The mechanical effects of femoral shaft perforation at total hip replacement

Perforation of the femoral shaft at total hip arthroplasty is a complication which is being reported more frequently. It has been suggested that the presence of bone cement in the perforation decreases the weakening effect of the perforation, but the mechanical basis for this belief is dubious. The anatomy of perforation was studied by cadaver dissection and its mechanical consequences were assessed in two models using Pedilen, a polyurethane foam, and pig femora. It was found that cement in a hole in bone decreased the weakening effect of the hole to tensile stress.