Hammering Sound Frequency Analysis to Fix an Acetabular Cup during Total Hip Arthroplasty: Clinical Trials and Biomechanical Studies
- 1 Department of Biomedical Engineering and Technology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
- 2 Department of Orthopedic Surgery, Kitasato University, Kanagawa, Japan
- 3 Department of Orthopedic Surgery, Kitasato University, Kanagawa, Japan
- 4 Department of Biomedical Engineering and Technology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
- 5 Department of Biomedical Engineering and Technology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
- 6 Department of Biomedical Engineering and Technology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
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.
- Foster, A.P., Thompson, N.W., John, W. and Charlwood, A.P. (2005) Periprosthetic Femoral Fractures—A Comparison between Cemented and Uncemented Hemiarthroplasties. Injury, 36, 424-429. https://doi.org/10.1016/j.injury.2004.07.023
- Lindahl, H. (2007) Epidemiology of Periprosthetic Femur Fracture around a Total Hip Arthroplasty. Injury, 38, 651-654. https://doi.org/10.1016/j.injury.2007.02.048
- Moroni, A., Faldini, C., Piras, F. and Giannini, S. (2000) Risk Factors for Intraoperative Femoral Fractures during Total Hip Replacement. Annales Chirurgiae et Gynaecologiae, 89, 113-118.
- Schwartz, J.T., Mayer, J.G. and Engh, C.A. (1989) Femoral Fracture during Non-Cemented Total Hip Arthroplasty. Journal of Bone and Joint Surgery American Volume, 71, 1135-1142. https://doi.org/10.2106/00004623-198971080-00003
- Callaghan, J.J., Templeton, J.E., Liu, S.S., Pedersen, D.R., Goetz, D.D., Sullivan, P.M. and Johnston, R.C. (2004) Results of Charnley Total Hip Arthroplasty at a Minimum of Thirty Years. A Concise Follow-Up of a Previous Report. Journal of Bone and Joint Surgery American Volume, 86, 690-695. https://doi.org/10.2106/00004623-200404000-00004
- Digas, G., Kärrholm, J. and Thanner, J. (2006) Different Loss of BMD Using Uncemented Press-Fit and Whole Polyethylene Cups Fixed with Cement: Repeated DXA Studies in 96 Hip Randomized to 3 Types of Fixation. Acta Orthopaedica, 77, 218-226. https://doi.org/10.1080/17453670610045948
- Mathieu, V., Michel, A. and Lachaniette, C.H.F. (2013) Variation of the Impact Duration during the in Vitro Insertion of Acetabular Cup Implants. Medical Engineering & Physics, 35, 1558-1563. https://doi.org/10.1016/j.medengphy.2013.04.005
- Albrektsson, T., Brånemark, P.I., Hansson, H.A. and Lindström, J. (1981) Osseointegrated Titanium Implants: Requirements for Ensuring a Long-Lasting, Direct Bone-to-Implant Anchorage in Man. Acta Orthopaedica Scandinavica, 52, 155-170. https://doi.org/10.3109/17453678108991776
- Kroeber, M., Ries, M.D., Suzuki, Y. and Renowitzky, G. (2002) Impact Biomechanics and Pelvic Deformation during Insertion of Press-Fit Acetabular Cups. The Journal of Arthroplasty, 17, 349-354. https://doi.org/10.1054/arth.2002.30412
- Sakai, R., Takahashi, A., Takahira, N., Uchiyama, K., Yamamoto, T., Uchida, K., Fukusima, K., Moriya, M., Takaso, M., Itoman, M. and Mabuchi, K. (2011) Hammering Force during Cementless Total Hip Arthroplasty and Risk of Microfracture. Hip International, 21, 330-335. https://doi.org/10.5301/hip.2011.8408