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  4. Influence of bone morphology and femur preparation method on the primary stability of hip revision stems
 
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Influence of bone morphology and femur preparation method on the primary stability of hip revision stems

Citation Link: https://doi.org/10.15480/882.4879
Publikationstyp
Journal Article
Date Issued
2023-06
Sprache
English
Author(s)
Konow, Tobias 
Schlieker, Peter  
Lampe, Frank  
Ondruschka, Benjamin  
Morlock, Michael  
Huber, Gerd  
Institut
Biomechanik M-3  
TORE-DOI
10.15480/882.4879
TORE-URI
http://hdl.handle.net/11420/14471
Journal
Journal of orthopaedic research  
Volume
41
Issue
6
Start Page
1283
End Page
1290
Citation
Journal of Orthopaedic Research 41 (6): 1283-1290 (2023-06)
Publisher DOI
10.1002/jor.25481
Scopus ID
2-s2.0-85143393490
PubMed ID
36370133
Publisher
Wiley
Aseptic loosening is one of the major reasons for re-revisions of cementless revision stems. Insufficient primary stability is associated with bone characteristics and the surgical process. This study aimed to investigate how femur morphology and preparation methods influence the primary stability of revision stems. The Femur morphology was described by the upper femoral curvature (UFC) and an individualized Dorr type classification based on the ratio between the canal-to-calcar ratio (CCR*) and the cortical index (CI*) introduced as the cortical-canal shape (CCS). Manual and powered reaming in combination with helical and straight reamers were used to prepare the bone cavity of 10 cadaveric human femur pairs. Forces during stem impaction were recorded (Reclaim, Depuy Synthes). Micromotion at the bone–implant interface during cyclic axial loading and torsional load to failure was determined. The CCS and impaction forces (R2 = 0.817, p < 0.001) or torsional strength (R2 = 0.577, p < 0.001) are inversely related. CCS did not correlate with micromotion during axial loading (R2 = 0.001, p > 0.999), but proximal femoral curvature did (R2 = 0.462, p = 0.015). Powered reaming and straight reamers led to an improved torsional strength (both: p = 0.043). The Individualized Dorr classification CCS and UFC allows a good estimation of the primary stability of revision stems. For severely curved Dorr type-C femurs, an alternative anchorage method should be considered clinically.
Subjects
bone morphology
canal reaming
Dorr type
femur curvature
primary stability
revision THA
DDC Class
570: Biowissenschaften, Biologie
610: Medizin
Funding(s)
Projekt DEAL  
More Funding Information
The authors would like to thank Depuy Synthes for providing the prosthesis components, surgical tools, and financial support. All experimental studies were performed at the University Medical Center Hamburg‐Eppendorf (UKE) and the TUHH Hamburg University of Technology.
Publication version
publishedVersion
Lizenz
https://creativecommons.org/licenses/by/4.0/
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