Biomechanical evaluation of the impact of collared cementless total hip arthroplasty stems on implant subsidence: a cadaveric study in German Shepherd

Document Type : Full paper (Original article)

Authors

1 Department of Veterinary Clinical Science, Cho Hyungsun Animal Hospital, Seoul, Republic of Korea

2 Ph.D. Student in Veterinary Emergency and Critical Care, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea

3 Department of Veterinary Clinical Science, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea

4 Department of Veterinary Clinical Science, Bien Animal Medical Center, Sosagu, Republic of Korea

5 Department of Veterinary Clinical Science, Yedam Animal Medical Center, Seoul, Republic of Korea

6 Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea

Abstract

Background: With the increasing use of cementless total hip arthroplasty (THA), stem subsidence has emerged as one of the primary complications. Although electron beam melting (EBM)-manufactured stems have been demonstrated to prevent subsidence, there has been limited investigation into the comparative biomechanical impact of collarless and collared EBM cementless stems on stem subsidence in veterinary medicine. Aims: This study aimed to compare the stem implant resistance and failure mechanical properties between collarless and collared EBM-manufactured stems. Methods: Seven pairs of femurs were harvested from canine cadavers. In each pair of femurs, the left femur was implanted with a collarless, and the right femur with a same-sized collared cementless stem. Specimen constructs were mounted to the loading frame of a testing machine and load was transferred to the femoral stem parallel to the longitudinal axis of the femur until the stem subsided 5 mm. Load and stem displacement data acquired during the tests were used to generate load-displacement curves and obtain stiffness, yield, and failure data for each specimen construct. Yield and failure energies were calculated as the areas under the load-displacement curves to the respective points. The effects of implant type and load during subsidence were analyzed using paired t-tests. Results: The yield and failure loads for the collared stems were approximately 40% greater than for the collarless stems (156.39 ± 43.63 kgf vs. 112.01 ± 59.83 kgf, P<0.05). Conclusion: This study supported the advantages of collared EBM stems, including subsidence prevention and better initial stability for early osteointegration.

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References

Aspenberg, P; Goodman, S; Toksvig-Larsen, S and Albrektsson, T (1992). Intermittent micromotion inhibits bone ingrowth: titanium implants in rabbits. Acta Orthop. Scand., 63: 141-145.
Barrack, RL; Jasty, M; Bragdon, C; Haire, T and Harris, WH (1992). Thigh pain despite bone ingrowth into uncemented femoral stems. J. Bone. Joint. Surg. Br., 74: 507-510.
Buks, Y; Wendelburg, KL; Stover, SM and Garcia-Nolen, TC (2016). The effects of interlocking a universal hip cementless stem on implant subsidence and mechanical properties of cadaveric canine femora. Vet. Surg., 45: 155-164.
Cross, AR; Newell, SM; Chambers, JN; Shultz, KB and Kubilis, PS (2000). Acetabular component orientation as an indicator of implant luxation in cemented total hip arthroplasty. Vet. Surg., 29: 517-523.
Demey, G; Fary, C; Lustig, S; Neyret, P and si Selmi, TA (2011). Does a collar improve the immediate stability of uncemented femoral hip stems in total hip arthroplasty? A
bilateral comparative cadaver study. J. Arthroplasty. 26: 1549-1555.
Fitzpatrick, N; Law, AY; Bielecki, M and Girling, S (2014). Cementless total hip replacement in 20 juveniles using BFX™ arthroplasty. Vet. Surg., 43: 715-725.
Gemmill, TJ; Pink, J; Renwick, A; Oxley, B; Downes, C; Roch, S and Mckee, WM (2011). Hybrid cemented/ cementless total hip replacement in dogs: seventy-eight consecutive joint replacements. Vet. Surg., 40: 621-630.
Hach, V and Delfs, G (2009). Initial experience with a newly developed cementless hip endoprosthesis. Vet. Comp. Orthop. Traumatol., 22: 153-158.
Hanson, SP; Peck, JN; Berry, CR; Graham, J and Stevens, G (2006). Radiographic evaluation of the Zurich cementless total hip acetabular component. Vet. Surg., 35: 550-558.
Iwata, D; Broun, HC; Black, AP; Preston, CA and Anderson, GI (2008). Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems. Vet. Comp. Orthop. Traumatol., 21: 221-230.
Kim, JY; Hayashi, K; Garcia, TC; Kim, SY; Entwistle, R; Kapatkin, AS and Stover, SM (2012). Biomechanical evaluation of screw-in femoral implant in cementless total hip system. Vet. Surg., 41: 94-102.
Lascelles, BDX; Freire, M; Roe, SC; DePuy, V; Smith, E and Marcellin-Little, DJ (2010). Evaluation of functional outcome after BFX total hip replacement using a pressure sensitive walkway. Vet. Surg., 39: 71-77.
Liska, WD and Doyle, ND (2015). Use of an electron beam melting manufactured titanium collared cementless femoral stem to resist subsidence after canine total hip replacement. Vet. Surg., 44: 883-894.
Manley, PA; Vanderby, R; Kohles, S; Markel, MD and Heiner, JP (1995). Alterations in femoral strain, micromotion, cortical geometry, cortical porosity, and bony ingrowth in uncemented collared and collarless prostheses in the dog. J. Arthroplasty. 10: 63-73.
Massat, BJ and Vasseur, PB (1994). Clinical and radiographic results of total hip arthroplasty in dogs: 96 cases (1986-1992). J. Am. Vet. Med. Assoc., 205: 448-454.
Olmstead, ML (1995). Canine cemented total hip replacements: state of the art. J. Small Anim. Pract., 36: 395-399.
Pernell, RT; Gross, RS; Milton, JL; Mongomery, RD; Wengel, JG; Savory, CG and Aberman, HM (1994). Femoral strain distribution and subsidence after physiological loading of a cementless canine femoral prosthesis: the effects of implant orientation, canal fill, and implant fit. Vet. Surg., 23: 503-518.
Rashmir-Raven, AM; Deyoung, DJ; Abrams, CF; Aberman, HA and Richardson, DC (1992). Subsidence of an uncemented canine femoral stem. Vet. Surg., 21: 327-331.
Schimmel, JW and Huiskes, R (1988). Primary fit of the Lord cementless total hip: a geometric study in cadavers. Acta Orthop. Scand., 59: 638-642.
Townsend, S; Kim, SE and Pozzi, A (2017). Effect of stem sizing and position on short-term complications with canine press fit cementless total hip arthroplasty. Vet. Surg., 46: 803-811.

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