In vitro testing of the primary stability of the VerSys enhanced taper stem: A comparative study in intact and intraoperatively cracked femora

Abstract The Zimmer VerSys enhanced taper uncemented stem was tested in vitro for primary stability. Six stems were implanted in six composite femora. Three femora were unintentionally damaged by cracking of the bone during stem insertion and press-fit. A previously validated protocol was used to load the specimens cyclically and to record locally the rotational and axial bone/implant relative motions in terms of elastic motion and permanent migration. For the undamaged femora, the VerSys stem showed excellent primary stability, in terms of both elastic motions (less than 9 μm) and permanent migrations (less than 6 μm), and in both axial and rotational directions, comparing favorably with the literature. Intraoperatively-induced proximal cracks did influence the primary stability of the stem in terms of permanent migration. As cracks may easily be produced in the diaphyseal canal during insertion of cementless stems, which rely for primary stability on conical fitting into the canal, great care must be taken in preparation of the canal and insertion of the stem.

[1]  L Cristofolini,et al.  Initial stability of a new hybrid fixation hip stem: experimental measurement of implant-bone micromotion under torsional load in comparison with cemented and cementless stems. , 2000, Journal of biomedical materials research.

[2]  L Cristofolini,et al.  Methods for quantitative analysis of the primary stability in uncemented hip prostheses. , 1999, Artificial organs.

[3]  P. Benum,et al.  In vivo measurements show tensile axial strain in the proximal lateral aspect of the human femur , 1997, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[4]  M. Maruyama In vivo properties of an intramedullary hydroxyapatite plug to improve femoral stem fixation , 1997, Archives of Orthopaedic and Trauma Surgery.

[5]  H. Schmotzer,et al.  Surgical management of intra- and postoperative fractures of the femur about the tip of the stem in total hip arthroplasty. , 1996, The Journal of arthroplasty.

[6]  L Cristofolini,et al.  Mechanical validation of whole bone composite femur models. , 1996, Journal of biomechanics.

[7]  W H Harris,et al.  Influence of intraoperative femoral fractures and cerclage wiring on bone ingrowth into canine porous-coated femoral components. , 1995, The Journal of arthroplasty.

[8]  A Rohlmann,et al.  Is staircase walking a risk for the fixation of hip implants? , 1995, Journal of biomechanics.

[9]  L Cristofolini,et al.  Initial stability of uncemented hip stems: an in-vitro protocol to measure torsional interface motion. , 1995, Medical engineering & physics.

[10]  C. Engh,et al.  Late mechanical stability of the proximal coated AML prosthesis. , 1994, Orthopedics.

[11]  W H Harris,et al.  Tensile bonding strength of the cement-prosthesis interface. , 1994, Orthopedics.

[12]  V. Fornasier,et al.  Functional osseointegration of hydroxyapatite-coated implants in a weight-bearing canine model. , 1993, The Journal of arthroplasty.

[13]  W H Harris,et al.  Quantification of Implant Micromotion, Strain Shielding, and Bone Resorption With Porous‐Coated Anatomic Medullary Locking Femoral Prostheses , 1992, Clinical orthopaedics and related research.

[14]  W. Hayes,et al.  Role of loads and prosthesis material properties on the mechanics of the proximal femur after total hip arthroplasty , 1992, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[15]  L. Whiteside,et al.  Failure of cementless fixation of the femoral component in total hip arthroplasty. , 1992, The Orthopedic clinics of North America.

[16]  C. Engh,et al.  Femoral fracture during non-cemented total hip arthroplasty. , 1989, The Journal of bone and joint surgery. American volume.

[17]  J. M. Lee,et al.  Observations on the Effect of Movement on Bone Ingrowth into Porous‐Surfaced Implants , 1986, Clinical orthopaedics and related research.

[18]  S. Cook,et al.  Interface mechanics and bone growth into porous Co-Cr-Mo alloy implants. , 1985, Clinical orthopaedics and related research.

[19]  W. Hayes,et al.  Cross-sectional geometry of Pecos Pueblo femora and tibiae--a biomechanical investigation: I. Method and general patterns of variation. , 1983, American journal of physical anthropology.

[20]  H. Amstutz,et al.  "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. , 1979, Clinical orthopaedics and related research.

[21]  M. M. Taylor,et al.  Intraoperative femur fractures during total hip replacement. , 1978, Clinical orthopaedics and related research.

[22]  S. Woo,et al.  A comparison of cortical bone atrophy secondary to fixation with plates with large differences in bending stiffness. , 1976, The Journal of bone and joint surgery. American volume.

[23]  L. Palm,et al.  Initial Stability of Two Different Hip Revision Concepts. A Biomechanical Study , 1999 .

[24]  I. Ziv,et al.  Cerclage wiring technique after proximal femoral fracture in total hip arthroplasty. , 1999, The Journal of arthroplasty.

[25]  H. Willert,et al.  Noncemented Hip Replacement using a Conical Screw-In Cup and a Straight Press-Fit Stem. A Six to Eight-Year Clinical and Radiological follow-up Study , 1998 .

[26]  L Cristofolini,et al.  A critical analysis of stress shielding evaluation of hip prostheses. , 1997, Critical reviews in biomedical engineering.

[27]  S. Cook,et al.  The effect of operative fit and hydroxyapatite coating on the mechanical and biological response to porous implants. , 1995, The Journal of bone and joint surgery. American volume.

[28]  K. Søballe,et al.  Hydroxyapatite ceramic coating for bone implant fixation. Mechanical and histological studies in dogs. , 1993, Acta orthopaedica Scandinavica. Supplementum.

[29]  E Schneider,et al.  Experimental method for the in vitro testing of the initial stability of cementless hip prostheses. , 1989, Journal of biomechanics.

[30]  E Y Chao,et al.  The effect of load alteration on the biological and biomechanical performance of a titanium fiber-metal segmental prosthesis. , 1986, The Journal of bone and joint surgery. American volume.

[31]  P C McLeod,et al.  Measurements of repetitive activities of the knee. , 1975, Journal of biomechanics.