Biomechanical evaluation of acetabular cup implantation in cementless total hip arthroplasty

Objective: To report biomechanical properties of the Biologic Fixation System (BFX) acetabular cup impacted into a normal canine pelvis and to compare the effect of implant positioned to and beyond the medial acetabular wall. Study Design: In vitro cadaveric study. Animals: Hemipelves of mature, large-breed dogs (n=6). Methods: For each dog, 1 hemipelvis was reamed to the depth of the acetabular wall (group A) and 1 was reamed an additional 6 mm after penetration of the medial cortex of the acetabulum (group B). The hemipelves were implanted with acetabular cups and loaded in compression through a matching femoral prosthetic component until failure. Specimen stiffness, and failure displacement, load, and energy were determined from load and displacement data and results between groups compared with a paired t-test. Results: Mean failure load was greater in group A (3812 ± 391 N) than group B (2924 ± 316 N; P<.014). No other differences (P>.05) were observed between groups. Bone fracture (n=5) and cup displacement (1) occurred in group A whereas in group B there were 3 fractures and 3 cup displacements. Conclusions: Although medial placement of the BFX cup affected compressive failure loads, failure loads for both groups exceeded normal physiologic loads. Clinical Relevance: Medial positioning of the acetabular cup does not appear to compromise acetabular implant-pelvic stability under normal physiologic loads. Because arthroplasty candidates often have abnormal acetabular architecture, mechanical properties of the cup placed in acetabula without a dorsal rim should be investigated.