ArticleArthroplasty (London, England)2021
Quantification of assembly forces during creation of head-neck taper junction considering soft tissue bearing: a biomechanical study.
Article in Arthroplasty (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Wear performance of metal and ceramic long-neck femoral head taper connections: an experimental ex vivo study.Acta orthopaedica · 2026Article
- Design of Surgical Impaction Instruments Matters.Arthroplasty today · 2025Article
- A Computational Study on the Neck-Stem Rectangular Tapered Connection: Effects of Angular Mismatch, Assembly, and Cyclic Loading.International journal for numerical methods in biomedical engineering · 2025Article
- Wear of Femoral Head Taper Connections of Contemporary Total Hip Prostheses: An Experimental Study.Medical devices (Auckland, N.Z.) · 2025Article
- The influence of surgical technique guidance and surgeon's experience on the femoral head assembly in total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
- Influence of a Modified Procedure of Joining Ceramic Head and Adapter Sleeve on the Stem Taper in Revision: An Experimental Study.Bioengineering (Basel, Switzerland) · 2024Article
- Effect of Femoral Head Material, Surgeon Experience, and Assembly Technique on Simulated Head-Neck Total Hip Arthroplasty Impaction Forces.The Journal of arthroplasty · 2024Article
- The force at the implant cannot be assessed by the mallet force-Unless supported by a model.PloS one · 2024Article
- Evaluating the Feasibility and Reproducibility of a Novel Insertion Method for Modular Acetabular Ceramic Liners.Bioengineering (Basel, Switzerland) · 2023Article
- Importance of surgical assembly technique on the engagement of 12/14 modular tapers.Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine · 2022Article
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Authors and funding
6 authors.
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Abstract
backgroundAll current total hip arthroplasty (THA) systems are modular in design. Only during the operation femoral head and stem get connected by a Morse taper junction. The junction is realized by hammer blows from the surgeon. Decisive for the junction strength is the maximum force acting once in the direction of the neck axis, which is mainly influenced by the applied impulse and surrounding soft tissues. This leads to large differences in assembly forces between the surgeries. This study aimed to quantify the assembly forces of different surgeons under influence of surrounding soft tissue.
methodsFirst, a measuring system, consisting of a prosthesis and a hammer, was developed. Both components are equipped with a piezoelectric force sensor. Initially, in situ experiments on human cadavers were carried out using this system in order to determine the actual assembly forces and to characterize the influence of human soft tissues. Afterwards, an in vitro model in the form of an artificial femur (Sawbones Europe AB, Malmo, Sweden) with implanted measuring stem embedded in gelatine was developed. The gelatine mixture was chosen in such a way that assembly forces applied to the model corresponded to those in situ. A study involving 31 surgeons was carried out on the aforementioned in vitro model, in which the assembly forces were determined.
resultsA model was developed, with the influence of human soft tissues being taken into account. The assembly forces measured on the in vitro model were, on average, 2037.2 N ± 724.9 N, ranging from 822.5 N to 3835.2 N. The comparison among the surgeons showed no significant differences in sex (P = 0.09), work experience (P = 0.71) and number of THAs performed per year (P = 0.69).
conclusionsAll measured assembly forces were below 4 kN, which is recommended in the literature. This could lead to increased corrosion following fretting in the head-neck interface. In addition, there was a very wide range of assembly forces among the surgeons, although other influencing factors such as different implant sizes or materials were not taken into account. To ensure optimal assembly force, the impaction should be standardized, e.g., by using an appropriate surgical instrument.
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