Monitoring the press-fit insertion of an acetabular cup by impact measurements: influence of bone abrasion.

Press-fit procedures used for the insertion of cementless hip prostheses aim at obtaining optimal implant primary stability. We have previously used the measurement of impact duration to follow the insertion of the acetabular cup implant within bone tissue. The aim of this study was to investigate the variation of the value of the impact momentum due to successive insertions of the acetabular cup into bone tissue. The results obtained with impact momentum and contact duration measurements were compared. A total of 10 bovine bone samples were subjected to three successive procedures consisting of 10 reproducible impacts (3.5 kg falling 40 mm). Each procedure aimed at inserting the acetabular cup implant into the same bone cavity. The time variation of force during each impact was recorded by a force sensor, allowing the measurement of the impact duration (I 1) and momentum (I 2). The value of I 2 increased as a function of the impact number and reached a constant value after N 2 = 5.07 ± 1.31 impacts. Moreover, statistical analyses show that N 2 decreased significantly as a function of the number of experiments, which may be due to abrasion phenomena at the bone-implant interface. Abrasion phenomena led to a faster insertion of the acetabular cup when the implant had been previously inserted into the same bone cavity. An empirical analytical model considering a flat punch configuration to model the bone-implant contact conditions was used to understand the trend of the variation of I 2 during the insertion of the acetabular cup. The measurement of the force during impacts is useful to assess the bone-implant interface properties, but needs to be validated in the clinic to be useful for orthopaedic surgeons intra-operatively.