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Stability and bone preservation in custom designed revision hip stems.

P S Walker¹, S G Culligan, J Hua

¹Centre for Biomedical Engineering, University College London, Royal National Orthopaedic Hospital Trust, United Kingdom.

Clinical Orthopaedics and Related Research

|May 16, 2000

Summary

This study developed custom uncemented femoral stems for hip revision surgery, showing comparable stability and bone preservation to primary hip replacements. These innovative designs offer effective solutions for various bone defect severities.

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Area of Science:

Orthopedic Surgery
Biomaterials Engineering
Medical Device Design

Background:

Revision hip surgery presents challenges in achieving stability and preserving bone stock.
Custom-designed uncemented femoral stems offer a potential solution for complex cases.

Purpose of the Study:

To design and evaluate three types of custom uncemented femoral stems for revision hip surgery.
To assess the axial stability and proximal bone stock preservation of these novel stem designs.

Main Methods:

Computer-aided design and manufacturing were used to create patient-specific stems.
Nonlinear finite element analysis evaluated various design features.
Radiographic and dual-energy x-ray absorptiometry (DXA) assessed migration and bone density over 2-4 years.

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Main Results:

Three stem designs were suitable for different severities of cavitary defects.
Axial migration rates were comparable to cemented and custom primary stems.
Bone density was maintained within 12% of postoperative values over 4 years.

Conclusions:

The custom uncemented femoral stem system demonstrated desirable properties for revision hip arthroplasty.
These designs offer comparable outcomes to primary hip replacements, addressing bone defects effectively.