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. 2023 Mar 23;30(2):83-91.
doi: 10.3390/pathophysiology30020008.

Acetabular Wall Weakening in Total Hip Arthroplasty: A Pilot Study

Madeline Gautreaux  1 , Steven Kautz  1 , Zashiana Martin  1 , Edward Morgan  1 , R Shane Barton  1 , Matthew Dubose  1 , Hayden McBride  1 , Giovanni F Solitro  1
Affiliations

Acetabular Wall Weakening in Total Hip Arthroplasty: A Pilot Study

Madeline Gautreaux et al. Pathophysiology. .

Abstract

Total hip arthroplasty is a widely performed operation allowing disabled patients to improve their quality of life to a degree greater than any other elective procedure. Planning for a THA requires adequate patient assessment and preoperative characterizations of acetabular bone loss via radiographs and specific classification schemes. Some surgeons may be inclined to ream at a larger diameter thinking it would lead to a more stable press-fit, but this could be detrimental to the acetabular wall, leading to intraoperative fracture. In the attempt to reduce the incidence of intraoperative fractures, the current study aims to identify how increased reaming diameter degrades and weakens the acetabular rim strength. We hypothesized that there is proportionality between the reaming diameter and the reduction in acetabular strength. To test this hypothesis, this study used bone surrogates, templated from CT scans, and reamed at different diameters. The obtained bone surrogate models were then tested using an Intron 8874 mechanical testing machine (Instron, Norwood, MA) equipped with a custom-made fixture. Analysis of variance (ANOVA) was used to identify differences among reamed diameters while linear regression was used to identify the relationship between reamed diameters and acetabular strength. We found a moderate correlation between increasing reaming diameter that induced thinning of the acetabular wall and radial load damage. For the simplified acetabular model used in this study, it supported our hypothesis and is a promising first attempt in providing quantitative data for acetabular weakening induced by reaming.

Keywords: acetabular strength; arthroplasty; hip; rim fracture.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Acetabular cup templating (a) and reaming of concentric layers in 1 mm diameter increments (b).
Figure 2
Figure 2
Custom made fixture used to convert the axial displacement of the Instron actuator (shown in green) in the radial expansion of the acetabulum (shown in purple) with reference to the center of the templated cup (shown in red).
Figure 3
Figure 3
Experimentally determined acetabular strength expressed in as the peak radial force measured during radial expansion.
See this image and copyright information in PMC

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