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The addition of a flange does not improve the pressure generated during cemented acetabular cup implantation

Lookup NU author(s): Dr Alex Boote, Professor David Deehan, Dr Kenneth RankinORCiD, Dr David Swailes, Dr Philip Hyde



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2022 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals LLC. Flanged acetabular cups were developed with the rationale that, at insertion, they would increase the pressure of the cement and improve penetration of cement into the acetabular bone. Various studies have been inconclusive regarding their effectiveness. In this work, we aimed to eliminate all confounding factors and measure the pressures generated during acetabular pressurization and cup implantation using a simplified steel acetabulum, high precision pressure transducers, proper surgical techniques and two acetabular cups, identical apart from the addition of a flange to one. It was found that the flanged acetabular component did not significantly increase the pressure in the acetabulum and in some cases reduced the pressures generated when compared to an unflanged cup. The addition of a flange did not reduce the pressure differential between the pole and the rim of the acetabulum, nor did it have a significant effect on pressure lost over the cup implantation period. It was concluded that flanged acetabular cups provide no significant improvement in the pressures generated in the acetabulum during acetabular cup implantation. It is hypothesized that the flange may be seen as a design feature intended to slow the insertion of the cup into the cement, thus requiring the surgeon to apply a larger load in order to correctly position the acetabular cup; in this way larger pressure will be generated.

Publication metadata

Author(s): Boote AT, Deehan DJ, Rankin KS, Swailes DC, Hyde PJ

Publication type: Article

Publication status: Published

Journal: Journal of Biomedical Materials Research - Part B Applied Biomaterials

Year: 2022

Volume: 110

Issue: 10

Pages: 2290-2298

Print publication date: 01/10/2022

Online publication date: 03/06/2022

Acceptance date: 18/04/2022

Date deposited: 24/06/2022

ISSN (print): 1552-4973

ISSN (electronic): 1552-4981

Publisher: John Wiley and Sons Inc.


DOI: 10.1002/jbm.b.35077


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Funder referenceFunder name
Zimmer Biomet. Grant Number: R512588