A BIOMECHANICAL STUDY ON POLYETHYLENE LINER CEMENTING INTO A FIXED ACETABULAR SHELL IN REVISION TOTAL HIP ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LU Weijie ¹ , JIN Dadi ¹ , LI Zhichen ² , CHEN Yi ² , CHEN Dongfeng ² , YU Nansheng. ²

1Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou Guangdong, 510630,P.R.China;;
2Department of Orthopedics, the First Affiliated Hospital of Guangzhou Medical College.;

Corresponding author：

Keywords：

Polyethylene linercement; Revision total hip arthroplasty; Biomechanics

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Objective To evaluate the strength of polyethylene l inercement interface when cementing a new linerinto a fixed acetabular cup in revision. Methods Twenty-five pairs of metal acetabular cups with polyethylene l iners were randomly divided into 5 groups: 1 group with standard locking device as control group (group A), other l iners were cemented into acetabular cups as 4 experimental groups. According to different intersection angles of metal acetabular cups with polyethylene liners and the polyethylene l iners with or without metal ball, the 4 experimental groups were no ball 0° group (group B), 0° group (group C), 10° group (group D), and 20° group (group E), metal acetabular cups intersected with polyethylene liners without metal ball in group B, with metal ball in groups C, D, and E, respectively. The lever-out biomechanical test reproduced in vivo failure mechanism was then performed to evaluate the lever-out failure strength of l iner-cement-metal
cup interface. Results The values of l iver-out failure force were (626.68 ± 206.12), (915.04 ± 197.49), (449.02 ± 119.78),
(814.68 ± 53.89), and (1 033.05 ± 226.44) N in groups A, B, C, D, and E, respectively, showing significant differences for
comparison among groups (F=8.989，P=0.000). The values of l iver-out failure force in groups B and E were significantly
higher than that in group A (P lt; 0.05), but no significant difference was found between groups C, D and group A (P gt; 0.05).
Conclusion Cementation of polyethylene l iner into a malposition shell meeting within 20° can provide enough fixed strength.

Citation： LU Weijie,JIN Dadi,LI Zhichen,CHEN Yi,CHEN Dongfeng,YU Nansheng.. A BIOMECHANICAL STUDY ON POLYETHYLENE LINER CEMENTING INTO A FIXED ACETABULAR SHELL IN REVISION TOTAL HIP ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(4): 437-440. doi: Copy

1.	Haft GF, Heiner AD, Dorr LD, et al. A biomechanical analysis of polyethylene liner cementation into a fixed metal acetabular shell. J Bone Joint Surg (Am), 2003, 85-A(6): 1100-1110.
2.	Hofmann AA, Prince EJ, Drake FT, et al. Cementation of a polyethylene liner into a metal acetabular shell: a biomechanical study. J Arthroplasty, 2009, 24(5): 775-782.
3.	Meldrum RD, Hollis JM. The strength of a cement acetabular locking mechanism. J Arthroplasty, 2001, 16(6): 748-752.
4.	Bonner KF, Delanois RE, Harbach G. Cementation of a polyethylene liner into a metal shell. Factors related to mechanical stability. J Bone Joint Surg (Am), 2002, 84-A(9): 1587-1593.
5.	Kurtz S, Hozack W, Ray R. Biomechanical analysis of cementing an acetabular liner in a metal shell for revision total hip arthroplasty. Presented at the Annual Meeting of the Orthopaedic Research Society, San Francisco, CA, 2001.
6.	Mauerhan DR, Peindl RD, Coley ER, et al. Cementation of polyethylene liners into well-fixed metal shells at the time of revision total hip arthroplasty. J Arthroplasty, 2008, 23(6): 874-878.
7.	Ebramzadeh E, Beaulé PE, Culwell JL, et al. Fixation strength of an all-metal acetabular component cemented into an acetabular shell: a biomechanical analysis. J Arthroplasty, 2004, 19(8 Suppl 3): 45-49.
8.	Haft GF, Heiner AD, Callaghan JJ, et al. Polyethylene liner cementation into fixed acetabular shells. J Arthroplasty, 2002, 17(4 Suppl 1): 167-170.
9.	Wang JP, Chen WM, Chen CF, et al. Cementation of cross-linked polyethylene liner into well-fixed acetabular shells: mean 6-years follow-up study. J Arthroplasty, 2010, 25(3): 420-424.
10.	Callaghan JJ, Parvizi J, Novak CC, et al. A constrained liner cemented into a secure cementless acetabular shell. J Bone Joint Surg (Am), 2004, 86-A(10): 2206-2211.
11.	Terefenko KM, Sychterz CJ, Orishimo K, et al. Polyethylene liner exchange for excessive wear and osteolysis. J Arthroplasty, 2002, 17(6): 798-804.
12.	Beaulé PE, Ebramzadeh E, Le Duff M, et al. Cementing a liner into a stable cementless acetabular shell: the double-socket technique. J Bone Joint Surg (Am), 2004, 86-A(5): 929-934.
13.	刘志宏, 冯建民, 杨庆铭. 单纯聚乙烯内衬更换在髋关节翻修手术中的应用. 中华关节外科杂志 (电子版), 2009, 3(5): 547-551.
14.	Springer BD, Hanssen AD, Lewallen DG. Cementation of an acetabular liner into a well-fixed acetabular shell during revision total hip arthroplasty. J Arthroplasty, 2003, 18(7 Suppl 1): 126-130.
15.	Yoon TR, Seon JK, Song EK, et al. Cementation of a metal-inlay polyethylene liner into a stable metal shell in revision total hip arthroplasty. J Arthroplasty, 2005, 20(5): 652-657.
16.	Jiranek WA. Acetabular liner fixation by cement. Clin Orthop Relat Res, 2003, (417): 217-223.
17.	LaPorte DM, Mont MA, Pierre-Jacques H, et al. Technique for acetabular liner revision in a nonmodular metal-backed component. J Arthroplasty, 1998, 13(3): 348-350.
18.	Delanois RE, Seyler TM, Essner A, et al. Cementation of a polyethylene liner into a metal shell. J Arthroplasty, 2007, 22(5): 732-737.
19.	Blom AW, Astle L, Loveridge J, et al. Revision of an acetabular liner has a high risk of dislocation. J Bone Joint Surg (Br), 2005, 87(12): 1636-1638.
20.	Lie SA, Hallan G, Furnes O, et al. Isolated acetabular liner exchange compared with complete acetabular components revision in revision of primary uncemented acetabular components: a study of 1649 revisions from the Norwegian Arthroplasty Register. J Bone Joint Surg (Br), 2007, 89(5): 591-594.

1. Haft GF, Heiner AD, Dorr LD, et al. A biomechanical analysis of polyethylene liner cementation into a fixed metal acetabular shell. J Bone Joint Surg (Am), 2003, 85-A(6): 1100-1110.
2. Hofmann AA, Prince EJ, Drake FT, et al. Cementation of a polyethylene liner into a metal acetabular shell: a biomechanical study. J Arthroplasty, 2009, 24(5): 775-782.
3. Meldrum RD, Hollis JM. The strength of a cement acetabular locking mechanism. J Arthroplasty, 2001, 16(6): 748-752.
4. Bonner KF, Delanois RE, Harbach G. Cementation of a polyethylene liner into a metal shell. Factors related to mechanical stability. J Bone Joint Surg (Am), 2002, 84-A(9): 1587-1593.
5. Kurtz S, Hozack W, Ray R. Biomechanical analysis of cementing an acetabular liner in a metal shell for revision total hip arthroplasty. Presented at the Annual Meeting of the Orthopaedic Research Society, San Francisco, CA, 2001.
6. Mauerhan DR, Peindl RD, Coley ER, et al. Cementation of polyethylene liners into well-fixed metal shells at the time of revision total hip arthroplasty. J Arthroplasty, 2008, 23(6): 874-878.
7. Ebramzadeh E, Beaulé PE, Culwell JL, et al. Fixation strength of an all-metal acetabular component cemented into an acetabular shell: a biomechanical analysis. J Arthroplasty, 2004, 19(8 Suppl 3): 45-49.
8. Haft GF, Heiner AD, Callaghan JJ, et al. Polyethylene liner cementation into fixed acetabular shells. J Arthroplasty, 2002, 17(4 Suppl 1): 167-170.
9. Wang JP, Chen WM, Chen CF, et al. Cementation of cross-linked polyethylene liner into well-fixed acetabular shells: mean 6-years follow-up study. J Arthroplasty, 2010, 25(3): 420-424.
10. Callaghan JJ, Parvizi J, Novak CC, et al. A constrained liner cemented into a secure cementless acetabular shell. J Bone Joint Surg (Am), 2004, 86-A(10): 2206-2211.
11. Terefenko KM, Sychterz CJ, Orishimo K, et al. Polyethylene liner exchange for excessive wear and osteolysis. J Arthroplasty, 2002, 17(6): 798-804.
12. Beaulé PE, Ebramzadeh E, Le Duff M, et al. Cementing a liner into a stable cementless acetabular shell: the double-socket technique. J Bone Joint Surg (Am), 2004, 86-A(5): 929-934.
13. 刘志宏, 冯建民, 杨庆铭. 单纯聚乙烯内衬更换在髋关节翻修手术中的应用. 中华关节外科杂志 (电子版), 2009, 3(5): 547-551.
14. Springer BD, Hanssen AD, Lewallen DG. Cementation of an acetabular liner into a well-fixed acetabular shell during revision total hip arthroplasty. J Arthroplasty, 2003, 18(7 Suppl 1): 126-130.
15. Yoon TR, Seon JK, Song EK, et al. Cementation of a metal-inlay polyethylene liner into a stable metal shell in revision total hip arthroplasty. J Arthroplasty, 2005, 20(5): 652-657.
16. Jiranek WA. Acetabular liner fixation by cement. Clin Orthop Relat Res, 2003, (417): 217-223.
17. LaPorte DM, Mont MA, Pierre-Jacques H, et al. Technique for acetabular liner revision in a nonmodular metal-backed component. J Arthroplasty, 1998, 13(3): 348-350.
18. Delanois RE, Seyler TM, Essner A, et al. Cementation of a polyethylene liner into a metal shell. J Arthroplasty, 2007, 22(5): 732-737.
19. Blom AW, Astle L, Loveridge J, et al. Revision of an acetabular liner has a high risk of dislocation. J Bone Joint Surg (Br), 2005, 87(12): 1636-1638.
20. Lie SA, Hallan G, Furnes O, et al. Isolated acetabular liner exchange compared with complete acetabular components revision in revision of primary uncemented acetabular components: a study of 1649 revisions from the Norwegian Arthroplasty Register. J Bone Joint Surg (Br), 2007, 89(5): 591-594.

Chinese Journal of Reparative and Reconstructive Surgery

A BIOMECHANICAL STUDY ON POLYETHYLENE LINER CEMENTING INTO A FIXED ACETABULAR SHELL IN REVISION TOTAL HIP ARTHROPLASTY

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