Effect of femoral stem length on stress raisers associated with revision hip arthroplasty

Abstract

The objective of this study was to experimentally determine the optimal length of a femoral component in revision total hip arthroplasty (THA). Embalmed cadaveric femurs were loaded in a physiologic manner, and strains on the lateral cortex were measured. Two kinds of defects were tested to simulate THA after removal of a nail plate and after removal of a loose femoral stem. A drill hole was made in the lateral cortex of the femur to simulate the removal of a nail plate. A reaming defect was made, using flexible reamers to thin the cortex from the lesser trochanter distally to a site corresponding to the tip of a standard femoral component, to simulate THA after removal of a previously inserted femoral stem. Femurs were tested intact, with the defects, and after insertion of femoral components with stem lengths of 100 to 250 mm. The strain increased with the creation of a defect and decreased with the insertion of an implant. For a femur with a defect, the strain was minimized when the stem length extended 1.5 femoral diameters past the defect.

Reduced Femoral Component Subsidence with Improved Impaction Grafting at Revision Hip Arthroplasty

“…The graft was double washed in warm saline, drained with a sieve, and manually impacted [40]. Also, from Series 2 onwards, nonirradiated allograft bone was used, and long-length stems [31,35] and proximal calcar mesh support [2] were used more commonly. From Series 2, the milled bone chips were mixed with vancomycin in a dose of 0.25 g per femoral head.…”

Calcar unloading after hip replacement: A cadaver study of femoral stem designs

“…Brockhurst & Svensson (1977), Oh & Harris (1978), McBeath et al (1979), , Rohlman et al (1983), Huiskes (1980), Voilin (1983), Lewis et al (1984). and Panjabi et al (1985).…”

Première reprise aseptique par scellement itératif des arthroplasties de hanche cimentées descellées. Influence de la perte de substance osseuse et de la qualité de la cimentation, à propos de 80 cas

“…Cela est validé expérimentalement par Panjabi et al [24]. Cependant, Gramkow et al [17] ne retrouvent pas une meilleur survie pour leur tiges supérieures à 210 mm par rapport à celles de longueur inférieure.…”