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Does impaction matter in hip resurfacing? A cadaveric study.

Ulf J Schlegel1, Stephan Rothstock, Jan Siewe

  • 1Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany.

The Journal of Arthroplasty
|June 24, 2010
PubMed
Summary
This summary is machine-generated.

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Vigorous impaction during hip resurfacing surgery significantly reduces bone strength. Gentle tapping is crucial for proper implant seating and preserving femoral head integrity in hip resurfacing procedures.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Biomechanics

Background:

  • Hip resurfacing arthroplasty is an alternative to total hip replacement.
  • The surgical technique, particularly the impaction forces applied, may influence the mechanical integrity of the femoral bone.
  • Understanding the impact of surgical forces is critical for long-term implant success and patient outcomes.

Purpose of the Study:

  • To investigate the effect of varying impaction forces during hip resurfacing on the ultimate fracture load of human femora.
  • To determine if vigorous impaction compromises the structural integrity of the femoral head compared to gentle impaction.

Main Methods:

  • Eight pairs of fresh frozen human femora were used.
  • One femur from each pair underwent vigorous impaction, the contralateral underwent gentle impaction.

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  • Specimens were subjected to axial loading to determine ultimate fracture load using a material testing machine.

    • Main Results:

    • Median impaction loads were significantly higher in the vigorous group (11,298N) versus the gentle group (1374N).
    • Failure loads were significantly reduced in the vigorously impacted femora (median, 8873N) compared to the gently impacted femora (median, 9237N; P = .0078).

    Conclusions:

    • Excessive impaction forces during hip resurfacing can compromise the mechanical strength of the femoral head.
    • Meticulous preparation of the femoral head and pinhole is essential to avoid excessive forces during implant seating.
    • Gentle tapping should be the preferred method for final implant seating to preserve bone integrity.