Abstract
Total hip arthroplasty (THA) is a surgical procedure for the replacement of hip joints with artificial prostheses. Several approaches are currently employed in the treatment of this kind of defect. Overall, the most common method involves using a quite invasive metallic support (a Burch–Schneider ring). Moreover, valid alternatives and less invasive techniques still need to be supported by novel material development. In this work, we evaluated the performance of SmartBone®, a xenohybrid bone graft composed of a bovine bone matrix reinforced with biodegradable polymers and collagen, as an effective support in acetabular prosthesis reconstruction. Specifically, the material’s mechanical properties were experimentally determined (E = ~1.25 GPa, Ef = ~0.34 GPa, and Et = ~0.49 GPa) and used for simulation of the hip joint system with a SmartBone® insert. Moreover, a comparison with a similar case treated with a Burch–Schneider ring was also conducted. It was found that it is possible to perform THA revision surgeries without the insertion of an invasive metal support and it can be nicely combined with SmartBone®’s osteointegration characteristics. The material can withstand the loads independently (σmax = ~12 MPa) or be supported by a thinner titanium plate in contact with the bone in the worst cases. This way, improved bone regeneration can be achieved.
Highlights
The number of primary and revisional total hip arthroplasties (THAs) has significantly increased over the last 25 years
We evaluated the performance of SmartBone®, a xenohybrid bone graft composed of a bovine bone matrix reinforced with biodegradable polymers and collagen, as an effective support in acetabular prosthesis reconstruction
The results showed that SmartBone® can be effectively employed as a structural material in acetabular reconstruction using a more conservative surgery approach and reducing the invasiveness of the most common prosthesis thanks to an easier fixation system
Summary
The number of primary and revisional total hip arthroplasties (THAs) has significantly increased over the last 25 years. Another common technique is the open reduction internal fixation, which is performed before THA [10,11,12] Another clinical practice involves different types of reinforcement rings to fix the acetabular component to the periacetabular bony structures, in place of using the femoral head as an autograft for acetabular reconstruction. The implants need to be fixed to ensure long-term stability This can be achieved using different techniques, such as press-fitting, positioning of bone cement along the femoral stem and backside to the acetabular cup, or the presence of porous coating to encourage tissue growth [5]. Considering the osteoconductive properties of the graft, further development into real cases seems to be fully possible, opening the way to a novel perspective in prosthesis treatment with completely resorbable biomaterials
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