Femoral component fixation with and without intramedullary plug. A 6-year follow-up

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Radiology

Background:

• Cemented total hip replacement (THR) is a common procedure for hip osteoarthritis.
• Ensuring stable femoral component fixation is crucial for long-term implant survival.
• The role of distal intramedullary plugs in cementation technique requires further investigation.

Purpose of the Study:

• To evaluate the impact of a distal intramedullary plug on femoral component fixation in cemented THR.
• To assess cement coating, component loosening, subsidence, and osteolytic changes.

Main Methods:

• A comparative radiographic study of 113 patients undergoing cemented THR.
• Patients were divided into two groups: without (n=57) and with (n=56) a distal intramedullary plug.
• Radiographic assessment of femoral component fixation at an average of 6 years post-surgery.

Main Results:

• Improved cement coating observed in the plug group (95%) compared to the non-plug group (86%).
• Significantly lower rates of femoral component loosening in the plug group (6 cases vs. 25 cases).
• Reduced mean femoral component subsidence in the plug group (1.5 mm vs. 5 mm).

Conclusions:

• The use of a distal intramedullary plug in cemented THR leads to superior cement mantle quality.
• Employing a distal intramedullary plug significantly decreases femoral component loosening and subsidence.
• This technique offers a potential method to enhance the longevity of cemented femoral stems.