogate polyurethane (PU) model. Acetabular components (cups) were implanted into 1 mm nominal under-sized cavities in PU foams (15 and 30 per cubic foot (PCF)) using a vibratory implant insertion device and an automated impaction device for single blows. The impaction force, remaining polar gap, and lever-out moment were measured and compared between the impaction methods.Aims
Methods
Objective. This study compared the primary stability of two commercially
available acetabular components from the same manufacturer, which
differ only in geometry; a hemispherical and a peripherally enhanced
design (peripheral self-locking (PSL)). The objective was to determine
whether altered geometry resulted in better primary stability. Methods. Acetabular components were seated with 0.8 mm to 2 mm interference
fits in reamed polyethylene bone substrate of two different densities
(0.22 g/cm. 3. and 0.45 g/cm. 3. ). The primary stability
of each component design was investigated by measuring the peak
failure load during uniaxial pull-out and tangential lever-out tests. Results. There was no statistically significant difference in seating
force (p = 0.104) or primary stability (pull-out p = 0.171, lever-out
p = 0.087) of the two components in the low-density substrate. Similarly,
in the high-density substrate, there was no statistically significant
difference in the peak pull-out force (p = 0.154) or lever-out moment
(p = 0.574) between the designs. However, the PSL component required
a significantly higher seating force than the hemispherical cup
in the high-density bone analogue (p = 0.006). Conclusions. Higher seating forces associated with the PSL design may result
in inadequate seating and increased risk of component malpositioning
or
The aim of the current study was to assess the reliability of the Ottawa classification for symptomatic acetabular dysplasia. In all, 134 consecutive hips that underwent periacetabular osteotomy were categorized using a validated software (Hip2Norm) into four categories of normal, lateral/global, anterior, or posterior. A total of 74 cases were selected for reliability analysis, and these included 44 dysplastic and 30 normal hips. A group of six blinded fellowship-trained raters, provided with the classification system, looked at these radiographs at two separate timepoints to classify the hips using standard radiological measurements. Thereafter, a consensus meeting was held where a modified flow diagram was devised, before a third reading by four raters using a separate set of 74 radiographs took place.Aims
Methods
Over recent years hip arthroscopic surgery has
evolved into one of the most rapidly expanding fields in orthopaedic surgery.
Complications are largely transient and incidences between 0.5%
and 6.4% have been reported. However, major complications can and
do occur. This article analyses the reported complications and makes recommendations
based on the literature review and personal experience on how to
minimise them.