Micromotion of cemented and uncemented femoral components

Burke, D. L.; O'Connor, D.O.; Zalenski, EB; Jasty, Murali; Harris, W.H.

doi:10.1302/0301-620x.73b1.1991771

Cited by 196 publications

(98 citation statements)

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“…However, proximal bone resorption due to distal fixation and proximal stress shielding has caused concerns and this has led to newer designs with a porous-coating applied only to the proximal metaphyseal part of the stem [13,14,31,37]. Femoral stem micro-motion studies have emphasized the importance of metaphyseal fit in reducing torsional motion [2,4,15] and enable bone ingrowth [5,38]. Likewise, inadequate canal filling has been considered to be the main cause for stem failures [7,9,30,31], and in the series of Kim and Kim [24,25,26] a poor initial stem "fit-and-fill" was associated with thigh pain and component loosening.…”

Section: Introductionmentioning

confidence: 99%

The effects of cementless femoral stem shape and proximal surface texture on ’fit-and-fill' characteristics and on bone remodeling

Laine

Puolakka

Moilanen

et al. 2000

International Orthopaedics

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We measured the post-operative radiological "fit and fill" of two different femoral stem designs, one with a straight proximally porous-coated n=50) and the other with a proximally anatomic, hydroxyapatite-coated and distally over-reamed stem (ABG, n=26). A comparison was then made between the clinical and radiological 5-year follow-up data of these two series and also of the bone remodeling changes around the stems. The observed differences in "fit and fill" parameters in the metaphyseal region were minute. However, in the diaphyseal bone the straight stem had substantially more cortical contact. The clinical results were excellent for both groups. Subsidence (>2 mm) was more frequent with the anatomical ABG stems, although the ABG stems had better bone ingrowth in the lower metaphyseal area. The present results indicate that the anatomical design may improve the fit and fill of a femoral stem in the metaphysis. On the other hand, a looser fill of the diaphyseal bone made the stems of this type more susceptible to subsidence. The straight stem with tight diaphyseal fit showed excellent stability, but the good bone ingrowth and remodeling around the distal part of the stem indicates stress transfer through this region and increased stress shielding of the proximal metaphyseal femur.Résumé Nous avons mesuré l'adaptation et le remplissage radiographique postopératoire de deux modèles diffé-rents de tiges fémorales, une tige droite avec la porosité proximale (BI-Metric, n=50) et une tige proximalement anatomique revêtue d'hydroxyapatite avec un surfaçage distal (ABG, n=26). Nous avons comparé les renseignements cliniques et radiographiques de ces deux séries de données résultant d'un suivi de cinq ans. Le remodelage osseux autour des tiges a été pris en compte. Les diffé-rences observées dans les paramètres de l'adaptation et de remplissage dans la région métaphysaire étaient minimales. Par contre dans la région diaphysaire la tige droite faisait montre de plus de contact cortical et ceci d'une manière significative. Les résultats cliniques sur ces deux groupes furent excellents. L'enfoncement (>2 mm.) de tiges anatomiques ABG était plus fréquent. Les résul-tats présentés indiquent que le modèle anatomique pourrait améliorer l'adaptation et le remplissage de la tige fé-morale dans la région de l'os métaphysaire.

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Section: Introductionmentioning

confidence: 99%

The effects of cementless femoral stem shape and proximal surface texture on ’fit-and-fill' characteristics and on bone remodeling

Laine

Puolakka

Moilanen

et al. 2000

International Orthopaedics

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“…It is not quite certain, what is the micromotion at the boneingrowth surface area preventing bone ingrowth. In simulated stair climbing micromotion of cementless implants it is up to 280 μm (Burke et al 1991) which is close to 100-400 μm pore size commonly used in the porous coated implants still allowing bone ingrowth. The best implant-bone contact (bone ingrowth) is achieved in contact with compact, cortical bone characterized by Haversian channels.…”

Section: Physiological Fixation Of Uncemented Implantsmentioning

confidence: 63%

Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

Gallo¹,

Konttinen²,

Goodman³

et al. 2012

Recent Advances in Arthroplasty

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“…Burke and colleagues reported vertical motions up to 30 (cementless stems) and 42 ím (cemented stems) under vertical loading of 445 N, but adding torsional loading increased these to 76 (cemented ) and 280 ím (cementless) [26 ]. Walker et al [24] reported micromotions of 10-50 ím, the smallest movements for cemented stems.…”

Section: Discussionmentioning

confidence: 98%

A proximal femoral implant preserves physiological bone deformation: A biomechanical investigation in cadaveric bones

Macdonald

Carlsson

Jacobsson

et al. 2003

Proc Inst Mech Eng H

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Abstract:The aim of this study was to compare the perturbances in bone deformation patterns of the proximal femur due to a conventional cemented femoral stem and a novel uncemented implant designed on the principles of osseointegration. Five matched pairs of fresh frozen human femora were mechanically tested. Bone deformation patterns, measured with a video digitizing system under 1.5 kN joint force, showed that the cemented Spectron femoral implant caused signi cant alterations to the proximal femoral deformation pattern, whereas the Gothenburg osseointegrated titanium femoral implant did not signi cantly alter the bone behaviour ( p<0.05). Vertical micromotions measured under 1 kN after 1000 cycles were within the threshold of movement tolerable for bone ingrowth (21 ím for the Gothenburg system and 26 ím for the cemented implant).

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Micromotion of cemented and uncemented femoral components

Cited by 196 publications

References 0 publications

The effects of cementless femoral stem shape and proximal surface texture on ’fit-and-fill' characteristics and on bone remodeling

The effects of cementless femoral stem shape and proximal surface texture on ’fit-and-fill' characteristics and on bone remodeling

Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

A proximal femoral implant preserves physiological bone deformation: A biomechanical investigation in cadaveric bones

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