Measurement of the migration of a cemented hip prosthesis in an in vitro test.
Academic Article
Overview
abstract
OBJECTIVE: To develop a method to measure the migration of a cemented hip prosthesis in an in vitro experimental test. DESIGN: A device to measure prosthesis movement relative to bone was designed and fabricated. It was tested using a Lubinus prosthesis (W. Link, Germany) implanted in a composite femur. BACKGROUND: Clinical studies using radiostereophotogrammetry have shown that those cemented hip prosthesis that migrate rapidly in the first two post-operative years are the ones that require early revision. If migration be used as a basis for a pre-clinical test, then it should be possible to screen-out inferior designs before implantation in animal or clinical trials. METHODS: The micromotion measurement device consisted of a 'target' of three spheres arranged in a cruciform structure. Six linear variable displacement transducers were aligned with the spheres so that motion of the prosthesis relative to the bone could be measured. RESULTS: The displacement and rotation of the prosthesis relative to the composite femur was recorded for two million cycles. Relative rapid initial migration was found, followed by a period of steady-state migration. Distal migration (called 'subsidence' in this paper) of up to 0.1 mm was measured; however the variability in absolute prosthesis migration was very high despite efforts to ensure that all extraneous factors were minimised. In the majority of cases, the prostheses migrated medially, distally and anteriorly. The absolute subsidence, and its variability, were similar to that recorded clinically. CONCLUSIONS: A method has been designed and tested which measures prosthesis migration in an experimental test. It provides a basis for a pre-clinical testing standard. Relevance. Hip prostheses need to be tested experimentally before implantation. However, no reliable test exists for such experimental tests. Rapid migration of a cemented prosthesis relative to bone has been shown in vivo to correlate with early failure, and in this paper a method to make such migration measurements in vitro is described and tested.
