The optimal surface finish for a cemented THA stem is still debated. We hypothesized surface finish would influence survival of Kerboull cemented hip arthroplasties and a matte finish would have lower survival. We reviewed survival of 433 total hip arthroplasties in 395 patients: 284 consecutive patients (310 hips) were enrolled in a prospective, randomized study of polished (165 hips) or matte finish stems (145 hips) and compared to a historical series of satin stems (123 hips) in 111 patients. The satin and matte finish implants had similar geometry but the polished was quadrangular rather than oval. Finish roughnesses were: polished (radius, 0.04 μm), satin (radius, 0.9 μm), and matte (radius, 1.7 μm). The mean age of the patients at the time of the index arthroplasty was 63.6 years. The survival rate at 13 years, using radiographic loosening as the end point, was 97.3% ± 2.6% for polished stems, 97.1% ± 2.1% for satin stems, and 78.9% ± 5.8% for matte stems. The data suggest survival of Kerboull stems was higher with a polished or satin surface finish than with a matte finish.
Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Femoral Component Surface Finish Radiolucent Line Cement Mantle Stem Surface
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
We thank Luc Kerboull, MD, for his participation in the data analysis and Jean Pierre Courpied, MD, for his participation in the study design and case contribution.
Collis DK. The value of maintaining outcomes in an individual practice for 25 years. Clin Orthop Relat Res. 1997;344:69–80.PubMedCrossRefGoogle Scholar
Collis DK, Mohler CG. Loosening rates and bone lysis with rough finished and polished stems. Clin Orthop Relat Res. 1998;355:113–122.PubMedCrossRefGoogle Scholar
Collis DK, Mohler CG. Comparison of clinical outcomes in total hip arthroplasty using rough and polished cemented stems with essentially the same geometry. J Bone Joint Surg Am. 2002;84:586–592.PubMedGoogle Scholar
Crowninshield RD, Tolbert JR. Cement strain measurement surrounding loose and well-fixed femoral component stems. J Biomed Mater Res. 1983;17:819–828.PubMedCrossRefGoogle Scholar
Della Valle AG, Zoppi A, Peterson MG, Salvati EA. A rough surface finish adversely affects the survivorship of a cemented femoral stem. Clin Orthop Relat Res. 2005;436:158–163.PubMedCrossRefGoogle Scholar
Gardiner RC, Hozack WJ. Failure of the cement-bone interface. A consequence of strengthening the cement-prosthesis interface? J Bone Joint Surg Br. 1994;76:49–52.PubMedGoogle Scholar
Gruen TA, McNeice GM, Amstutz HC. ‘Modes of failure’ of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979;141:17–27.PubMedGoogle Scholar
Hamadouche M, Kerboull L, Meunier A, Courpied JP, Kerboull M. Total hip arthroplasty for the treatment of ankylosed hips: a five to twenty-one-year follow-up study. J Bone Joint Surg Am. 2001;83:992–998.PubMedCrossRefGoogle Scholar
Harris WH. Is it advantageous to strengthen the cement-metal interface and use a collar for cemented femoral components of total hip replacements? Clin Orthop Relat Res. 1992;285:67–72.PubMedGoogle Scholar
Harris WH, McGann WA. Loosening of the femoral component after use of the medullary-plug cementing technique. Follow-up note with a minimum five-year follow-up. J Bone Joint Surg Am. 1986;68:1064–1066.PubMedGoogle Scholar
Howie DW, Middleton RG, Costi K. Loosening of matt and polished cemented femoral stems. J Bone Joint Surg Br. 1998;80:573–576.PubMedCrossRefGoogle Scholar
Jasty M, Maloney WJ, Bragdon CR, Haire T, Harris WH. Histomorphological studies of the long-term skeletal responses to well fixed cemented femoral components. J Bone Joint Surg Am. 1990;72:1220–1229.PubMedGoogle Scholar
Jasty M, Maloney WJ, Bragdon CR, O’Connor DO, Haire T, Harris WH. The initiation of failure in cemented femoral components of hip arthroplasties. J Bone Joint Surg Br. 1991;73:551–558.PubMedGoogle Scholar
Kerboull L, Hamadouche M, Courpied JP, Kerboull M. Long-term results of Charnley-Kerboull hip arthroplasty in patients younger than 50 years. Clin Orthop Relat Res. 2004;418:112–118.PubMedCrossRefGoogle Scholar
Kerboull M. Arthroplastie totale de hanche par voie transtrochantérienne: editions techniques. In: Encyclopédie Médico Chirurgicale: Techniques Chirurgicales-Orthopédie-Traumatologie. Paris, France: Elsevier; 1994;44–668;[12pp.].Google Scholar
Kerboull M, Hamadouche M, Kerboull L. Total hip arthroplasty for Crowe type IV developmental hip dysplasia: a long-term follow-up study. J Arthroplasty. 2001;16(Suppl 1):170–176.PubMedCrossRefGoogle Scholar
Ling RS. The use of a collar and precoating on cemented femoral stems is unnecessary and detrimental. Clin Orthop Relat Res. 1992;285:73–83.PubMedGoogle Scholar
Maloney WJ, Jasty M, Burke DW, O’Connor DO, Zalenski EB, Bragdon C, Harris WH. Biomechanical and histologic investigation of cemented total hip arthroplasties. A study of autopsy-retrieved femurs after in vivo cycling. Clin Orthop Relat Res. 1989;249:129–140.PubMedGoogle Scholar
Maloney WJ, Schmalzried T, Harris WH. Analysis of long-term cemented total hip arthroplasty retrievals. Clin Orthop Relat Res. 2002;405:70–78.PubMedCrossRefGoogle Scholar
Mantel N, Haenzel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719–748.PubMedGoogle Scholar
Merle d’Aubigné R. Numerical evaluation of hip function [in French]. Rev Chir Orthop Réparatrice Appar Mot. 1970;56:481–486.Google Scholar
Mohler CG, Callaghan JJ, Collis DK, Johnston RC. Early loosening of the femoral component at the cement-prosthesis interface after total hip replacement. J Bone Joint Surg Am. 1995;77:1315–1322.PubMedGoogle Scholar
Murray DW, Carr AJ, Bulstrode C. Survival analysis of joint replacements. J Bone Joint Surg Br. 1993;75:697–704.PubMedGoogle Scholar
Nich C, Courpied JP, Kerboull M, Postel M, Hamadouche M. Charnley-Kerboull total hip arthroplasty for osteonecrosis of the femoral head: a minimal 10-year follow-up study. J Arthroplasty. 2006;21:533–540.PubMedCrossRefGoogle Scholar
Ong A, Wong KL, Lai M, Garino JP, Steinberg ME. Early failure of precoated femoral components in primary total hip arthroplasty. J Bone Joint Surg Am. 2002;84:786–792.PubMedGoogle Scholar
Rasquinha VJ, Ranawat CS, Dua V, Ranawat AS, Rodriguez JA. A prospective, randomized, double-blind study of smooth versus rough stems using cement fixation: minimum 5-year follow-up. J Arthroplasty. 2004;19(Suppl 2):2–9.PubMedCrossRefGoogle Scholar
Sanchez-Sotelo J, Berry DJ, Harmsen S. Long-term results of use of a collared matte-finished femoral component fixed with second-generation cementing techniques. A fifteen-year median follow-up study. J Bone Joint Surg Am. 2002;84:1636–1641.PubMedCrossRefGoogle Scholar
Sporer SM, Callaghan JJ, Olejniczak JP, Goetz DD, Johnston RC. The effects of surface roughness and polymethylmethacrylate precoating on the radiographic and clinical results of the Iowa hip prosthesis. A study of patients less than fifty years old. J Bone Joint Surg Am. 1999;81:481–492.PubMedCrossRefGoogle Scholar
Vail TP, Goetz D, Tanzer M, Fisher DA, Mohler CG, Callaghan JJ. A prospective randomized trial of cemented femoral components with polished versus grit-blasted surface finish and identical stem geometry. J Arthroplasty. 2003;18(Suppl 1):95–102.PubMedCrossRefGoogle Scholar
Verdonschot N, Huiskes R. The effects of cement-stem debonding in THA on the long-term failure probability of cement. J Biomech. 1997;30:795–802.PubMedCrossRefGoogle Scholar
Verdonschot N, Tanck E, Huiskes R. Effects of prosthesis surface roughness on the failure process of cemented hip implants after stem-cement debonding. J Biomed Mater Res. 1998;42:554–559.PubMedCrossRefGoogle Scholar