Effect of cement fill ratio in loosening of hip implants

Gunn, Elizabeth; Gundapaneni, Dinesh; Goswami, Tarun

doi:10.4161/biom.20709

Cited by 19 publications

(13 citation statements)

References 11 publications

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“…More cracks have also been observed in retrievals, when the cement mantle is thin . In fact, numerical studies have shown that thin mantles generate higher stress in the cement, especially close to the stem‐cement interface …”

Section: Discussionmentioning

confidence: 99%

“…The thickness of the cement mantle is often indicated as a critical factor . It has been shown that a mantle thicker than 2–3 mm reduces cement stress and micromotions . Conversely, more cracks are found both ex vivo and in vitro where the cement mantle is thin.…”

mentioning

confidence: 99%

“…Conversely, more cracks are found both ex vivo and in vitro where the cement mantle is thin. Numerical studies have shown that thin mantles result in higher cement stress, especially near the stem‐cement interface, where fractures often initiate, especially when the mantle is thinner than 2 mm …”

mentioning

confidence: 99%

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Standard and line‐to‐line cementation of a polished short hip stem: Long‐term in vitro implant stability

Morellato

Grupp

Bader³

et al. 2018

Journal Orthopaedic Research

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The current trend is toward shorter hip stems. While there is a general agreement on the need for a cement mantle thicker than 2 mm, some surgeons prefer line-to-line cementation, where the mantle has only the thickness provided by the cement-bone interdigitation. The aim of this study was to assess if a relatively short, polished hip stem designed for a standard cementation can also be cemented line-to-line without increasing the risk of long-term loosening. Composite femurs with specific open-cell foam to allow cement-bone interdigitation were used. A validated in-vitro biomechanical cyclic test replicating long-term physiological loading was applied to femurs where the same stem was implanted with the Standard-mantle (optimal stem size) and Line-to-line (same rasp, one-size larger stem). Implant-bone motions were measured during the test. Inducible micromotions never exceeded 10 μm for both implant types (differences statistically not-significant). Permanent migrations ranged 50-300 μm for both implant types (differences statistically not-significant). While in the standard-mantle specimens there was a pronounced trend toward stabilization, line-to-line had less tendency to stabilize. The cement cracks were observed after the test by means of dye penetrants: The line-to-line specimens included the same cracks of the standard-mantle (but in the line-to-line specimens they were longer), and some additional cracks. The micromotions and cement damage were consistent with those observed in-vitro and clinically for stable stems, confirming that none of the specimens became dramatically loose. However, it seems that for this relatively short polished stem, standard-mantle cementation is preferable, as it results in less micromotion and less cement cracking. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2736-2744, 2018.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Standard and line‐to‐line cementation of a polished short hip stem: Long‐term in vitro implant stability

Morellato

Grupp

Bader³

et al. 2018

Journal Orthopaedic Research

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“…The bone has a diameter of 60.2 mm and the ball has a diameter of 28 mm. The thickness of cement mantle used by Gun et al [15] was adopted for calculating contact parameters in this study.…”

Section: Methodsmentioning

confidence: 99%

Study of an Additional Layer of Cement Mantle Hip Joints for Reducing Cracks

Jamari

Saputra

Anwar

et al. 2019

JFB

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Failure of the cement mantle in total hip arthroplasty is not a simple phenomenon. Cracking, which can be caused by crack initiation and repeated loading, can cause loosening of the acetabular liner component. A previous study showed that addition of a metal layer between the liner and acetabular could reduce the stress at the contact surface of the cement mantle. This study elaborates on the performance of the additional layer. Several material properties of the layer were simulated using finite element analysis for maximum performance. A static contact analysis was used to simulate the stresses at the contact surface of the cement mantle. The results show that an additional layer of cobalt chrome produced the best performance.

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“…The above-mentioned conditions are usually observed in patients who have an overly active lifestyle or suffer from osteoporosis and/or overweight. They may also occur if the implant is incorrectly installed or if thickness of the cement mantle is wrongly chosen (Gunn et al, 2012), what results from low skills of a surgeon.…”

Section: Introductionmentioning

confidence: 99%

On the choice of the thickness of the cement mantle in cemented hip arthroplasty

Levadnyi

Awrejcewicz

Loskutov

et al. 2017

jtam

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Recommendations for the optimal thickness of the cement mantle in cemented hip arthroplasty are outlined based on the results obtained with the finite element method. The investigations show that distal femur cement thickness higher than 2 mm positively affects mechanical behaviour of the cement mantle and can be useful in reducing stress-strain levels in the distal part of the femur what leads to prevention of development of a stress-shielding effect. The results of the study can contribute to the success of long-term implants.

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Effect of cement fill ratio in loosening of hip implants

Cited by 19 publications

References 11 publications

Standard and line‐to‐line cementation of a polished short hip stem: Long‐term in vitro implant stability

Standard and line‐to‐line cementation of a polished short hip stem: Long‐term in vitro implant stability

Study of an Additional Layer of Cement Mantle Hip Joints for Reducing Cracks

On the choice of the thickness of the cement mantle in cemented hip arthroplasty

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