The femoral canal fill of two different cementless stem designs

In 19 cadaver femora we compared the fill of two types of femoral stems (plastic replica) using computed tomographic (CT) scan with a border detecting computer program and conventional radiographs. In the metaphyseal area the fill of the two types was surprisingly similar. In the diaphysis the straight stem filled significantly more than the proximally anatomic and distally over-reamed stem. Using conventional radiographs the fill measures were from 1.2 to 2.1 times higher than the values of CT scan, depending on the method of calculation. When both anteroposterior and lateral views were used, the fill as measured by radiographs correlated well with the fill as measured using CT scan. When conventional radiographs are used for evaluation of the canal fill, the calculation based on hypothetical rectangular areas at each level seemed to provide the most accurate results.RésuméSur 19 fémurs de cadavre nous avons comparé le remplissage par deux types de tiges fémorales (une droite et l'autre anatomique) en utilisant la tomodensitométrie avec un programme informatique adapté à l'étude des zones limites et les radiographies conventionnelles. Dans la région metaphysaire le remplissage par les deux types était étonnamment semblable. Dans la région diaphysaire la tige droite a rempli nettement plus que la tige anatomique en région proximale et avec sur-alésage en zone distale. En utilisant les radiographies conventionnelles les mesures du remplissage étaient de 1.2 à 2.1 fois plus hautes que les valeurs de la tomodensitométrie, dépendantes de la méthode de calcul. Quand les incidences frontale et latérale ont été utilisées, le remplissage mesuré par radiographies avait une bonne corrélation avec le remplissage mesuré par tomodensitométrie. Quand les radiographies conventionnelles sont utilisées pour l'évaluation du remplissage du canal, le calcul basé sur la section rectangulaire hypothétique à chaque niveau a paru fournir les résultats les plus exacts.

[1]  H. Tullos,et al.  The anatomic basis of femoral component design. , 1988, Clinical orthopaedics and related research.

[2]  J. Kärrholm,et al.  Subsidence, tip, and hump micromovements of noncoated ribbed femoral prostheses. , 1993, Clinical orthopaedics and related research.

[3]  The hydroxyapatite-ABG hip system: 5- to 7-year results from an international multicentre study. The International ABG Study Group. , 2000, The Journal of arthroplasty.

[4]  J Lund-Larsen,et al.  Determination of Hounsfield value for CT-based design of custom femoral stems. , 1999, The Journal of bone and joint surgery. British volume.

[5]  J. Mokris,et al.  Integral porous femoral stem. 5-to 8-Year follow-up study. , 1997, The Journal of arthroplasty.

[6]  P S Walker,et al.  Accuracy of using radiographs for custom hip stem design. , 1996, The Journal of arthroplasty.

[7]  T. Moilanen,et al.  The effects of cementless femoral stem shape and proximal surface texture on ’fit-and-fill’ characteristics and on bone remodeling , 2000, International Orthopaedics.

[8]  I Ziv,et al.  The accuracy of computed tomography-based linear measurements of human femora and titanium stem. , 1996, Investigative radiology.

[9]  H. Tullos,et al.  Effect of rotation on the radiographic appearance of the femoral canal. , 1994, The Journal of arthroplasty.

[10]  James P. Crutcher,et al.  Preoperative planning for total hip arthroplasty , 2000 .

[11]  J O Galante,et al.  Primary total hip reconstruction with a titanium fiber-coated prosthesis inserted without cement. , 1993, The Journal of bone and joint surgery. American volume.

[12]  Y.H. Kim,et al.  Uncemented porous-coated anatomic total hip replacement , 1993 .

[13]  John A. Anderson,et al.  Hydroxyapatite‐Coated Hip Prostheses: Early Results From an International Study , 1995, Clinical orthopaedics and related research.

[14]  C J Sutherland,et al.  Artifacts and thresholding in X-ray CT of a cortical bone and titanium composite. , 1996, Journal of computer assisted tomography.

[15]  A. Tonino,et al.  Rheumatoid arthritis and hydroxyapatite-coated hip prostheses: Five-year results , 1998 .

[16]  M. Lehto,et al.  Image processing for femoral endosteal anatomy detection: description and testing of a computed tomography based program. , 1997, Physics in medicine and biology.

[17]  P. Leyvraz,et al.  The morphology of the proximal femur. A three-dimensional radiographic analysis. , 1992, The Journal of bone and joint surgery. British volume.

[18]  C. Engh,et al.  Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. , 1987, The Journal of bone and joint surgery. British volume.

[19]  R B Bourne,et al.  Early radiographic results comparing cemented and cementless total hip arthroplasty. , 1996, The Journal of arthroplasty.