The fixation of the cemented femoral component. Effects of stem stiffness, cement thickness and roughness of the cement-bone surface.

After cemented total hip arthroplasty (THA) there may be failure at either the cement-stem or the cement-bone interface. This results from the occurrence of abnormally high shear and compressive stresses within the cement and excessive relative micromovement. We therefore evaluated micromovement and stress at the cement-bone and cement-stem interfaces for a titanium and a chromium-cobalt stem. The behaviour of both implants was similar and no substantial differences were found in the size and distribution of micromovement on either interface with respect to the stiffness of the stem. Micromovement was minimal with a cement mantle 3 to 4 mm thick but then increased with greater thickness of the cement. Abnormally high micromovement occurred when the cement was thinner than 2 mm and the stem was made of titanium. The relative decrease in surface roughness augmented slipping but decreased debonding at the cement-bone interface. Shear stress at this site did not vary significantly for the different coefficients of cement-bone friction while compressive and hoop stresses within the cement increased slightly.

[1]  J Kärrholm,et al.  Micromotion of femoral stems in total hip arthroplasty. A randomized study of cemented, hydroxyapatite-coated, and porous-coated stems with roentgen stereophotogrammetric analysis. , 1994, The Journal of bone and joint surgery. American volume.

[2]  J L Lewis,et al.  The influence of prosthetic stem stiffness and of a calcar collar on stresses in the proximal end of the femur with a cemented femoral component. , 1984, The Journal of bone and joint surgery. American volume.

[3]  N Verdonschot,et al.  Mechanical effects of stem cement interface characteristics in total hip replacement. , 1996, Clinical orthopaedics and related research.

[4]  D. W. Roberts,et al.  The effects of modern cementing techniques on the longevity of total hip arthroplasty. , 1988, The Orthopedic clinics of North America.

[5]  R. H. Fitzgerald,et al.  Non-cemented total hip arthroplasty , 1987 .

[6]  A Sarmiento,et al.  The cement mantle in total hip arthroplasty. Analysis of long-term radiographic results. , 1994, The Journal of bone and joint surgery. American volume.

[7]  H. Mckellop,et al.  In vivo wear of titanium-alloy hip prostheses. , 1990, The Journal of bone and joint surgery. American volume.

[8]  N Verdonschot,et al.  Cement Debonding Process of Total Hip Arthroplasty Stems , 1997, Clinical orthopaedics and related research.

[9]  R. Rothman,et al.  Cemented versus cementless total hip arthroplasty. A critical review. , 1990, Clinical orthopaedics and related research.

[10]  D R Pedersen,et al.  An analysis of collar function and the use of titanium in femoral prostheses. , 1981, Clinical orthopaedics and related research.

[11]  P. Walker.  Human joints and their artificial replacements , 1977 .

[12]  R. Crowninshield,et al.  A physiologically based criterion of muscle force prediction in locomotion. , 1981, Journal of biomechanics.

[13]  W H Harris,et al.  Is It Advantageous to Strengthen the Cement‐Metal Interface and Use a Collar for Cemented Femoral Components of Total Hip Replacements? , 1992, Clinical orthopaedics and related research.

[14]  R. Crowninshield,et al.  Analytical support for acetabular component metal backing. , 1983, The Hip.

[15]  R Huiskes,et al.  Some fundamental aspects of human joint replacement. Analyses of stresses and heat conduction in bone-prosthesis structures. , 1980, Acta orthopaedica Scandinavica. Supplementum.

[16]  W. Hayes,et al.  The compressive behavior of bone as a two-phase porous structure. , 1977, The Journal of bone and joint surgery. American volume.

[17]  H. Bertram,et al.  Osteolysis in alloarthroplasty of the hip. The role of bone cement fragmentation. , 1990, Clinical orthopaedics and related research.

[18]  P. D. Wilson,et al.  Metallic wear in failed titanium-alloy total hip replacements. A histological and quantitative analysis. , 1988, The Journal of bone and joint surgery. American volume.

[19]  W. Hozack,et al.  Failure of the cement-bone interface. A consequence of strengthening the cement-prosthesis interface? , 1994, The Journal of bone and joint surgery. British volume.

[20]  R A Brand,et al.  The effect of femoral stem cross-sectional geometry on cement stresses in total hip reconstruction. , 1980, Clinical orthopaedics and related research.

[21]  S. Woo,et al.  Regional variation in shear strength of the bone-polymethylmethacrylate interface. , 1987, The Journal of arthroplasty.

[22]  J H Heegaard,et al.  Frictional interface micromotions and anisotropic stress distribution in a femoral total hip component. , 1993, Journal of biomechanics.

[23]  H. Skinner,et al.  Current concepts in orthopaedic biomaterials and implant fixation. , 1993, Instructional course lectures.

[24]  J. Galante,et al.  Metallosis associated with a stable titanium-alloy femoral component in total hip replacement. A case report. , 1990, The Journal of bone and joint surgery. American volume.

[25]  T P Harrigan,et al.  A three-dimensional non-linear finite element study of the effect of cement-prosthesis debonding in cemented femoral total hip components. , 1991, Journal of biomechanics.

[26]  R. Crowninshield,et al.  An analysis of femoral component stem design in total hip arthroplasty. , 1980, The Journal of bone and joint surgery. American volume.

[27]  A. Sarmiento,et al.  Wear of Ti-6A1-4V Implant Alloy and Ultrahigh Molecular Weight Polyethylene Combinations , 1983 .

[28]  W J Maloney,et al.  The initiation of failure in cemented femoral components of hip arthroplasties. , 1991, The Journal of bone and joint surgery. British volume.

[29]  A. Terrier,et al.  Adaptation Models of Anisotropic Bone. , 1997, Computer methods in biomechanics and biomedical engineering.

[30]  R. Huiskes.  The various stress patterns of press-fit, ingrown, and cemented femoral stems. , 1990, Clinical orthopaedics and related research.

[31]  M H Stone,et al.  Some factors affecting the strength of the cement-metal interface. , 1989, The Journal of bone and joint surgery. British volume.

[32]  T W Phillips,et al.  Femoral stem fixation in hip replacement. A biomechanical comparison of cementless and cemented prostheses. , 1990, The Journal of bone and joint surgery. British volume.

[33]  T B Belytschko,et al.  A stress analysis of the femoral stem in total hip prostheses. , 1976, The Journal of bone and joint surgery. American volume.

[34]  G. Steinberg,et al.  Quantifying bone loss from the proximal femur after total hip arthroplasty. , 1991, The Journal of bone and joint surgery. British volume.

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

[36]  W H Harris,et al.  Micromotion of cemented and uncemented femoral components. , 1991, The Journal of bone and joint surgery. British volume.