A plasma-sprayed titanium proximal coating reduces the risk of periprosthetic femoral fracture in cementless hip arthroplasty.

Publisher: IOS Press Country of Publication: Netherlands NLM ID: 9104021 Publication Model: Print Cited Medium: Internet ISSN: 1878-3619 (Electronic) Linking ISSN: 09592989 NLM ISO Abbreviation: Biomed Mater Eng Subsets: MEDLINE

Publication: Amsterdam : IOS Press
Original Publication: New York : Pergamon Press, c1991-

Femoral Fractures/*physiopathology ; Femoral Fractures/*prevention & control ; Hip Prosthesis/*adverse effects ; Periprosthetic Fractures/*physiopathology ; Periprosthetic Fractures/*prevention & control ; Titanium/*chemistry; Adult ; Aged ; Arthroplasty, Replacement, Hip/adverse effects ; Arthroplasty, Replacement, Hip/instrumentation ; Arthroplasty, Replacement, Hip/methods ; Cadaver ; Cementation ; Coated Materials, Biocompatible/chemical synthesis ; Compressive Strength ; Elastic Modulus ; Equipment Failure Analysis ; Female ; Femoral Fractures/etiology ; Humans ; Male ; Middle Aged ; Periprosthetic Fractures/etiology ; Plasma Gases/chemistry ; Prosthesis Design ; Risk Assessment ; Stress, Mechanical ; Surface Properties ; Tensile Strength ; Treatment Outcome

Background: The design of femoral component used in total hip arthroplasty is known to influence the incidence of periprosthetic femoral fractures (PFFs) in cementless hip arthroplasty.
Objective: This study was undertaken to determine if 2 potential changes to an existing ABG II-standard cementless implant - addition of a roughened titanium plasma-sprayed proximal coating (ABG II-plasma) and lack of medial scales (ABG II-NMS) could decrease the risk of PFF in the intraoperative and early postoperative periods.
Methods: Six pairs of human cadaveric femurs were harvested and divided into 2 groups, each receiving either of the altered implants and ABG II-standard (control). Each implant was tested in a biomechanical setup in a single-legged stance orientation. Surface strains were measured in intact femurs, during implant insertion, cyclic loading of the bone with the implant, and loading to failure. Strains with the ABG II-standard and the altered implants were compared.
Findings: ABG II-plasma showed better load-bearing capacity, with an average 42% greater failure load than that of ABG II-standard. The cortical hoop, axial and mean strains ABG II-plasma were less than those of ABG II-standard, demonstrating decreased tensile behaviour and better load transfer to the proximal femur. The final residual hoop strains in ABG II-plasma were closer to those of intact bone as compared to the standard stem. No differences in strains were observed between the standard stem and ABG II-NMS.
Conclusion: The increased load-bearing capacity and decreased proximal surface strains on femurs implanted with ABG II-plasma stem should reduce the risks of intraoperative and early postoperative PFF.

Keywords: Cementless implant; failure load; periprosthetic femoral fractures; strain; titanium plasma-sprayed coating

0 (Coated Materials, Biocompatible)
0 (Plasma Gases)
15FIX9V2JP (titanium dioxide)
D1JT611TNE (Titanium)

Date Created: 20150926 Date Completed: 20160706 Latest Revision: 20191210

20221213

10.3233/BME-151279

26407113