Atlas : Welcome

Explants analysis

The various Atlas

Atlas and Low-friction

Primary stability

Surgical procedure

Clinical data

Insert stability

Quality requirement

Insert thickness

Atlas : The inventor

Secondary stability

Contact

International distribution

Explant analysis

Are impacted cups with a polyethylene insert subjected to micro fretting between the insert and the cup ? That is a frequently asked question, especially with elastic cup acetabular prostheses.

This prompted microscopic studies of Esop®' explants, conducted at the Laboratoire National d'Essai (LNE) and in FHI (Fournitures Hospitalières Industrie)'s lab in Quimper..

Explants

We studies 30 explanted Esop®

Out of 1919 Esop® used in our institution since 1987, 30 have been explanted for various reasons : 11 infections, 8 metallosis cases due to titanium head deterioration, 3 dislocations, 5 femoral failures and 3 acetabular loosening.

There were 7 cases of explant within the first 3 years after the operation, 10 between 4 and 6 years, 8 between 7 and 9 years and 5 after 10 years or more.
All explants were studied under the microscope, first of all over the whole convexity, for friction signs, then in the unpolished-looking tightening area.

 

Microscope study

The convexity shows the marks left by the machining tool.

 

Enlarged machining marks (LNE)Enlarged machining marks (LNE)

Enlarged machining marks (LNE)

 

The tightening area shows grooves in the impaction axis, small enlargement in our labs, strong enlargement at the Laboratoire National d'Essai, LNE.

These grooves were made when the cup was impacted, with the rough internal surface allows for rotation stabilisation.

Tightening grooves : enlarged 25 times

Tightening grooves : enlarged 25 times

 

Tightening grooves found by the LNE : enlarged 300 times

Tightening grooves found by the LNE : enlarged 300 times

 

The slot is clearly visible after 11 years and 9 months

The slot is clearly visible after 11 years and 9 months

Conclusion

Nowhere on any explant did we observe that the marks disappears, which rules out friction on the insert convexity.
Observing the area opposite the slot shows that without clamping at that place, the machining marks are still there, even after 10 years. The clear outline in strong enlargement images points to the absence of micromobility.

No micromobility

Welcome - The various Esop - Primary stability - Insert stability - Insert thickness - Secondary stability - Explant analysis - Low-friction
Surgical procedure - Clinical data - Quality requirement - The inventor - Contact - International distribution