[Primary stability of cement-free press-fit acetabulum cups. In vitro displacement studies]

The initial stability of 6 different hemispherical press-fit titanium acetabular cups was investigated by lever-out tests using a foam model. Each cup was implanted in a standardised manner into machined PVC-foam blocks with an underreaming of 1/2/3 mm, and levered out 5 times. A computer recorded the load-displacement curves. Both insertion forces and lever-out forces increased with increasing press-fit from 1 to 2 mm. With underreaming of 2 mm, insertion forces varied between 9 and 34 Nm, and lever-out torques between 13 and 23 Nm. The cup made up of multi-layer irregular titanium wire mesh had the highest initial stability of all the cups tested. 3 mm underreaming was associated with insertion difficulties, so that lever-out is difficult to compare with that with 1 and 2 mm. The amount of contact on the equatorial rim, where we saw the most attrition after lever-out, is the most important factor for determining the lever-out torque. The quality of the PVC foam blocks, the accuracy of reaming, and the definition of cup insertion are very important parameters for test reproduction. Since the trials were conducted under laboratory conditions, translation of the results to the intraoperative situation should be undertaken only with certain reservations.