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The in vivo location of edge-wear in hip arthroplasties : combining pre-revision 3D CT imaging with retrieval analysis

Bergiers, S; Hothi, H; Henckel, J; Di Laura, A; Belzunce, M; Skinner, J; Hart, A; (2021) The in vivo location of edge-wear in hip arthroplasties : combining pre-revision 3D CT imaging with retrieval analysis. Bone & Joint Research , 10 (10) pp. 639-649. 10.1302/2046-3758.1010.BJR-2021-0132.R1. Green open access

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Abstract

AIMS: Acetabular edge-loading was a cause of increased wear rates in metal-on-metal hip arthroplasties, ultimately contributing to their failure. Although such wear patterns have been regularly reported in retrieval analyses, this study aimed to determine their in vivo location and investigate their relationship with acetabular component positioning. METHODS: 3D CT imaging was combined with a recently validated method of mapping bearing surface wear in retrieved hip implants. The asymmetrical stabilizing fins of Birmingham hip replacements (BHRs) allowed the co-registration of their acetabular wear maps and their computational models, segmented from CT scans. The in vivo location of edge-wear was measured within a standardized coordinate system, defined using the anterior pelvic plane. RESULTS: Edge-wear was found predominantly along the superior acetabular edge in all cases, while its median location was 8° (interquartile range (IQR) -59° to 25°) within the anterosuperior quadrant. The deepest point of these scars had a median location of 16° (IQR -58° to 26°), which was statistically comparable to their centres (p = 0.496). Edge-wear was in closer proximity to the superior apex of the cups with greater angles of acetabular inclination, while a greater degree of anteversion influenced a more anteriorly centred scar. CONCLUSION: The anterosuperior location of edge-wear was comparable to the degradation patterns observed in acetabular cartilage, supporting previous findings that hip joint forces are directed anteriorly during a greater portion of walking gait. The further application of this novel method could improve the current definition of optimal and safe acetabular component positioning. Cite this article: Bone Joint Res 2021;10(10):639-649.

Type: Article
Title: The in vivo location of edge-wear in hip arthroplasties : combining pre-revision 3D CT imaging with retrieval analysis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1302/2046-3758.1010.BJR-2021-0132.R1
Publisher version: https://doi.org/10.1302/2046-3758.1010.BJR-2021-01...
Language: English
Additional information: © 2021 Author(s) et al. Open Access This article is distributed under the terms of the Creative Commons Attributions (CC BY 4.0) licence (https://creativecommons.org/ licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original author and source are credited.
Keywords: CT, CT scans, Retrieval analysis, Subluxation, Wear, acetabular cartilage, acetabular component positioning, acetabular components, acetabular cups, hip arthroplasties, hip implants, hip joints, metal-on-metal hip arthroplasties
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10138624
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