Deformable titanium for acetabular revision surgery: a proof of concept.

Autor: Magré J; Department of Orthopedics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. j.magre-2@umcutrecht.nl.; 3D Lab, Division of Surgical Specialties, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands. j.magre-2@umcutrecht.nl., Willemsen K; Department of Orthopedics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.; 3D Lab, Division of Surgical Specialties, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands., Kolken HMA; Department of Biomechanical Engineering, Delft University of Technology, 2628 CD, Delft, The Netherlands., Zadpoor AA; Department of Biomechanical Engineering, Delft University of Technology, 2628 CD, Delft, The Netherlands., Vogely HC; Department of Orthopedics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., van der Wal BCH; Department of Orthopedics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., Weinans H; Department of Orthopedics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.; Department of Biomechanical Engineering, Delft University of Technology, 2628 CD, Delft, The Netherlands.
Jazyk: angličtina
Zdroj: 3D printing in medicine [3D Print Med] 2023 Jun 09; Vol. 9 (1), pp. 16. Date of Electronic Publication: 2023 Jun 09.
DOI: 10.1186/s41205-023-00177-9
Abstrakt: Custom-made triflange acetabular implants are increasingly used in complex revision surgery where supporting bone stock is diminished. In most cases these triflange cups induce stress-shielding. A new concept for the triflange is introduced that uses deformable porous titanium to redirect forces from the acetabular rim to the bone stock behind the implant and thereby reduces further stress-shielding. This concept is tested for deformability and primary stability.Three different designs of highly porous titanium cylinders were tested under compression to determine their mechanical properties. The most promising design was used to design five acetabular implants either by incorporating a deformable layer at the back of the implant or by adding a separate generic deformable mesh behind the implant. All implants were inserted into sawbones with acetabular defects followed by a cyclic compression test of 1800N for 1000 cycles.The design with a cell size of 4 mm and 0.2 mm strut thickness performed the best and was applied for the design of the acetabular implants. An immediate primary fixation was realized in all three implants with an incorporated deformable layer. One of the two implants with a separate deformable mesh needed fixation with screws. Cyclic tests revealed an average additional implant subsidence of 0.25 mm that occurred in the first 1000 cycles with minimal further subsidence thereafter.It is possible to realize primary implant fixation and stability in simulated large acetabular revision surgery using a deformable titanium layer behind the cup. Additional research is needed for further implementation of such implants in the clinic.
(© 2023. The Author(s).)
Databáze: MEDLINE
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