Optimisation of a Reinforced Cement Spacer in Total Hip Arthroplasty


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Infections total hip arthroplasty (THA) are common and can lead to serious complications for patients. Newly developed antibiotic spacers successfully eradicated infection in more than 90 percent of patients. However, the low mechanical strength of the orthopedic cement can be a serious handicap for the success of the surgical operation. The reinforcement of cement spacers with high strength materials can improve the efficiency of this type of surgery. In this study, the three-dimensional finite element method (FEM) is coupled with the experimental design method (EDM) to optimize the geometrical and mechanical properties of the reinforcement that can be applied to cements spacers. The obtained results show that the full stem reinforcement in bio-ceramic with a thickness of 8.2 mm can represent the optimal model to ensure good mechanical resistance of the cement spacer.





H. Salah et al., "Optimisation of a Reinforced Cement Spacer in Total Hip Arthroplasty", Journal of Biomimetics, Biomaterials and Biomedical Engineering, Vol. 35, pp. 35-49, 2018

Online since:

January 2018




* - Corresponding Author

[1] H. Sun, H. Inaoka, Y. Fukuoka, T. Masuda, A. Ishida and S. Morita, Range of motion measurement of an artificial hip joint using CT images. Medical & Biological Engineering & Computing, 45(12), 1229–1235. (2007).

[2] F. Bachtar, X. Chen and T. Hisada, Finite element contact analysis of the hip joint. Medical & Biological Engineering &Computing, 44(8), 643–651. (2006).

[3] B. Cameron, L. Galatz and GR. Williams, Factors affecting the outcome of total shoulder arthroplasty. The American Journal of Orthopedic, 30: 613–623. (2001).

[4] L. Ezquerra, M. P. Quilez, M. A. Perez, J. Albareda and B. Seral, Range of Movement for Impingement and Dislocation Avoidance in Total Hip Replacement Predicted by Finite Element Model, J. Med. Biol. Eng, 37: 26–34. (2017).

[5] T. Kubo, S. Inoue, T. Maeda Y. Arai, K. Hirakawa, Y. Wu, H. Suehara, T. Ogura and Y. Hirasawa, Cement less lord total hip arthroplasty: cup loosening common after minimum 10-year follow-up of 103 hips. Acta orthopaedics Scandinowa, 72: 585–590. (2001).

[6] B. Rajesh, R. Anwar and KJ. Ravikumar, Fractured cement spacers a report of two cases. The Iowa Orthopedic Journal Vol. 29, 17-18. (2009).

[7] T. Thielen, S. Maas, A. Zuerbes, D. Waldmann, K. Anagnostakos and J. Kelm, Development of a reinforced PMMA-based hip spacer adapted to patients needs. Medical Engineering & Physics, 31: 930–936. (2009).

[8] T. Andriacchi and D. Hurwitz, Gait biomechanics and the evolution of total joint replacement, Gait & Posture, 5 (3), pp.256-264. (1997).

[9] K. Oguz and F. Erzincanli, Finite element modeling and analysis of a new cemented hip prosthesis. Advances in Engineering Software, 37: 477–483. (2006).

[10] J. E. Bialoblocka, M. Baleani, L. Cristofolini and M. Viceconti, Fracture properties of an acrylic bone cement. Acta of Bioengineering and Biomechanics, Vol. 10, No. 1: 21-26. (2008).

[11] G. Bergmann, HIP98, Free University, Berlin, ISBN, 3-9807848-0-0. (2001).

[12] G. N. Duda et al, Influence of Muscle Forces on Femoral Strain Distribution. Journal of Biomechanics, Vol. 31: 841-846. (1998).

[13] A. Rohlmann et al, Finite element analysis and experimental investigation in a femur with hip endoprosthesis. Journal of Biomechanics, Vol. 16: 727–742. (1983).

[14] K. P. Rupesh and S. P. Sudhanshu, Modeling and optimisation of temperature in orthopedic drilling: An in vitro study. Acta of Bioengineering and Biomechanics, Vol. 16, No. 1: 107-116. (2014).

[15] N. L. Frigon, D. Mathews, Practical Guide to Experimental Design. Wiley, New York. (1996).

[16] L. Eriksson, E. Johansson, N. Kettaneh-Wold, C. Wikström and S. Wold, Design of Experiments: Principles and Applications. Learn ways AB, Stockholm. (2000).

[17] MODDE 5. 0 (Modeling and Design) Umetrics AB, Umea, Sweden.

[18] T. Thielen, S. Maas, A. Zuerbes, D. Waldmann, K. Anagnostakos and J. Kelm, Mechanical behaviour of standardized, endoskeleton-including hip spacers implanted into composite femurs. International Journal of Medical Sciences, 6(5): 280-286. (2009).

[19] M. M. Bouziane, H. Salah, S. Benbarek, B. Bachir Bouiadjra and B. Serier, Finite element Analysis of the Mechanical Behaviour of a Reinforced PMMA-based Hip Spacer. Advanced Materials Research, Vol. 110: 5 36-40. (2015).

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