Email this article 
Rotational stability of different hip revision systems
- Authors: Thomsen M.1, Jakubowitz E.2
-
Affiliations:
- Mittelbaden Clinics Baden-Baden, Trauma and Orthopaedic Surgery Units
- Laboratory of Biomechanics and Implant Research, University of Heidelberg, Department of Orthopaedics
- Issue: Vol 20, No 4 (2014)
- Pages: 57-61
- Section: Theoretical and experimental studies
- Submitted: 12.09.2016
- Published: 12.12.2014
- URL: https://journal.rniito.org/jour/article/view/98
- DOI: https://doi.org/10.21823/2311-2905-2014-0-4-57-61
- ID: 98
Cite item
Full Text
Abstract
The authors present an experimental investigation that compares the primary rotational fixation of 4 revision stems. Methods: Each stem was implanted into 4 synthetic femora. Micromotion of stem and bone was measured at defined sites under torque application. Femoral neck osteotomy and AAOS type I and III defects were simulated by reproducible saw lines. Results: Up to a type I defect, all implants are capable of bridging the substance loss in a rotationally stable manner. The relative movements show a dependence both on the bone defect and on implant design. Even within the basic design types clear differences (p < 0.0001) are partially observable. Major differences were seen in type III defects. Whereas the conical stem designs had the ability to bridge the extensive defect the cylindric shapes showed no rotationally stability. Conclusion: As the major fixation area the femoral isthmus plays a decisive role for all tested stems. Due to enormous and partly selective load transmission of the conical stems the cylindrical designs is good for type I defects. In case of an extensive substance loss the decision should be a conical implant.
About the authors
M. Thomsen
Mittelbaden Clinics Baden-Baden, Trauma and Orthopaedic Surgery Units
Author for correspondence.
Email: marc.thomsen@klinikum-mittelbaden.de
Россия
E. Jakubowitz
Laboratory of Biomechanics and Implant Research, University of Heidelberg, Department of Orthopaedics
Email: noemail@neicon.ru
Россия
References
- Chandler HP, Ayres DK, Tan RC. et al. Revision total hip replacement using the S-ROM femoral component. Clin Orthop Relat Res. 1995; 319:130-140.
- Gebauer D, Refior HJ, Haake M. Micromotions in the primary fixation of cementless femoral stem prostheses. Arch Orthop Trauma Surg. 1989; 108:300-307.
- Görtz W, Nägerl UV, Nägerl H, Thomsen M. Spatial micromovements of uncemented femoral components after torsional loads. J Biomech Eng. 2002; 124:706-713.
- Jakubowitz E, Seeger JB, Lee C, Heisel C, Kretzer J, Thomsen M. Primary rotational stability of cylindrical and conical revision hip stems as a function of femoral bone defects: An in vitro comparison. J Biomech. 2008; 41(14):3078-3084.
- Jakubowitz E, Kinkel S, Nadorf J, Heisel C, Kretzer JP, Thomsen M. The effect of multifilaments and monofilaments on cementless femoral revision hip components: an experimental study. Clin Biomech (Bristol, Avon). 2011 ;26(3):257-261.
- Mumme T, Muller-Rath R, Weisskopf M. et al. The cement- free modular revision prosthesis MRP-hip revision stem prosthesis in clinical follow-up. Z Orthop Ihre Grenzgeb. 2004; 142:314-321.
- Ohl MD, Whiteside LA, McCarthy DS, White SE. Torsional fixation of a modular femoral hip component. Clin Orthop Relat Res. 1993; 287:135-141.
- Schuh A, Werber S, Holzwarth U, Zeiler G. Cementless modular hip revision arthroplasty using the MRP Titan revision stem: Outcome of 79 hips after an average of 4 years’ follow-up. Arch Orthop Trauma Surg. 2004; 124:306-309.
- Sugiyama H, Whiteside LA, Engh CA. Torsional fixation of the femoral component in total hip arthroplasty. The effect of surgical press-fit technique. Clin Orthop Relat Res. 1992; 275:187-193.
- Thomsen M, Aldinger P, Gortz W. et al. The importance to generate robot-assisted milled cavities for total hip replacement. A comparative experimental study: manual versus robotic preparation. Unfallchirurg. 2001; 104: 692-699.
- Thomsen M, Gortz W, Nagerl H. Charakterisierung moderner Huftendoprothesen. Z Orthop Ihre Grenzgeb. 1999; 137:A32.
- Thomsen M, Kretzer JP, Heisel C , Lee C, Nadorf J, Jakubowitz E. Femorale Revisionsprothesen - Eine Analyse der Verankerung. Orthopäde. 2010; 39:623-630.
- Thomsen M, Lee C. In-vitro rotational stability of cemented stem designs. In: Breusch SJ, Malchau H. (eds). The wellcemented total hip arthroplasty. Theory and practice. 1st ed. Berlin, Heidelberg, New York: Springer; 2005. p. 196-205.
- Thomsen MN, Breusch SJ, Aldinger PR. et al. Roboticallymilled bone cavities: a comparison with hand-broaching in different types of cementless hip stems. Acta Orthop Scand. 2002; 73:379-385.
- Wagner H, Wagner M. Konische Schaftverankerung zementfreier Huftprothesen - Primarimplantation und Prothesenwechsel. In: Morscher EW. (ed). Endoprothetik. 1st ed. Berlin, Heidelberg, New York: Springer; 1995. p. 278-288.
- Wagner H. Femur revision prosthesis. Z Orthop Ihre Grenzgeb. 1993; 131:574-577.
- Warren PJ, Thompson M, Fletcher MD. Transfemoral implantation of the Wagner SL stem. The abolition of subsidence and enhancement of osteotomy union rate using Dall-Miles cables. Arch Orthop Trauma Surg. 2002; 122:557-560.
- Wirtz DC, Heller KD, Holzwarth U. et al. A modular femoral implant for uncemented stem revision THR. Int Orthop. 2000; 24:134-138.
- Wirtz DC. Modulare Schaftimplantate: Klinische Ergebnisse der MRP-Titanprothese. In: Thumler P, Forst R, Zeiler G. (eds). Modulare Revisionsendoprothetik des Huftgelenks. 1st ed. Berlin, Heidelberg, New York: Springer; 2005. p. 271-281.
Supplementary files
