An analysis of screw fixation of the femoral component in cementless hip arthroplasty.

Abstract

A cementless hip stem that allows screw fixation of the collar to cortical bone in the calcar region was found to achieve enhanced rotational stability when implanted in preserved cadaveric human femora. Although the implants with screws showed less tendency for subsidence than the implants without screws, rotational micromotion was not found to be statistically different under light loading conditions. When implanted in composite bone, the addition of screws in the configuration tested was associated with significant metal-on-metal wear during combined compression and rotational cyclic loading. This finding is of concern due to potential wear particle toxicity and possible lowered fatigue life of the prosthesis. Therefore, specific design changes are recommended.