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Updated: Jul 4, 2026
An Improved Mechanical Testing Method to Assess Bone-implant Anchorage
Published on: February 10, 2014
[Technique of implantation of a cementless press-fit cup in revisions with severe bone defects]
Bernd Fink1, Alexandra Grossmann
1Klinik für Endoprothetik, Allgemeine und Rheumorthopädie, Orthopädische Klinik Markgröningen, Kurt-Lindemann-Weg 10, 71706 Markgröningen. b.fink@okm.de
Objective:
Revision of loose cups of total hip arthroplasties. Implantation and solid fixation of a cementless press-fit cup to restore painless joint function.
Indications:
Loose cups of total hip arthroplasties. Reimplantation of a prosthetic cup after removal of an infected total hip arthroplasty.
Contraindications:
Bone defects of the acetabulum precluding a press-fit fixation (at least three-surface fixation) of the cup. Persistent infection.
Surgical Technique:
Exposure of the acetabulum using a standard approach. Removal of the loose cup. Cleaning of the ground with a spoon. Reaming of a new, deeper center of rotation in the acetabulum using a small reamer. Stepwise reaming of the acetabulum using increasing reamer sizes without pressure until sufficient bone contact at the rim is reached (at least three-surface fixation). Hammering in of a thin-walled cementless press-fit cup (e.g., AllofitStrade mark) of the next size as compared to the reamer chosen last to reach a 4-mm press-fit fixation. Additional screwing in of two to three cancellous screws into the os ilium.
Postoperative Management:
Thrombosis prophylaxis, physiotherapy, gait training with partial loading of the limb at 10 kg for a period of 6 weeks. Then increased loading by 10 kg per week.
Results:
52 cup exchanges using an AllofitStrade mark cup were clinically and radiologically analyzed over an average period of 35.8 +/- 8.8 months (26-53 months). The Harris Hip Score increased from a preoperative value of 46.4 to 87.3 points 2 years postoperatively. Two cups showed migration and one hip dislocated. Loosening has not been observed so far.
