Implant malpositioning has been identified as a factor associated with clinical failures of metal-on-metal hip resurfacings (MoMHRs). This study investigated the effect of cup orientation and cup coverage on the contact mechanics (incidence of edge-loading) and range of motion (ROM) of MoMHR. Three generic MoMHRs with differing amounts of cup coverage were considered at various orientations. Contact area and contact pressure at the bearing surface were predicted for each design using finite element (FE) method. The ROM was determined based on the geometry overlap. Edge contact was found at lower angles of inclination (65°) for lower coverage cup designs; however, they also provided the greatest ROM. Conversely, cups with greater coverage did not exhibit edge contact until the cup was more steeply positioned (75°), however ROM was reduced. This study enables both sets of variable to be considered in the design of metal-on-metal bearings in hip.
AmstutzHCCampbellPMcKellopH. Metal on metal total hip replacement workshop consensus document. Clin Orthop Relat Res1996; (329 Suppl.): S297–S303.
2.
McMinnDTreacyRLinK. Metal on metal surface replacement of the hip. Experience of the McMinn prosthesis. Clin Orthop Relat Res1996; (329 Suppl.): S89–S98.
3.
AmstutzHLe DuffM. Background of metal-on-metal resurfacing. Proc IMechE Part H: J Engineering in Medicine2006; 220: 85–94.
4.
JinZMMeakinsSMorlockMM. Deformation of press-fitted metallic resurfacing cups. Part 1: experimental simulation. Proc IMechE Part H: J Engineering in Medicine2006; 220: 299–309.
5.
McMinnDDanielJ. History and modern concepts in surface replacement. Proc IMechE Part H: J Engineering in Medicine2006; 220: 239–251.
6.
De SmetKAPattynCVerdonkR. Early results of primary Birmingham hip resurfacing using a hybrid metal-on-metal couple. Hip Int2002; 12: 158–162.
7.
BragdonCREstokDMMalchauH. Comparison of two digital radiostereometric analysis methods in the determination of femoral head penetration in a total hip replacement phantom. J Orthop Res2004; 22: 659–664.
8.
DanielJPynsentPBMcMinnDJ. Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg Br2004; 86: 177–184.
9.
BackDLDalzielRYoungD. Early results of primary Birmingham hip resurfacings: a independent prospective study of the first 230 hips. J Bone Joint Surg Br2005; 87: 324–329.
10.
TreacyRBCMcBrydeCWPynsentPB. Birmingham hip resurfacing arthroplasty: a minimum follow-up of five years. J Bone Joint Surg Br2005; 87: 167–170.
11.
AmstutzHCBeaulePEDoreyFJ. Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg Am2004; 86: 28–39.
12.
MacphersonGBreuschS. Metal-on-metal hip resurfacing: a critical review. Arch Orthop Trauma Surg2010; 131: 101–10.
13.
PanditHGlyn-JonesSMcLardy-SmithP. Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br2008; 90: 847–851.
14.
GrammatopolousGPanditHKwonYM. Hip resurfacings revised for inflammatory pseudotumour have a poor outcome. J Bone Joint Surg Br2009; 91: 1019–1024.
15.
MorlockMMBishopNZustinJ. Modes of implant failure after hip resurfacing: morphological and wear analysis of 267 retrieval specimens. J Bone Joint Surg Am2008; 90(Suppl. 3): 89–95.
16.
BeaulePELeeJLLe DuffMJ. Orientation of the femoral component in surface arthroplasty of the hip. A biomechanical and clinical analysis. J Bone Joint Surg Am2004; 86: 2015–2021.
17.
De SmetKA. Belgium experience with metal-on-metal surface arthroplasty. Orthop Clin North Am2005; 36: 203–213.
18.
BrodnerWGrüblAJankovskyR. Cup inclination and serum concentration of cobalt and chromium after metal-on-metal total hip arthroplasty. J Arthroplasty2004; 19(Suppl. 1): 66–70.
19.
WilliamsDRoyleMNortonM. Metal-on-metal hip resurfacing: the effect of cup position and component size on range of motion to impingement. J Arthroplasty2009; 24: 144–151.
20.
WilliamsSLeslieIIsaacG. Tribology and wear of metal-on-metal hip prostheses: influence of cup angle and head position. J Bone Joint Surg Am2008; 90(Suppl. 3): 111–117.
21.
LeslieIWilliamsSIsaacG. High cup angle and microseparation increase the wear of hip surface replacements. Clin Orthop Relat Res2009; 467: 2259–2265.
22.
CampbellPBeaulePEEbramzadehE. The John Charnley award: a study of implant failure in metal-on-metal surface arthroplasties. Clin Orthop Relat Res2006; 453: 35–46.
23.
DalstraMHuiskesR. Load transfer across the pelvic bone. J Biomech1995; 28: 715–724.
24.
SpeirsADHellerMOTaylorWR. Influence of changes in stem positioning on femoral loading after THR using a short-stemmed hip implant. Clin Biomech2007; 22: 431–439.
25.
SpeirsADHellerMODudaGN. Physiologically based boundary conditions in finite element modelling. J Biomech2007; 40: 2318–2323.
26.
AndreausUCollocaM. Prediction of micromotion initiation of an implanted femur under physiological loads and constraints using the finite element method. Proc IMechE Part H: J Engineering in Medicine2009; 223: 589–605.
27.
UdofiaILiuFJinZ. The initial stability and contact mechanics of a press-fit resurfacing arthroplasty of the hip. J Bone Joint Surg Br2007; 89: 549–556.
28.
MurrayDW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br1993; 75: 228–232.
29.
HellerMOBergmannGDeuretzbacherG. Musculo-skeletal loading conditions at the hip during walking and stair climbing. J Biomech2001; 34: 883–893.
30.
AndreausUCollocaMToscanoA. Mechanical behaviour of a prosthesized human femur: a comparative analysis between walking and stair climbing by using the finite element method. Biophys Bioeng Lett2008; 1: 1–15.
31.
SpearsIRPfleidererMSchneiderE. Interfacial conditions between a press-fit acetabular cup and bone during daily activities: implications for achieving bone in-growth. J Biomech2000; 33: 1471–1477.
32.
AugatPLinkTLangTF. Anisotropy of the elastic modulus of trabecular bone specimens from different anatomical locations. Med Eng Phys1998; 20: 124–131.
33.
ShultzTRBlahaJDGruenTA. Cortical bone viscoelasticity and fixation strength of press-fit femoral stems: a finite element model. J Biomech Eng2006; 128: 7–12.
34.
BoardmanDRMiddletonFRKavanaghTG. A benign psoas mass following metal-on-metal resurfacing of the hip. J Bone Joint Surg Br2006; 88: 402–404.
35.
IsaacGHSchmalzriedTPVailTP. Component mal-position: the ‘Achilles’ heel’ of bearing surfaces in hip replacement. Proc IMechE Part J: J Engineering Tribology2009; 223: 275–286.
36.
FisherJ. Bioengineering reasons for the failure of metal-on-metal hip prostheses: an engineer’s perspective. J Bone Joint Surg Br2011; 93: 1001–1004.
37.
LangtonDJJamesonSSJoyceTJ. The effect of component size and orientation on the concentrations of metal ions after resurfacing arthroplasty of the hip. J Bone Joint Surg Br2008; 90: 1143–1151.
38.
De HaanRPattynCGillHS. Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement. J Bone Joint Surg Br2008; 90: 1291–1297.
39.
JeffersJRRoquesATaylorA. The problem with large diameter metal-on-metal acetabular cup inclination. Bull NYU Hosp Jt Dis2009; 67: 189–192.
40.
JamesonSSLangtonDJNargolAVF. Articular surface replacement of the hip: a prospective single-surgeon series. J Bone Joint Surg Br2010; 92: 28–37.
41.
LiuFJinZMRiekerC. Comparison of contact mechanics between a total hip replacement and a hip resurfacing with a metal-on-metal articulation. Journal of Mechanical Engineering Science, Proceedings of the Institution of Mechanical Engineers2005; 219: 727–732.
42.
UdofiaIJJinZM. Contact mechanics of metal-on-metal hip resurfacing prostheses. Proc IMechE Part H: J Engineering in Medicine2004; 218: 293–305.
43.
IsaacGHSiebelTOakeshottRD. Changes in whole blood metal ion levels following resurfacing: serial measurements in a multi-centre study. Hip Int2009; 19: 330–337.
44.
HartAJ. Component malposition in patients with very high metal levels following hip resurfacing. In: Proceedings of the 75th annual meeting of AAOS, 2008, p. 82.
45.
MalikAMaheshwariADorrLD. Impingement with total hip replacement. J Bone Joint Surg Am2007; 89: 1832–1842.
46.
JohnstonRCSmidtGL. Hip motion measurements for selected activities of daily living. Clin Orthop Relat Res1970; 72: 205–215.
47.
LavigneMRamaKRBSRoyA. Painful impingement of the hip joint after total hip resurfacing: a report of two cases. J Arthroplasty2008; 23: 1074–1079.
48.
GalvinALKangLUdofiaI. Effect of conformity and contact stress on wear in fixed-bearing total knee prostheses. J Biomech2009; 42: 1898–902.
