Experimental analysis of insertion torques and forces of threaded and press-fit acetabular cups by means of ex vivo and in vivo measurements

In THA sufficient primary implant stability is the precondition for successful secondary stability. Industrial foams of different densities have been used for primary stability investigations. The aim of this study was to analyse and compare the insertion behaviour of threaded and press-fit cups in vivo and ex vivo using bone substitutes with various densities. Methods: Two threaded (Bicon Plus®, Trident® TC) and one press-fit cup (Trident PSL®) were inserted by orthopaedic surgeons (S1, S2) into 10, 20 and 31 pcf blocks using modified surgical instruments allowing measurements of the insertion forces and torques. Furthermore, the insertion behaviour of two cups were analysed intraoperatively. Results:Torques for the threaded cups increased while bone substitute density increased. Maximum insertion torques were observed for S2 with 102 Nm for the Bicon Plus® in 20 pcf blocks and 77 Nm for the Trident® TC in 31 pcf blocks which compares to the in vivo measurement (85 Nm). The average insertion forces for the press-fit cup varied from 5.2-6.8 kN (S1) and 7.2-11.5 kN (S2) ex vivo. Intraoperatively an average insertion force of 8.0 kN was determined. Conclusions: Implantation behaviour was influenced by acetabular cup design, bone substitute and experience of the surgeon. No specific density of bone substitute could be favoured for ex vivo investigations on the implantation behaviour of acetabular cups. The synthetic bone blocks of high density (31 pcf) led to problems regarding cup orientation and seating. Therefore, bone substitutes used should be critically scrutinized in terms of the comparability to the in vivo situation

Glacier recession and water resources in Peru's Cordillera Blanca

The tropical glaciers of the Cordillera Blanca, Peru, are rapidly retreating, resulting in complex impacts on the hydrology of the upper Rio Santa watershed. The effect of this retreat on water resources is evaluated by analyzing historical and recent time series of daily discharge at nine measurement points. Using the Mann-Kendall nonparametric statistical test, the significance of trends in three hydrograph parameters was studied. Results are interpreted using synthetic time series generated from a hydrologic model that calculates hydrographs based on glacier retreat sequences. The results suggest that seven of the nine study watersheds have probably crossed a critical transition point, and now exhibit decreasing dry-season discharge. Our results suggest also that once the glaciers completely melt, annual discharge will be lower than present by 2-30% depending on the watershed. The retreat influence on discharge will be more pronounced during the dry season than at other periods of the year. At La Balsa, which measures discharge from the upper Rio Santa, the glacier retreat could lead to a decrease in dry-season average discharge of 30%