The Frank Stinchfield Award : Assembly and Dissociation Forces Differ Between Commonly Used Dual Mobility Implants: A Biomechanical Study
Copyright © 2024 Elsevier Inc. All rights reserved..
BACKGROUND: Intraprosthetic dissociation (IPD) is a complication unique to dual mobility (DM) implants where the outer polyethylene head dissociates from the inner femoral head. Increasing reports of IPD at the time of closed reduction of large head DM dislocations prompted this biomechanical study evaluating the assembly and dissociation forces of DM heads.
METHODS: We tested 17 polyethylene DM heads from 5 vendors. Of the heads, 12 were highly cross-linked polyethylene (4 vendors) and 5 were infused with vitamin E (2 vendors). Heads were between 46 and 47 mm in diameter, accepting a 28 mm-inner ceramic head. Implants were assembled and disassembled using a servohydraulic machine that recorded the forces and torques applied during testing. Dissociation was tested via both axial pull-out and lever-out techniques, where lever-out simulated stem-on-acetabular component impingement.
RESULTS: The initial maximum assembly force was significantly different between all vendors (P < .01) and decreased for all implants with subsequent assembly. Vendor 4-E (Link with vitamin E) heads required the highest assembly force (1,831.9 ± 81.95 N), followed by Vendor 3 (Smith & Nephew), Vendor 5 (DePuy Synthes), Vendor 1-E (Zimmer Biomet with vitamin E), Vendor 2 (Stryker), and Vendor 1 (Zimmer Biomet Arcom). Vendor 4-E implants showed the greatest dissociation resistance in both pull-out (2,059.89 N, n = 1) and lever-out (38.95 ± 2.79 Nm) tests. Vendor 1-E implants with vitamin E required higher assembly force, dissociation force, and energy than Vendor 1 heads without vitamin E.
CONCLUSIONS: There were notable differences in DM assembly and dissociation forces between implants. Diminishing force was required for assembly with each additional trial across vendors. Vendor 4-E DM heads required the highest assembly and dissociation forces. Vitamin E appeared to increase the assembly and dissociation forces. Based on these results, DM polyethylene heads should not be reimplanted after dissociation, and there may be a role for establishing a minimum dissociation energy standard to minimize IPD risk.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
The Journal of arthroplasty - (2024) vom: 12. März |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Mallett, Katherine E [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Dislocation |
|---|
| Anmerkungen: |
Date Revised 12.04.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.arth.2024.03.002 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36969337X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36969337X | ||
| 003 | DE-627 | ||
| 005 | 20240413232542.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240315s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.arth.2024.03.002 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1374.xml |
| 035 | |a (DE-627)NLM36969337X | ||
| 035 | |a (NLM)38479635 | ||
| 035 | |a (PII)S0883-5403(24)00205-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Mallett, Katherine E |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Frank Stinchfield Award |b Assembly and Dissociation Forces Differ Between Commonly Used Dual Mobility Implants: A Biomechanical Study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 12.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Intraprosthetic dissociation (IPD) is a complication unique to dual mobility (DM) implants where the outer polyethylene head dissociates from the inner femoral head. Increasing reports of IPD at the time of closed reduction of large head DM dislocations prompted this biomechanical study evaluating the assembly and dissociation forces of DM heads | ||
| 520 | |a METHODS: We tested 17 polyethylene DM heads from 5 vendors. Of the heads, 12 were highly cross-linked polyethylene (4 vendors) and 5 were infused with vitamin E (2 vendors). Heads were between 46 and 47 mm in diameter, accepting a 28 mm-inner ceramic head. Implants were assembled and disassembled using a servohydraulic machine that recorded the forces and torques applied during testing. Dissociation was tested via both axial pull-out and lever-out techniques, where lever-out simulated stem-on-acetabular component impingement | ||
| 520 | |a RESULTS: The initial maximum assembly force was significantly different between all vendors (P < .01) and decreased for all implants with subsequent assembly. Vendor 4-E (Link with vitamin E) heads required the highest assembly force (1,831.9 ± 81.95 N), followed by Vendor 3 (Smith & Nephew), Vendor 5 (DePuy Synthes), Vendor 1-E (Zimmer Biomet with vitamin E), Vendor 2 (Stryker), and Vendor 1 (Zimmer Biomet Arcom). Vendor 4-E implants showed the greatest dissociation resistance in both pull-out (2,059.89 N, n = 1) and lever-out (38.95 ± 2.79 Nm) tests. Vendor 1-E implants with vitamin E required higher assembly force, dissociation force, and energy than Vendor 1 heads without vitamin E | ||
| 520 | |a CONCLUSIONS: There were notable differences in DM assembly and dissociation forces between implants. Diminishing force was required for assembly with each additional trial across vendors. Vendor 4-E DM heads required the highest assembly and dissociation forces. Vitamin E appeared to increase the assembly and dissociation forces. Based on these results, DM polyethylene heads should not be reimplanted after dissociation, and there may be a role for establishing a minimum dissociation energy standard to minimize IPD risk | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a dislocation | |
| 650 | 4 | |a dual mobility | |
| 650 | 4 | |a hip instability | |
| 650 | 4 | |a intraprosthetic dissociation | |
| 650 | 4 | |a total hip arthroplasty | |
| 700 | 1 | |a Guarin Perez, Sergio F |e verfasserin |4 aut | |
| 700 | 1 | |a Hooke, Alexander W |e verfasserin |4 aut | |
| 700 | 1 | |a Tanner, Allison M |e verfasserin |4 aut | |
| 700 | 1 | |a Bland, Joshua T |e verfasserin |4 aut | |
| 700 | 1 | |a Fitzsimmons, James S |e verfasserin |4 aut | |
| 700 | 1 | |a Taunton, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Sierra, Rafael J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of arthroplasty |d 1995 |g (2024) vom: 12. März |w (DE-627)NLM012629375 |x 1532-8406 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:12 |g month:03 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.arth.2024.03.002 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 12 |c 03 | ||