Detection of the insertion end point of cementless hip prostheses using the comparison between successive frequency response functions.

Vibration analysis is a non-destructive testing technique, which has a potential to assess the mechanical properties of the stem/femur system in total hip replacement (THR). Different methods based on vibration analysis have already been successfully used to determine bone mechanical properties, to monitor fracture healing, and to quantify the fixation of dental implants. This paper describes an in vitro study of the change in the frequency response function (FRF) of the hip stem/femur structure during implant insertion. At successive insertion stages, the FRF of the system was measured by impulse excitation on the prosthesis neck, in the range 0-5000 Hz. To quantify the difference between two successive FRF spectra, the Pearson's correlation coefficient and the cross correlation function were used. The stiffness of the implant/bone system varies during insertion, which results in a change in FRF, especially in the range of higher frequencies. If the FRF spectrum shifts to the right, then the stiffness of the implant/bone connection increases and, consequently, the stability of the implant increases as well. If the FRF does not change between two successive insertion stages, then the mechanical properties of the prosthesis-femur structure does not change; therefore, the stem-bone connection is stable and the insertion should stop to avoid intra-operative fractures. Based on the obtained results, a per-operative protocol based on FRF analysis can be designed to assess the stability of a cementless hip prosthesis, and to detect the insertion end point.