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. 2022 Aug 12;17(1):386.
doi: 10.1186/s13018-022-03260-9.

The optimal screw-hole positions of the eccentric revision cup based on a morphological study

Yanchao Zhang #  1   2   3 , Haiyang Ma #  1 , Yang Liu  2   4 , Junmin Shen  2   4 , Bohan Zhang  1   2   3 , Yonggang Zhou  5   6   7
Affiliations

The optimal screw-hole positions of the eccentric revision cup based on a morphological study

Yanchao Zhang et al. J Orthop Surg Res. .

Abstract

Background: Bridging bone defects in revision total hip arthroplasty is a challenge to orthopedic surgeons. The eccentric revision cup is a progression of jumbo cup. Our aim is to confirm the optimal screw-hole positions of the eccentric revision cup by morphological measurements of three-dimensional pelvic reconstruction.

Methods: Eighty CT images were converted to virtual three-dimensional bones. After simulating the surgery procedure, all available screw holes were inserted with the screws in virtual. By measuring the length of the screw in the pelvic bone, we determined the rich bone stock area. Then the screw holes were designed according to the characteristics of bone stock distribution. The peripheral screw-hole cluster and inner screw-hole cluster were studied respectively.

Results: For peripheral screw-hole cluster, five screw holes were evenly distributed between point A and point B in the thicker rim. For inner screw-hole cluster, screw hole 1 and screw hole 2 are the recommended inner screw holes.

Conclusion: The eccentric revision cup has inherited the strengths of jumbo cup besides several unique advantages, including using the peripheral screws enhancing primary stability; decreasing the shift of hip rotation center and restoring biomechanical function; reducing the risk of dislocation because of the smaller head-cup differences; increasing the contact area between the outer cup and the host bone while maintaining a normal inclination of the inner cup. In this study, we confirmed the optimal screw-hole positions of the eccentric revision cup by surgical simulation and morphological measurement. However, biomechanical tests are still being further explored.

Keywords: Bone defect; Eccentric revision cup; Revision; Screw; Total hip arthroplasty.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
The Eccentric Revision Cup. a: top view of the virtual eccentric revision cup; b: side view of the virtual eccentric revision cup; c: top view of the eccentric revision cup; d: side view of the eccentric revision cup; Red arrow: outer cup; Blue arrow: inner cup
Fig. 2
Fig. 2
Measurement of Peripheral Screw-hole Positions. O: the center of the outer cup opening plane; A and B: the outermost available screw holes; C: the point that the symmetrical axis of the eccentric cup intersected the superior edge of the outer cup
Fig. 3
Fig. 3
Measurement of Inner Screw-hole Positions. O’: the center of the inner cup opening plane; Red arrow: pointing to the anterior superior iliac spine; 1, 2, 3 and 4: the inner screw holes within the “safe zone”
See this image and copyright information in PMC

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