1. Experimental periprosthetic fractures with collarless polished tapered cemented stems.
- Author
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Yagura T, Oe K, Kobayasi F, Sogawa S, Nakamura T, Iida H, and Saito T
- Subjects
- Humans, Reoperation adverse effects, Bone Cements, Prosthesis Design, Alloys, Periprosthetic Fractures epidemiology, Periprosthetic Fractures etiology, Periprosthetic Fractures surgery, Hip Prosthesis adverse effects, Arthroplasty, Replacement, Hip adverse effects, Arthroplasty, Replacement, Hip methods, Femoral Fractures surgery
- Abstract
Purpose: After cemented total hip arthroplasty, the risk of periprosthetic fracture (PPF) of taper-slip stems is higher than that of composite-beam stems. We aimed to assess the conditions resulting in PPFs of taper-slip stems using a falling weight., Methods: Taper-slip stems were fixed to five types of simulated bone models using bone cement, and the fractures were evaluated by dropping stainless-steel weights from a predetermined height onto the heads. The periprosthetic fracture height in 50% of the bone models (PPFH
50 ) was calculated using the staircase method., Results: For the fixation with 0° of flexion, the values for PPFH50 were 61 ± 11, 60 ± 13, above 110, 108 ± 49, and 78 ± 12 cm for the cobalt-chromium-molybdenum alloy, stainless steel alloy (SUS), titanium alloy (Ti), smooth surface, and thick cement mantle models, respectively; for the fixation with 10° of flexion (considering flexure), the PPFH50 values were 77 ± 5, 85 ± 9, 90 ± 2, 89 ± 5, and 81 ± 11 cm, respectively. The fracture rates of the polished-surface stems were 78.6 and 35.7% at the proximal and distal sites, respectively (p < 0.05); the fracture rates of the smooth-surface stems were 14.2 and 100%, respectively (p < 0.05)., Conclusion: The impact tests demonstrated that the conditions that were less likely to cause PPFs were use of Ti, a smooth surface, a thick cement mantle, and probably, use of SUS., (© 2024. The Author(s) under exclusive licence to SICOT aisbl.)- Published
- 2024
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