The primary stability of the acetabular cup (AC) implant is an important determinant for the long term success of cementless hip surgery. However, it remains difficult to assess the AC implant stability due to the complex nature of the bone-implant interface. A compromise should be found when inserting the AC implant in order to obtain a sufficient implant stability without risking bone fracture. The aim of this study is to evaluate the potential of impact signals analyses to assess the primary stability of AC implants inserted in cadaveric specimens. AC implants with various sizes were inserted in 12 cadaveric hips following the same protocol as the one employed in the clinic, leading to 86 different configurations. A hammer instrumented with a piezoelectric force sensor was then used to measure the variation of the force as a function of time produced during the impact between the hammer and the ancillary. Then, an indicator I was determined for each impact based on the impact momentum. For each configuration, twelve impacts were realized with the hammer, the value of the maximum amplitude being comprised between 2500 and 4500 N, which allows to determine an averaged value I_M of the indicator for each configuration. The pull-out force F was measured using a tangential pull-out biomechanical test. A significant correlation (R² = 0.69) was found between I_M and F when pooling all data, which indicates that information related to the AC implant biomechanical stability can be retrieved from the analysis of impact signals obtained in cadavers. These results open new paths in the development of a medical device that could be used in the future in the operative room to help orthopedic surgeons adapt the surgical protocol in a patient specific manner.

To describe a new surgical procedure and its results: the vulvo-vaginal rejuvenation by lipofilling and an injection of combined platelet-rich-plasma (PRP) and hyaluronic acid (HA). Sexual life for women is affected by the effect of aging and by post partum traumatism. There are no standard non-invasive treatments to offer to improve the trophic and dimensional alterations of the vulvo-vaginal area. The surgical procedure consists in a vaginoplasty by lipofilling of the posterior vaginal wall far from the vascular axes and with an injection of an injection of combined PRP and HA subcutaneously in the perineum. To illustrate the technique and evaluate its results, we present the case of a 39 year-old-female with history of episiotomy presented that vaginal laxity resistant to physical therapy. To assess the results regarding the sexual quality of life we used the modified Stabbatsberg self-rating scale. There were no intra-operative complications with this simple procedure. During follow-up we observed an improvement in the modified Stabbatsberg scale and a vulvo-perineal rejuvenation by improving the vaginal trophicity and restoring a normal vaginal caliber. No post-operative complications occurred. Vulvo-vaginal rejuvenation lipofilling and an injection of combined platelet-rich-plasma and hyaluronic acid is a minimally invasive technique that is safe and easy to perform. Further studies are necessary to assess more thoroughly the effectiveness and safety of this procedure and assess medium and long term results.