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  • IMPACT OF CEMENTLESS ZWEYMU...
    Cengic, Tomislav; Kodvanj, Janos; Smoljanovic, Tomislav; Adamovic, Petra; Aleric, Andrija; Bohacek, Ivan; Milosevic, Milan; Sabalic, Srecko; Delimar, Domagoj

    Acta clinica Croatica (Tisak), 09/2021, Letnik: 60, Številka: 3
    Journal Article

    Total hip arthroplasty implies proper orientation of both acetabular and femoral components with a range of 25-40degrees of combined anteversion. The aim of the study was to examine resistance to periprosthetic fracture of the axially loaded cross section rectangular femoral stem (Zw-eymiiller) with respect to different degrees of anteversion, implanted in the artificial bone model, in laboratory conditions. Femoral bone models with implanted femoral stems were divided into 3 groups depending on the degree of stem anteversion (A, control group 13-17degrees; B, stem retroverted 0degrees-4degrees; and C, stem anteverted 26-30degrees). The amount of axial load leading to periprosthetic fracture (PPFx) of the artificial bone model was determined experimentally for each construct. The results showed that the load at which the PPFx occurred significantly increased with the increase of the endoprosthesis anteversion angle. In our clinical practice, we are often unable to place the acetabular component in an ideal grade of anteversion for intraoperatively determined reasons. The results of this experimental study suggested that increasing rectangular femoral (Zweymuller) stem anteversion lowered the risk of PPFx. This study was limited by experimental design (laboratory conditions, artificial bone) and should be clinically verified. Key words: Total hip arthroplasty; Periprosthetic fracture; Artificial bone model Potpuna zamjena kuka podrazumijeva pravilnu orijentaciju acetabularne i femoralne komponente u rasponu od 25degrees-40degrees kombinirane anteverzije. Cilj ovoga istrazivanja bio je ispitati otpornost na periprotetski prijelom aksijalno opterecene femoralne komponente endoproteze kuka tipa Zweymuller, pravokutnog poprecnog presjeka s obzirom na razlicite iznose kutova anteverzije, ugradene u model umjetne kosti pri laboratorijskim uvjetima. Modeli femura s ugradenim endoprotezama podijeljeni su u tri skupine ovisno o stupnju anteverzije endoproteze (A, kontrolna skupina 13degrees-17degrees; B endoproteza u retroverziji 0degrees-4degrees; C, endoproteza u anteverziji 26degrees-30degrees). Iznos aksijalnog opterecenja koje dovodi do periprotetskog prijeloma umjetne kosti odreden je eksperimentalno za svaki sklop. Rezultati su pokazali da se opterecenje pri kojem je doslo do periprotetskog prijeloma znatno povecalo s povecanjem kuta anteverzije. U nasoj klinickoj praksi cesto nismo u mogucnosti pozicionirati acetabularnu komponentu u idealan stupanj anteverzije iz intraoperativno odredenih razloga. Rezultati ove eksperimentalne studije pokazuju da povecanjem anteverzije pravokutne femoralne (Zweymuller) endoproteze dolazi do smanjenja rizika od periprotetskog prijeloma. Ova studija je ogranicena eksperimentalnim dizajnom (laboratorijski uvjeti, umjetna kost) i trazi klinicku verifikaciju. Kljucne rijeci: Umjetni zglob kuka; Femoralna komponenta Zweymuller; Anteverzija; Periprotetski prijelom