Abstract
Failure during total hip arthroplasty may lead to bedridden of the elderly. Since the acetabulum cup fix in an anatomically deep region, failures, such as loosening and fracture, occur three times more frequently compared with failures of the stem fix in the femur. We investigated the possibility of evaluating whether fixation was acquired by frequency analysis of the hammering sound of implanting a cup into the acetabulum. The subjects were 11 patients (11 joints) who underwent total hip arthroplasty, biomechanical test materials, and orthopedic models. Surgeries and experiments were performed by orthopedists specialized in the hip. A system was constructed with a tablet PC and directional microphone, the peak frequency at which the amplitude reached the maximum was determined, and judgment processing (stable, unstable) of cup fixability was performed in real time. The stable maximum peak frequency observed in the clinical trials was 4.42 ± 4.02 kHz. The mean stable maximum peak frequency in the biomechanical tests was 4.46 ± 1.19 kHz in biomechanical test materials and 4.56 ± 2.02 kHz in orthopaedicmodels. When hammering was continued, the frequency leading to fracture decreased in both biomechanical test materials and orthopaedicmodels. In conclusion, in clinical trials and biomechanical studies, variation of the maximum peak frequency decreased when fixation was acquired and the frequency stabilized. It was suggested that this method can serve as a fixability evaluation method of acetabular cups because analysis can be performed in real time during surgery, for which prevention of intraoperative fracture can be expected.
Highlights
The total hip arthroplasty (THA) failure rate has been reported to be 4% - 30% [1] [2] [3] [4]
Since the position of acetabular cup fixation in the acetabulum is located in an anatomically deep region, fixation failure occurs three times more frequently compared with those of stem set into the femur [5] [6] [7]
The maximum peak frequency judged as stable was present in all PP
Summary
The total hip arthroplasty (THA) failure rate has been reported to be 4% - 30% [1] [2] [3] [4]. Since the position of acetabular cup fixation in the acetabulum is located in an anatomically deep region, fixation failure occurs three times more frequently compared with those of stem set into the femur [5] [6] [7]. A hammering with strong impacting is employed to prevent loosening of the acetabulum and cup for a long time [8] [9]. Blood vessels and nerves are present around the acetabulum and strong hammering has a risk of damaging the surrounding tissue. For this problem, there is no criterion to judge whether sufficient fixation was acquired at the time of cup placement and it depends on the surgeon’s experience and sense [10]
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