Stem diameter and rotational stability in revision total hip arthroplasty

A biomechanical analysis

R. Meneghini, Nadim J. Hallab, Richard A. Berger, Joshua J. Jacobs, Wayne G. Paprosky, Aaron G. Rosenberg

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Proximal femoral bone loss during revision hip arthroplasty often requires bypassing the deficient metaphyseal bone to obtain distal fixation. The purpose of this study was to determine the effect of stem diameter and length of diaphyseal contact in achieving rotational stability in revision total hip arthroplasty. Methods: Twenty-four cadaveric femoral specimens were implanted with a fully porous-coated stem. Two different diameters were tested and the stems were implanted at multiple contact lengths without proximal bone support. Each specimen underwent torsional testing to failure and rotational micromotion was measured at the implant-bone interface. Results: The larger stem diameter demonstrated a greater torsional stability for a given length of cortical contact (p ≤ 0.05). Decreasing length of diaphyseal contact length was associated with less torsional stability. Torsional resistance was inconsistent at 2 cm of depth. Conclusion: Larger stem diameters frequently used in revisions may be associated with less diaphyseal contact length to achieve equivalent rotational stability compared to smaller diameter stems. Furthermore, a minimum of 3 cm or 4 cm of diaphyseal contact with a porous-coated stem should be achieved in proximal femoral bone deficiency and will likely be dependent on the stem diameter utilized at the time of surgery.

Original languageEnglish (US)
Article number5
JournalJournal of Orthopaedic Surgery and Research
Volume1
Issue number1
DOIs
StatePublished - 2006

Fingerprint

Arthroplasty
Hip
Thigh
Bone and Bones

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Stem diameter and rotational stability in revision total hip arthroplasty : A biomechanical analysis. / Meneghini, R.; Hallab, Nadim J.; Berger, Richard A.; Jacobs, Joshua J.; Paprosky, Wayne G.; Rosenberg, Aaron G.

In: Journal of Orthopaedic Surgery and Research, Vol. 1, No. 1, 5, 2006.

Research output: Contribution to journalArticle

Meneghini, R. ; Hallab, Nadim J. ; Berger, Richard A. ; Jacobs, Joshua J. ; Paprosky, Wayne G. ; Rosenberg, Aaron G. / Stem diameter and rotational stability in revision total hip arthroplasty : A biomechanical analysis. In: Journal of Orthopaedic Surgery and Research. 2006 ; Vol. 1, No. 1.
@article{5553445c1a4a45ca8ca297499c5fab10,
title = "Stem diameter and rotational stability in revision total hip arthroplasty: A biomechanical analysis",
abstract = "Background: Proximal femoral bone loss during revision hip arthroplasty often requires bypassing the deficient metaphyseal bone to obtain distal fixation. The purpose of this study was to determine the effect of stem diameter and length of diaphyseal contact in achieving rotational stability in revision total hip arthroplasty. Methods: Twenty-four cadaveric femoral specimens were implanted with a fully porous-coated stem. Two different diameters were tested and the stems were implanted at multiple contact lengths without proximal bone support. Each specimen underwent torsional testing to failure and rotational micromotion was measured at the implant-bone interface. Results: The larger stem diameter demonstrated a greater torsional stability for a given length of cortical contact (p ≤ 0.05). Decreasing length of diaphyseal contact length was associated with less torsional stability. Torsional resistance was inconsistent at 2 cm of depth. Conclusion: Larger stem diameters frequently used in revisions may be associated with less diaphyseal contact length to achieve equivalent rotational stability compared to smaller diameter stems. Furthermore, a minimum of 3 cm or 4 cm of diaphyseal contact with a porous-coated stem should be achieved in proximal femoral bone deficiency and will likely be dependent on the stem diameter utilized at the time of surgery.",
author = "R. Meneghini and Hallab, {Nadim J.} and Berger, {Richard A.} and Jacobs, {Joshua J.} and Paprosky, {Wayne G.} and Rosenberg, {Aaron G.}",
year = "2006",
doi = "10.1186/1749-799X-1-5",
language = "English (US)",
volume = "1",
journal = "Journal of Orthopaedic Surgery and Research",
issn = "1749-799X",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Stem diameter and rotational stability in revision total hip arthroplasty

T2 - A biomechanical analysis

AU - Meneghini, R.

AU - Hallab, Nadim J.

AU - Berger, Richard A.

AU - Jacobs, Joshua J.

AU - Paprosky, Wayne G.

AU - Rosenberg, Aaron G.

PY - 2006

Y1 - 2006

N2 - Background: Proximal femoral bone loss during revision hip arthroplasty often requires bypassing the deficient metaphyseal bone to obtain distal fixation. The purpose of this study was to determine the effect of stem diameter and length of diaphyseal contact in achieving rotational stability in revision total hip arthroplasty. Methods: Twenty-four cadaveric femoral specimens were implanted with a fully porous-coated stem. Two different diameters were tested and the stems were implanted at multiple contact lengths without proximal bone support. Each specimen underwent torsional testing to failure and rotational micromotion was measured at the implant-bone interface. Results: The larger stem diameter demonstrated a greater torsional stability for a given length of cortical contact (p ≤ 0.05). Decreasing length of diaphyseal contact length was associated with less torsional stability. Torsional resistance was inconsistent at 2 cm of depth. Conclusion: Larger stem diameters frequently used in revisions may be associated with less diaphyseal contact length to achieve equivalent rotational stability compared to smaller diameter stems. Furthermore, a minimum of 3 cm or 4 cm of diaphyseal contact with a porous-coated stem should be achieved in proximal femoral bone deficiency and will likely be dependent on the stem diameter utilized at the time of surgery.

AB - Background: Proximal femoral bone loss during revision hip arthroplasty often requires bypassing the deficient metaphyseal bone to obtain distal fixation. The purpose of this study was to determine the effect of stem diameter and length of diaphyseal contact in achieving rotational stability in revision total hip arthroplasty. Methods: Twenty-four cadaveric femoral specimens were implanted with a fully porous-coated stem. Two different diameters were tested and the stems were implanted at multiple contact lengths without proximal bone support. Each specimen underwent torsional testing to failure and rotational micromotion was measured at the implant-bone interface. Results: The larger stem diameter demonstrated a greater torsional stability for a given length of cortical contact (p ≤ 0.05). Decreasing length of diaphyseal contact length was associated with less torsional stability. Torsional resistance was inconsistent at 2 cm of depth. Conclusion: Larger stem diameters frequently used in revisions may be associated with less diaphyseal contact length to achieve equivalent rotational stability compared to smaller diameter stems. Furthermore, a minimum of 3 cm or 4 cm of diaphyseal contact with a porous-coated stem should be achieved in proximal femoral bone deficiency and will likely be dependent on the stem diameter utilized at the time of surgery.

UR - http://www.scopus.com/inward/record.url?scp=34248191684&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34248191684&partnerID=8YFLogxK

U2 - 10.1186/1749-799X-1-5

DO - 10.1186/1749-799X-1-5

M3 - Article

VL - 1

JO - Journal of Orthopaedic Surgery and Research

JF - Journal of Orthopaedic Surgery and Research

SN - 1749-799X

IS - 1

M1 - 5

ER -