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Related Experiment Videos

Migration, stem shape, and surface finish in cemented total hip arthroplasty

R Huiskes1, N Verdonschot, B Nivbrant

  • 1Orthopaedic Research Lab, University of Nijmegen, The Netherlands.

Clinical Orthopaedics and Related Research
|January 26, 1999
PubMed
Summary

Early femoral stem subsidence in total hip arthroplasty is not a sole predictor of revision. Stem design, including shape and surface, influences subsidence patterns, which can be estimated through preclinical testing.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Implant Design

Background:

  • Early subsidence of femoral stems in total hip arthroplasty (THA) has been linked to later revision rates.
  • However, stem design variations (shape, surface roughness) can create distinct postoperative subsidence patterns.
  • These inherent patterns may influence the predictability of revision based on early migration.

Purpose of the Study:

  • To investigate if inherent subsidence patterns of different femoral stem designs can be predicted using preclinical testing.
  • To compare the stress transfer, migration, and micromotion behavior of two cement-fixed, collarless stems with distinct design philosophies.

Main Methods:

  • Finite element analysis (FEA) was employed to model stress and migration.
  • Cyclic bench testing on synthetic bone models assessed micromotion.

Related Experiment Videos

  • Clinical radiostereophotogrammetric analysis (RSA) provided in vivo migration data.
  • Two cement-fixed, collarless stems were compared: Exeter (force-closed fixation) and SHP (shape-closed fixation).

    • Main Results:

    • Both stem designs behaved according to their intended fixation principles in the analyses.
    • The Exeter stem exhibited significantly greater migration and micromotion compared to the SHP stem.
    • Preclinical methods like FEA and bench tests provided reliable indications of in vivo postoperative behavior.

    Conclusions:

    • Early clinical migration values must be interpreted in the context of the femoral stem's specific shape and surface characteristics.
    • Preclinical testing can effectively estimate the in vivo subsidence patterns of THA stems.
    • Considering stem design is crucial for accurately predicting the probability of later revision surgery.