alexa True Angle between Anterior-Posterior Impingement in To
ISSN: 2229-8711

Global Journal of Technology and Optimization
Open Access

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Research Article

True Angle between Anterior-Posterior Impingement in Total Hip Arthroplasty: Why Common Constrained Cups have to Fail

Andrej M. Nowakowski1*, Sebastian Gehmert1*, Irène Roesle1 and Karl-Heinz Widmer2

1Orthopaedic Department, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland

2Orthopaedic Department, Kantonsspital Schaffhausen, Geissbergstrasse 81, 8208 Schaffhausen, Switzerland

Corresponding Authors:
Andrej M. Nowakowski
Orthopaedic Department
University of Basel, Spitalstrasse 21
4031 Basel, Switzerland
Tel: +41-61 26 57197
E-mail: [email protected]
 
Sebastian Gehmert
Orthopaedic Department
University of Basel, Spitalstrasse 21
4031 Basel, Switzerland
E-mail: [email protected]

Received date: May 07, 2016; Accepted date: May 20, 2016; Published date: May 24, 2016

Citation: Nowakowski AM, Gehmert S, Roesle I, Widmer KH (2016) True Angle between Anterior-Posterior Impingement in Total Hip Arthroplasty: Why Common Constrained Cups have to Fail. Global J Technol Optim 7:194. doi:10.4172/2229-8711.1000194

Copyright: © 2016 Gehmert G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: Dislocation after total hip arthroplasty is a common complication and partially based on impingement. Questions/purposes: (1) The purpose of this study was to investigate the angle between anterior and posterior impingement in current hip cup designs. (2) Furthermore, the aim was to design a model of an acetabular cup with sparing gaps that match to impact areas. Methods: The range of motion was simulated with Maple R8 software using standard parameters in hip arthroplasty. Afterwards, a preliminary model for an optimized acetabular cup was designed in order to avoid impingement and dislocation. Results: (1) Anterior and posterior areas of impingement were not opposite but twisted by an angle of 108.3°. (2) The two main trajectories of motion were identified and areas with corresponding reductions and elevations were appropriate modified. The improvement resulted in a “bidirectional total hip prosthesis” with a combination of a snapfit acetabular cup and a reduced cup profile. Conclusion: The improvements of the described hip prosthesis are based on a simulation and are most likely to prevent impingement and subsequent dislocation. In addition, simulation with standard implantation parameters resulted in a rotational asymmetric implant design. Clinical relevance: Our data provide evidence that conventional hip cup designs fail to prevent impingement due to (1) The incorrect assumption of diagonally arranged impingement areas and the diagonal arranged sparing gaps (2) The sparing gap design itself that technically is not reducing the rim of the cup but instead only has an elevated coverage relative to the center of motion.

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