The Influence of Femoral Stem Thickness and Implantation Technique on the Strength of the Bone Cement Bond

Savino, A. W.; Andersson, Gunnar; Andriacchi, T.P.; Hampton, S.J.; Galante, Jorge O.

doi:10.3109/17453678208992174

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…Heat injury can be reduced, and even avoided, by keeping the amount of cement used to a minimum (104,136,140). The reduced rate of loosening of femoral components with a thick stem ( 5 , 40, 48, 54) may thus be a consequence of the small amount of cement used, rather than of the higher extrusion pressure of the cement dough (128) or of the increased stiffness of the stem (123,132). Conversely, the increased rate of loosening in cases with a large femoral canal (3, 5 , 40) and following revision arthroplasty (4,42,43) may at least partly be due to the larger risk of heat injury.…”

Section: Discussionmentioning

confidence: 99%

Loosening of the cemented hip prosthesis

Mjöberg

1986

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Loosening of the cemented hip prosthesis

Mjöberg

1986

Acta Orthopaedica Scandinavica

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“…In the first instance, thicker steam was used to decrease the possibility of movement. 7 Retrograde cementing technique was performed, which is widely known since Barrack et al 8 proved in 1992 that it decreases the loosening rate significantly. Recently, in 2019, Gausden et al reported that cemented femoral endoprosthesis is a versatile option that allows immediate full weight-bearing.…”

Section: Discussionmentioning

confidence: 99%

“…We present a novel surgical technique in which primary stability of a proximal femur endoprosthesis is achieved using multiple methods. In the first instance, thicker steam was used to decrease the possibility of movement 7. Retrograde cementing technique was performed, which is widely known since Barrack et al8 proved in 1992 that it decreases the loosening rate significantly.…”

Section: Discussionmentioning

confidence: 99%

Proximal Femur Endoprosthesis Augmentation With Polymethylmethacrylate and Condylar Plate: Surgical Technique Description

García

Lee

Rincón

2021

Techniques in Orthopaedics

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Introduction: Aseptic loosening by mechanical failure is one of the main causes of proximal femur endoprosthesis failure with different clinical consequences such as pain, inflammation, progressive loosening of muscular volume, and strength with functional limitation. Materials and Methods:We present the surgical description of the case of a patient with aseptic loosening of proximal femur endoprosthesis that was treated with a novel technique that combines different methods to achieve primary stability.Discussion: Different surgical techniques have been described to treat aseptic loosening of femoral endoprosthesis, including bone allografts, and total femur prosthesis which provides good functional results but high rates of complications such as infection (13%), dislocation (6%), and material failure (3%).Results: Proximal femur endoprosthesis augmentation with polymethylmethacrylate and condylar plate is a novel surgical technique that allows primary stabilization of the construct, early rehabilitation, improvement of functionality, and no signs of new loosening in a follow-up period of 6 months.

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“…Excluding infections, the revision rates for the prostheses are 1.6% (straight stem), 3.9% (curved stem), and 4.5% (130 ° stem) 5 to 10 years from implantation. A thick cement envelope probably also hastens loosening [30], and by minimal reaming of the femoral canal a thin cement layer results. Technical improvements which have led to this type of result probably include better cementing techniques, although the use of a cement restrictor was adopted only toward the end of the study period.…”

Section: Discussionmentioning

confidence: 99%

“…Using finite element analysis, Lewis et al [16] showed that the larger and stiffer the stem, the more unloading there was of the calcar. Other suggested causes for calcar resorption include heat injury from the cement [18], stress concentration [14], infection or loosening of the prosthesis [3,5,15,23], or reaction to the wear products of cement or polyethylene [9,12,30]. Other suggested causes for calcar resorption include heat injury from the cement [18], stress concentration [14], infection or loosening of the prosthesis [3,5,15,23], or reaction to the wear products of cement or polyethylene [9,12,30].…”

Section: Discussionmentioning

confidence: 99%

Comparison between straight- and curved-stem M�ller femoral prostheses

Wilson-MacDonald

Morscher

1989

Arch Orthop Trauma Surg

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Between 1977 and 1982, 545 cemented femoral prostheses were implanted, in combination with a noncoated cementless polyethylene acetabular component (RM cup). Three hundred and eighty-one straight-stem and 76 curved-stem Müller femoral components were implanted, as well as 88 collared components with a 130-mm stem and a 130 degrees neck-shaft angle, derived from a long-stem steel prosthesis. Survivorship analysis of revisions for aseptic loosening at 10 years revealed 97% straight-stem survival, 91.6% curved-stem survival, and 88.3% 130 degrees stem survival. "Survival" curves were also constructed for radiological loosening, and the survival rates (patients without radiological evidence of loosening) were 69.8%, 78.8%, and 63.1% respectively at 10 years. The 130 degrees collared stem was associated with significantly less acetabular loosening than the other prostheses. This resulted in less calcar resorption, but there was a higher rate of stem loosening. Acetabular loosening and associated wear products appear to be responsible for calcar resorption, and stress shielding of the calcar appears to be of minor importance in the pathogenesis of aseptic stem loosening. Better cementing techniques have improved survivorship of the curved-stem prosthesis, and early fears of high rates of radiological loosening with the straight stem have not been substantiated.

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The Influence of Femoral Stem Thickness and Implantation Technique on the Strength of the Bone Cement Bond

Cited by 10 publications

References 12 publications

Loosening of the cemented hip prosthesis

Loosening of the cemented hip prosthesis

Proximal Femur Endoprosthesis Augmentation With Polymethylmethacrylate and Condylar Plate: Surgical Technique Description

Comparison between straight- and curved-stem M�ller femoral prostheses

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