The compression—rotation stem: An experimental study on the primary stability of a new revision hip stem

• Published in: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine Vol. 223; no. 1; pp. 45 - 52
• Main Authors: Kraenzlein, J, Mazoochian, F, Fottner, A, Birkenmaier, C, von Schulze Pellengahr, C, Jansson, V
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2009; SAGE PUBLICATIONS, INC
• Subjects: Arthroplasty (hip); Arthroscopy; Biomedical materials; Bone diseases; Bone grafts; Bones; Cementing; Chips; Compression; Compressive Strength; Computer Simulation; Defects; Elastic Modulus; Equipment Failure Analysis; Femur; Femur Head - physiopathology; Femur Head - surgery; Flanks; Grafting; Hip; Hip joint; Hip Prosthesis; Humans; Implantation; Joint Instability - prevention & control; Joint Instability - surgery; Joint replacement surgery; Joint surgery; Mechanical loading; Models, Biological; Motion; Prosthesis Design; Revisions; Rotation; Simulation; Stability analysis; Stress, Mechanical; Surgical implants; Transducers; micromotion; total hip replacement; cementless; stem; revision
• ISSN: 0954-4119; 2041-3033
• DOI: 10.1243/09544119JEIM444

Abstract In revision hip arthroplasty with bone defects of the proximal femur, a well-established treatment method is reconstruction with impacted allograft spongiosa chips and cemented implantation of a polished stem. Building on this principle of impacted bone grafting, a femoral implant, which is suited to uncemented hip arthroplasty as well as for uncemented revisions, was designed. This so-called compression—rotation stem (CR stem) is collarless and has flanks which compress the impacted bone chips during implantation and thereby increase the rotational stability. To evaluate the primary stability of this new shaft after impaction grafting, the micromotion was determined using six motion transducers. Under physiological loading conditions with simulation of the muscle activities at the proximal femur the application was dynamically loaded for 15 000 cycles with 1000 ± 500 N and afterwards for 5000 cycles with 1300 ± 1000 N. Uncemented CR stems and the control Exeter stems were implanted in a standardized manner according to the X-Change method. Therefore they were implanted into artificial femora that had been previously resected, hollowed, and filled with impacted human spongeous bone allograft to simulate bone defects. Subsequently, the femora were loaded under identical conditions and the micromotions measured. In the majority of the implantations, no significant differences could be found. In conclusion, similar clinical results for the two stems should be expected.