Modelling changes in modular taper micromechanics due to surgeon assembly technique in total hip arthroplasty

Methods: Finite element models of generic cobalt-chromium (cocr) heads on a titanium stem taper were developed and driven using dynamic assembly loads collected from clinicians. To verify contact mechanics at the taper interface, comparisons of deformed microgroove characteristics (height and width of microgrooves) were made between model estimates with those measured from five retrieved implants. Additionally, these models were used to assess the role of assembly technique—one-hit versus three-hits—on the taper interlock mechanical behaviour.

Results: The model compared well to deformed microgrooves from the retrieved implants, pre- dicting changes in microgroove height (mean 1.1 μm (0.2 to 1.3)) and width (mean 7.5 μm (1.0 to 18.5)) within the range of measured changes in height (mean 1.4 μm (0.4 to 2.3); p = 0.109) and width (mean 12.0 μm (1.5 to 25.4); p = 0.470). consistent with benchtop studies, our model found that increasing assembly load magnitude led to increased taper engage- ment, contact pressure, and permanent deformation of the stem taper microgrooves. inter- estingly, our model found assemblies using three hits at low loads (4 kN) led to decreased taper engagement, contact pressures and microgroove deformations throughout the stem taper compared with tapers assembled with one hit at the same magnitude.

Conclusion: These findings suggest additional assembly hits at low loads lead to inferior taper interlock strength compared with one firm hit, which may be influenced by loading rate or material strain hardening. These unique models can estimate microgroove deformations represen- tative of real contact mechanics seen on retrievals, which will enable us to better under- stand how both surgeon assembly techniques and implant design affect taper interlock strength.