Three-dimensional measurement of cemented femoral stem stability: an in vitro cadaver study.

Abstract

To compare the in vitro stability of two cemented hip stem designs: Stem I was a collarless, double-tapered, highly polished implant; Stem II had a collar and matt finish. Stability of the femoral component of a hip implant is important for its long-term clinical success. Excessive migration or cyclic motion can increase the risk of early implant failure. The stems were implanted in paired human cadaver femurs, and custom-designed micromotion sensors were used to measure three-dimensional motions of the stems at proximal, middle and distal locations during simulated in vivo loading cycles. This study found that despite 'rigid' fixation, cemented stems exhibit detectable motions under a limited number of cycles of simulated physiologic loads. At four times the donor body weight, Stem I showed a subsidence of 90 microm, compared to 25 microm of Stem II (P<0.05). In contrast, the proximal end of Stem II exhibited greater cyclic motions in the medial-lateral direction (P<0.05). The different motion patterns could be due to the design differences, such as surface finish and geometry. RelevanceImplant design is an important factor related to the behavior of the cement/bone interface and the overall success of the implant. This study compares in vitro micromotion of two cemented femoral prostheses with differing proximal designs.