Vet Comp Orthop Traumatol 2009; 22(02): 142-147
DOI: 10.3415/VCOT-08-02-0020
Original Research
Schattauer GmbH

An evaluation of prosthetic femoral head impact on acetabular articular cartilage in a hemiarthroplasty model

J. R. Field
1   Comparative Orthopaedic Research Surgical Facility, School of Medicine, Flinders University, South Australia, Australia
,
R. Stanley
1   Comparative Orthopaedic Research Surgical Facility, School of Medicine, Flinders University, South Australia, Australia
,
R. Appleyard
2   Raymond Purves Bone and Joint Research Laboratory, Royal North Shore Hospital, University of Sydney, New South Wales, Australia
,
M. McGee
3   Orthopaedics and Trauma, Royal Adelaide Hospital, University of Adelaide, South Australia, Australia
,
S. Callary
3   Orthopaedics and Trauma, Royal Adelaide Hospital, University of Adelaide, South Australia, Australia
,
K. Nilsson
4   Orthopaedic Department, Umeå University Hospital, Umeå, Sweden
› Author Affiliations
Further Information

Publication History

Received 19 February 2008

Accepted 23 March 2008

Publication Date:
17 December 2017 (online)

Summary

Objectives: The quantitation of the impact of hemiarthroplasty currently involves clinical outcome measures and radiographic evaluation. This study used in vivo and in vitro means in order to evaluate articular cartilage changes following hemiarthroplasty in the sheep.

Methods: Radiostereometric analysis (RSA) was utilized in order to quantitate migration (penetration) in vivo of the femoral head into the articular cartilage of the acetabulum. Dynamic stiffness of retrieved specimens was quantitated in vitro using a handheld device. Chondrocyte viability was assessed using live/dead cell staining and quantitated using image analysis techniques. Saffranin-O staining provided histological assessment of the cellular response to hemiarthroplasty.

Results: RSA showed rapid penetration of the femoral head into the acetabular cartilage over six months. Significantly higher levels of dynamic stiffness were observed in the acetabula following hemiarthroplasty. Confocal imagery highlighted changes in chondrocyte distribution and morphology. A loss of metachromasia, fibrovascular tissue invasion and apoptosis were observed histologically.

Conclusions: RSA and measurement of the dynamic mechanical characteristics of cartilage provide a means of evaluating the development of degenerative articular cartilage changes in response to hemiarthroplasty.

 
  • References

  • 1 Baker RP, Squires B, Gargan MF. et al. Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomised, controlled trial. J Bone Joint Surg Am 2006; 88: 2583-2589.
  • 2 Blomfeldt R, Tornkvist H, Ponzer S. et al. Comparison of internal fixation with total hip replacement for displaced femoral neck fractures. Randomised, controlled trial performed at four years. J bone joint Surg Am 2005; 87: 1680-1688.
  • 3 Squires B, Bannister G. Displaced intracapsular neck of femur fractures in mobile independent patients: total hip or hemiarthroplasty. Injury 1999; 30: 345-334.
  • 4 Ravikumar KJ, Marsh G. Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur – 13 year results of a prospective randomised study. Injury 2000; 31: 793-797.
  • 5 Frihagen F, Madsen JE, Aksnes E. et al. Comparison of re-operation rates following primary and secondary hemiarthroplasty of the hip. Injury 2007; 38: 815-819.
  • 6 Cannon CP, Lin PL, Lewis VO. et al. Acetabular outcome after hip hemiarthroplasty in patients with tumors. Clin Orthop Rel Res 2007; 457: 183-187.
  • 7 McGibbon CA, Krebs DE, Trahan CA. et al. Cartilage degeneration in relation to repetitive pressure: a case study of a unilateral hip hemiarthroplasty patient. J Arthroplasty 1999; 14: 52-58.
  • 8 Van der Meulen M, Beaupre GS, Lane Smith R. et al. Factors influencing changes in articular cartilage following hemiarthroplasty in sheep. J Orthop Res 2002; 20: 669-675.
  • 9 Athanasiou KA, Agarwal A, Muffoletto A. et al. Biomechanical properties of hip cartilage in experimental animal models. Clin Orthop Rel Res 1995; 316: 254-266.
  • 10 Minihane KP, Turner TM, Urban RM. et al. Effect of hip hemiarthroplasty on articular cartilage and bone in a canine model. Clin Orthop Rel Res 2005; 437: 157-163.
  • 11 Cruess RL, Kwok DC, Duc PN. et al. The response of articular cartilage to weight-bearing against metal. A study of hemiarthroplasty in the dog. J Bone Joint Surg Br 1984; 66: 592-597.
  • 12 Cook SD, Thomas KA, Kester MA. Wear characteristics of the canine acetabulum against different femoral prostheses. J Bone Joint Surg 1989; 71: 189-197.
  • 13 Dalldorf PG, Banas MP, Hicks DG. et al. Rate of degeneration of human articular cartilage after hemiarthroplasty. J Bone Joint Surg Am 1995; 77: 877-882.
  • 14 Bae WC, Schumacher BL, Sah RL. Indentation probing of human articular cartilage: Effect on chondrocyte viability. Osteoarthritis Cartilage 2007; 15: 9-18.
  • 15 Appleyard RC, Swain MV, Khanna S. et al. The accuracy and reliability of a novel handheld dynamic indentation probe for analysing articular cartilage. Phys Med Biol 2001; 46: 541-550.
  • 16 Jadin KD, Bae WC, Schumacher BL. et al. Three-dimensional imaging of chondrocytes in articular cartilage: growth-associated changes in cell organization. Biomaterials 2007; 28: 230-239.
  • 17 Lyyra T, Jurvelin J, Pitkanen P. et al. Indentation instrument for the measurement of cartilage stiffness under arthoscopic control. Med Eng Phys 1995; 17: 395-399.
  • 18 Bae WC, Lewis CW, Levenston ME. et al. Indentation testing of human articular cartilage: effects of probe tip geometry and indentation depth on intra-tissue strain. J Biomech 2006; 39: 1039-1047.
  • 19 Field JR, Aberman H, Carbone A. et al. An ovine model for total hip replacement: operative procedure and complications. Vet Comp Orthop Traumatol 2001; 14: 32-39.
  • 20 Karrholm J, Herberts P, Hultmark P. et al. Radio-sterometry of hip prostheses. Review of methodology and clinical results. Clin Orthop Rel Res 1997; 344: 94-110.
  • 21 Digas G, Karrholm J, Thanner J. et al. Highly cross-linked polyethylene in total hip arthroplasty: randomised evaluation of penetration rate in cemented and uncemented sockets using radiostereometric analysis. Clin Orthop Rel Res 2004; 429: 6-16.
  • 22 Bragdon CR, Malchau H, Yuan X. et al. Experimental assessment of precision and accuracy of radiostereometric analysis for the determination of polyethylene wear in a total hip replacement model. J Orthop Res 2002; 20: 688-695.
  • 23 Loening AM, James IE, Levenston ME. et al. Injurious mechanical compression of bovine articular cartilage induces chondrocyte apoptosis. Arch Biochem Biophys 2000; 381: 205-212.
  • 24 D’Lima DD, Hasimoto S, Chen PC. et al. Cartilage injury induces chondrocyte apoptosis. J bone Joint Surg Am 2001; 83: 19-21.
  • 25 Kurz B, Jin M, Patwari P. et al. Biosynthetic response and mechanical properties of articular cartilage after injurious compression. J Orthop Res 2001; 19: 1140-1146.
  • 26 Clements KM, Bee ZC, Crossingham GV. et al. How severe must repetitive loading be to kill chondrocytes in articular cartilage?. Osteoarthritis Cartilage 2001; 9: 499-507.
  • 27 Young AA, Appleyard RC, Smith MM. et al. Dynamic biomechanics correlate with histopathology in human tibial cartilage: a preliminary study. Clin Orthop Relat Res 2007; 462: 212-220.
  • 28 Swann AC, Seedhom BB. Improved techniques for measuring the indentation and thickness of articular cartilage. Proc Inst Mech Eng [H] 1989; 203: 143-50. Review