title: Assessment of Head Displacement and Disassembly Force With Increasing Assembly Load at the Head/Trunnion Junction of a Total Hip Arthroplasty Prosthesis.
abstract: Most femoral components used now for total hip arthroplasty are modular, requiring a strong connection at assembly. The aim of this study was to assess the effect of assembly force on the strength of head-trunnion interface and to measure the initial displacement of the head on the trunnion with different assembly forces.
  
  
  
  Three assembly load levels were assessed (A: 2 kN, B: 4 kN, C: 6 kN) with 4 implants in each group. The stems were mounted in a custom rig and the respective assembly loads were applied to the head at a constant rate of 0.05 kN/s (ISO7260-10:2003). Load levels were recorded during assembly. Head displacement was measured with a laser sensor. The disassembly force was determined by a standard pull-off test.
  
  
  
  The maximum head displacement on the trunnion was significantly different between the 2 kN group and the other 2 groups (4 kN, 6 kN, P = .029), but not between the 4 kN and 6 kN groups (P = .89). The disassembly forces between the 3 groups were significantly different (mean ± standard deviation, A: 1316 ± 223 kN; B: 2224 ± 151 kN; C: 3965 ± 344 kN; P = .007), with increasing assembly load leading to a higher pull-off force. For the 4 kN and 6 kN groups, a first peak of approximately 2.5 kN was observed on the load recordings during assembly before the required assembly load was eventually reached corresponding to sudden increase in head displacement to approximately 150 μm.
  
  
  
  An assembly force of 2 kN may be too low to overcome the frictional forces needed to engage the head and achieve maximum displacement on the trunnion and thus an assembly load of greater than 2.5 kN is recommended.
authors.affiliation: Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
authors.forename: Darryl N
authors.initials: DN
authors.lastname: Ramoutar
authors.affiliation: Department of Mechanical Engineering, Centre for Orthopaedic Biomechanics, University of Bath, Bath, United Kingdom.
authors.forename: Emilie A
authors.initials: EA
authors.lastname: Crosnier
authors.affiliation: Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
authors.forename: Faiz
authors.initials: F
authors.lastname: Shivji
authors.affiliation: Department of Mechanical Engineering, Centre for Orthopaedic Biomechanics, University of Bath, Bath, United Kingdom.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Miles
authors.affiliation: Department of Mechanical Engineering, Centre for Orthopaedic Biomechanics, University of Bath, Bath, United Kingdom.
authors.forename: Harinderjit S
authors.initials: HS
authors.lastname: Gill
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D004867:Equipment Design; D005269:Femur / Q000601:surgery; D017276:Friction; D006622:Hip Prosthesis; D006801:Humans; D011312:Pressure; D011474:Prosthesis Design; D013314:Stress, Mechanical
keywords: Biomechanical testing; assembly force; head-taper connection; modular hip prosthesis; pull-off force