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Design Of Surgical Impaction Instruments Matters.

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Design Of Surgical Impaction Instruments Matters.

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Design of Surgical Impaction Instruments Matters.

Peter J Schlieker¹, Frank Lampe^2,3, Johann Zwirner^4,5

¹Institute of Biomechanics, Hamburg University of Technology, Hamburg, Germany.

Arthroplasty Today

|December 1, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Impactor design significantly affects force transmission during total hip arthroplasty femoral stem impaction. Only 24-47% of mallet force reaches the implant, highlighting the need for surgeon awareness of instrument influence.

Keywords:

Cadaveric study Force transmission Impaction Numerical simulation Total hip arthroplasty

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Area of Science:

Orthopedic Surgery
Biomechanical Engineering
Medical Device Design

Background:

Femoral stem impaction in total hip arthroplasty (THA) relies on mallet blows.
Impactor design (mass, stiffness) influences force transmission, but this is poorly understood.
Patient and surgeon factors also affect impaction outcomes.

Purpose of the Study:

To investigate force transmission through different impactor designs during THA.
To analyze the proportion of mallet force reaching the femoral stem implant.
To evaluate the influence of patient-specific femur-tissue systems.

Main Methods:

Measured mallet and impactor forces during 9 blows on femoral stems in 4 cadavers.
Utilized 2 surgical approaches and 2 different impactor designs.
Calculated mallet-implant force transmission using a phenomenological model.

Main Results:

Impactor force was 65-75% of mallet peak force, independent of approach or cadaver.
Force measurements distant from the tip overestimated transferred force.
Only 24-47% of mallet peak force reached the implant, dependent on impactor design.

Conclusions:

Force transmission during THA stem impaction is primarily determined by impactor design.
Patient and approach factors have minimal influence on overcritical mallet blows.
Surgeons should exercise caution with novel instruments to prevent complications.