The Journal of Bone and Joint Surgery, Vol 77, Issue 1 111-117, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Fracture of the acetabulum during insertion of an oversized hemispherical component
YS Kim, JJ Callaghan, PB Ahn and TD Brown
Department of Orthopaedic Surgery, University of Iowa, Iowa City.
A hemispherical metal-backed acetabular component that was oversized by two
or four millimeters was introduced without cement into thirty fresh or
embalmed cadaveric acetabula that were fifty, fifty-two, fifty-four,
fifty-six, or fifty-eight millimeters in diameter. Manual tapping was used
to insert the component into ten fresh and ten embalmed specimens, and a
materials testing machine was used for the remaining five fresh and five
embalmed specimens. The magnitude of force and the number of pulses
necessary to seat the component were determined for the insertions
performed with the materials testing machine; 2000 and 3000 newtons of
force were required to insert the cups that were oversized by two and four
millimeters, respectively. Visual and radiographic assessments were used to
identify any resulting acetabular fractures. Over-all, eighteen (60 per
cent) of the thirty acetabular specimens fractured. Of the eighteen
fractures, only fifteen were detectable radiographically: ten on en face or
lateral radiographs of the cup and five only on oblique radiographs of the
cup. The remaining three fractures were apparent only after the removal of
the acetabular component.(ABSTRACT TRUNCATED AT 250 WORDS)