|
1
|
Morosato F, Traina F, Schierjott RA, Hettich G, Grupp TM, Cristofolini L. Primary Stability of Revision Acetabular Reconstructions Using an Innovative Bone Graft Substitute: A Comparative Biomechanical Study on Cadaveric Pelvises. MATERIALS 2020; 13:ma13194312. [PMID: 32992567 PMCID: PMC7579522 DOI: 10.3390/ma13194312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022]
Abstract
Hip implant failure is mainly due to aseptic loosening of the cotyle and is typically accompanied by defects in the acetabular region. Revision surgery aims to repair such defects before implantation by means of reconstruction materials, whose morselized bone graft represents the gold standard. Due to the limited availability of bone tissue, synthetic substitutes are also used. The aim of this study was to evaluate if a synthetic fully resorbable tri-calcium phosphate-based substitute can provide adequate mechanical stability when employed to restore severe, contained defects, in comparison with morselized bone graft. Five cadaveric pelvises were adopted, one side was reconstructed with morselized bone graft and the other with the synthetic substitute, consisting of dense calcium phosphate granules within a collagen matrix. During the biomechanical test, cyclic load packages of increasing magnitude were applied to each specimen until failure. Bone/implant motions were measured through Digital Image Correlation and were expressed in terms of permanent and inducible translations and rotations. The reconstruction types exhibited a similar behavior, consisting of an initial settling trend followed by failure as bone fracture (i.e., no failure of the reconstruction material). When 2.2 Body Weight was applied, the permanent translations were not significantly different between the two reconstructions (p = 0.06–1.0) and were below 1.0 mm. Similarly, the inducible translations did not differ significantly (p = 0.06–1.0) and were below 0.160 mm. Rotations presented the same order of magnitude but were qualitatively different. Overall, the synthetic substitute provided adequate mechanical stability in comparison with morselized bone graft, thus representing a reliable alternative to treat severe, contained acetabular defects.
Collapse
Affiliation(s)
- Federico Morosato
- Department of Industrial Engineering, Alma Mater Studiorum, Università di Bologna, 40131 Bologna, Italy;
| | - Francesco Traina
- Chirurgia Protesica, IRCCS Rizzoli Orthopaedic Institute, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, Università di Bologna, 40126 Bologna, Italy
| | - Ronja A. Schierjott
- Aesculap AG, Research & Development, Am Aesculap-Platz, 78532 Tuttlingen, Germany; (R.A.S.); (G.H.); (T.M.G.)
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Grosshadern, Ludwig Maximilian University, 81377 Munich, Germany
| | - Georg Hettich
- Aesculap AG, Research & Development, Am Aesculap-Platz, 78532 Tuttlingen, Germany; (R.A.S.); (G.H.); (T.M.G.)
| | - Thomas M. Grupp
- Aesculap AG, Research & Development, Am Aesculap-Platz, 78532 Tuttlingen, Germany; (R.A.S.); (G.H.); (T.M.G.)
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Grosshadern, Ludwig Maximilian University, 81377 Munich, Germany
| | - Luca Cristofolini
- Department of Industrial Engineering, Alma Mater Studiorum, Università di Bologna, 40131 Bologna, Italy;
- Correspondence:
| |
Collapse
|