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Related Experiment Video

Updated: Dec 18, 2025

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Dynamic trial fitting by an expanding trial cup does not jeopardize primary acetabular component stability.

D Hoornenborg1, J van Loon2, S de Waard1

  • 1Xpert Orthopedie Amsterdam/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA Amsterdam, the Netherlands.

Clinical Biomechanics (Bristol, Avon)
|June 20, 2020
PubMed
Summary

Dynamic trial fitting with the X-pander® does not compromise initial press-fit stability in uncemented total hip replacement. This study found no significant difference in primary stability between the X-pander® and traditional trial cups.

Keywords:
Acetabular componentHip arthroplastyPress-fitPrimary stability

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Implant stability

Background:

  • Traditional trial cups for acetabular component fitting in hip replacement do not accurately mimic definitive press-fit.
  • The X-pander® dynamic trial inserter was developed to better replicate press-fit but raised concerns about potential loss of initial stability due to acetabular pre-expansion.

Purpose of the Study:

  • To compare the primary stability of acetabular components fitted using the X-pander® dynamic trial inserter versus traditional trial cups.

Main Methods:

  • A biomechanical randomized study using bovine calf acetabula.
  • Randomization between X-pander® and traditional trial cups for acetabular component fitting.
  • Measurement of the force required to lever out the implanted cup as the primary outcome.

Main Results:

  • No significant difference in mean lever-out force was found between the X-pander® group (45.1 Nm) and the trial cups group (45.0 Nm).
  • Mixed model analysis, adjusted for cup size and type, confirmed no statistically significant difference in primary stability between the two trial fitting methods (p=0.77).

Conclusions:

  • Pre-expansion of the acetabulum using the X-pander® dynamic trial fitting does not result in a loss of initial press-fit stability.
  • Both dynamic trial fitting with the X-pander® and traditional trial cups provide comparable primary stability for uncemented acetabular components.