Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing Arthroplasty
Background. To date, there have been no published investigations on the cause of acetabular debonding, a rare failure phenomenon in metal-on-metal hip resurfacing where the acetabular porous coating delaminates from the implant while remaining well fixed to the pelvic bone. Purposes. This study aims...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2018/5282167 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849308658691735552 |
|---|---|
| author | Eric Robinson Dani Gaillard-Campbell Thomas P. Gross |
| author_facet | Eric Robinson Dani Gaillard-Campbell Thomas P. Gross |
| author_sort | Eric Robinson |
| collection | DOAJ |
| description | Background. To date, there have been no published investigations on the cause of acetabular debonding, a rare failure phenomenon in metal-on-metal hip resurfacing where the acetabular porous coating delaminates from the implant while remaining well fixed to the pelvic bone. Purposes. This study aims to summarize the current understanding of acetabular debonding and to investigate the discrepancy in rate of debonding between two implant systems. Patients and Methods. To elucidate potential causes of debonding, we retrospectively analyzed a single-surgeon cohort of 839 hip resurfacing cases. Specifically, we compared rate of debonding and manufacturing processes between two implant systems. Results. Group 1 experienced significantly more cases of debonding than Group 2 cases (4.0% versus 0.0%, p value<0.0001). Implant manufacturing processes differed in surface coating, heat treatment, postmanufacturing treatment, and apex thickness. Debonded implants were more likely to have missed RAIL guidelines (p=0.04). Conclusions. We identified implant system, postoperative time, and acetabular component placement as variables contributing to rate of debonding. We recommend minimizing acetabular inclination angle according to RAIL guidelines. Further, we evaluated manufacturing differences between the two implant systems but did not have access to proprietary data to identify the cause of debonding. Both implants met ASTM standards, yet only the Group 1 implant debonded. This suggests the second implant had greater fatigue shear strength. Because the Group 2 implant achieved a more durable interface that did not debond, we suggest the ASTM F1160 standard for fatigue shear strength be increased to that achieved by its manufacturer. Level of Evidence II. A retrospective evaluation of prospectively collected data. |
| format | Article |
| id | doaj-art-0ec165f30187418db3c44fc2fc5511fe |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-0ec165f30187418db3c44fc2fc5511fe2025-08-20T03:54:24ZengWileyAdvances in Orthopedics2090-34642090-34722018-01-01201810.1155/2018/52821675282167Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing ArthroplastyEric Robinson0Dani Gaillard-Campbell1Thomas P. Gross2Midlands Orthopaedics & Neurosurgery, 1910 Blanding Street, Columbia, SC 29201, USAMidlands Orthopaedics & Neurosurgery, 1910 Blanding Street, Columbia, SC 29201, USAMidlands Orthopaedics & Neurosurgery, 1910 Blanding Street, Columbia, SC 29201, USABackground. To date, there have been no published investigations on the cause of acetabular debonding, a rare failure phenomenon in metal-on-metal hip resurfacing where the acetabular porous coating delaminates from the implant while remaining well fixed to the pelvic bone. Purposes. This study aims to summarize the current understanding of acetabular debonding and to investigate the discrepancy in rate of debonding between two implant systems. Patients and Methods. To elucidate potential causes of debonding, we retrospectively analyzed a single-surgeon cohort of 839 hip resurfacing cases. Specifically, we compared rate of debonding and manufacturing processes between two implant systems. Results. Group 1 experienced significantly more cases of debonding than Group 2 cases (4.0% versus 0.0%, p value<0.0001). Implant manufacturing processes differed in surface coating, heat treatment, postmanufacturing treatment, and apex thickness. Debonded implants were more likely to have missed RAIL guidelines (p=0.04). Conclusions. We identified implant system, postoperative time, and acetabular component placement as variables contributing to rate of debonding. We recommend minimizing acetabular inclination angle according to RAIL guidelines. Further, we evaluated manufacturing differences between the two implant systems but did not have access to proprietary data to identify the cause of debonding. Both implants met ASTM standards, yet only the Group 1 implant debonded. This suggests the second implant had greater fatigue shear strength. Because the Group 2 implant achieved a more durable interface that did not debond, we suggest the ASTM F1160 standard for fatigue shear strength be increased to that achieved by its manufacturer. Level of Evidence II. A retrospective evaluation of prospectively collected data.http://dx.doi.org/10.1155/2018/5282167 |
| spellingShingle | Eric Robinson Dani Gaillard-Campbell Thomas P. Gross Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing Arthroplasty Advances in Orthopedics |
| title | Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing Arthroplasty |
| title_full | Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing Arthroplasty |
| title_fullStr | Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing Arthroplasty |
| title_full_unstemmed | Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing Arthroplasty |
| title_short | Acetabular Debonding: An Investigation of Porous Coating Delamination in Hip Resurfacing Arthroplasty |
| title_sort | acetabular debonding an investigation of porous coating delamination in hip resurfacing arthroplasty |
| url | http://dx.doi.org/10.1155/2018/5282167 |
| work_keys_str_mv | AT ericrobinson acetabulardebondinganinvestigationofporouscoatingdelaminationinhipresurfacingarthroplasty AT danigaillardcampbell acetabulardebondinganinvestigationofporouscoatingdelaminationinhipresurfacingarthroplasty AT thomaspgross acetabulardebondinganinvestigationofporouscoatingdelaminationinhipresurfacingarthroplasty |