Comparison of trans-cortical and cancellous screws to press fit for acetabular shell fixation in total hip arthroplasty: A cadaveric study
Total hip arthroplasty complications are associated with mechanical loosening of the acetabular component, which may be attributed to the type of fixation used (press fit, trans-cortical screws, cancellous screws). Therefore, the purpose of this study was to compare trans-cortical and cancellous scr...
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| Published in: | Clinical biomechanics (Bristol) Vol. 69; pp. 34 - 38 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Elsevier Ltd
01-10-2019
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| Online Access: | Get full text |
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| Summary: | Total hip arthroplasty complications are associated with mechanical loosening of the acetabular component, which may be attributed to the type of fixation used (press fit, trans-cortical screws, cancellous screws). Therefore, the purpose of this study was to compare trans-cortical and cancellous screws to press fit for fixation of the acetabular shell.
Five cadaveric pelvis specimens were hemisected (N = 10) at the sacroiliac joint. Each hemi-pelvis was initially tested with a press fit cup followed by the left and right pairs being randomized to either a cancellous or trans-cortical screw condition. Each fixation was tested by applying a load to a rod inserted into the centre of the acetabular cup at 0.5 mm/s, until failure occurred. The failure force, failure moment, and the rotation angle of the cup at failure were calculated.
The cups fixated with a trans-cortical screw failed at a significantly greater mean [SD] force (1046.20 [386.52] N). The trans-cortical screws also significantly increased the angle of failure 46.29 (16.90) ° compared to the press-fit cups (6.73 [4.59] °). Finally, there was a significant increase in the failure moment, such that, the trans-cortical condition failed at a mean (SD) moment of 53.75 (16.24) Nm compared to 9.59 (1.85) Nm and 32.15 (18.16) Nm for the press fit and cancellous (p = 0.044) conditions, respectively.
The acetabular shells that were fixated with trans-cortical screws provide greater stability compared to the press-fit cups or cancellous screws.
•The type of screw fixation may contribute to hip arthroplasty complications.•Trans-cortical screws, cancellous screws, and pres-fit are all viable options.•Trans-cortical screws resulted in greater failure force and failure rotation.•Trans-cortical-screws resulted in greater failure moment. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0268-0033 1879-1271 |
| DOI: | 10.1016/j.clinbiomech.2019.06.017 |