Influence of bone morphology and femur preparation method on the primary stability of hip revision stems

Aseptic loosening is one of the major reasons for re‐revisions of cementless revision stems. Insufficient primary stability is associated with bone characteristics and the surgical process. This study aimed to investigate how femur morphology and preparation methods influence the primary stability o...

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Bibliographic Details
Published in:Journal of orthopaedic research 2023-06, Vol.41 (6), p.1283-1290
Main Authors: Konow, Tobias, Schlieker, Peter J., Lampe, Frank, Ondruschka, Benjamin, Morlock, Michael M., Huber, Gerd
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Hip - methods
bone morphology
canal reaming
Dorr type
Femur - surgery
femur curvature
Hip Prosthesis
Humans
Lower Extremity - surgery
primary stability
Prosthesis Design
Reoperation
Retrospective Studies
revision THA
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Summary:Aseptic loosening is one of the major reasons for re‐revisions of cementless revision stems. Insufficient primary stability is associated with bone characteristics and the surgical process. This study aimed to investigate how femur morphology and preparation methods influence the primary stability of revision stems. The Femur morphology was described by the upper femoral curvature (UFC) and an individualized Dorr type classification based on the ratio between the canal‐to‐calcar ratio (CCR*) and the cortical index (CI*) introduced as the cortical‐canal shape (CCS). Manual and powered reaming in combination with helical and straight reamers were used to prepare the bone cavity of 10 cadaveric human femur pairs. Forces during stem impaction were recorded (Reclaim, Depuy Synthes). Micromotion at the bone–implant interface during cyclic axial loading and torsional load to failure was determined. The CCS and impaction forces (R2 = 0.817, p 
ISSN:0736-0266
1554-527X
DOI:10.1002/jor.25481