In-Vitro Rotational Stability of Cemented Stem Designs

  • Marc Thomsen
  • Christoph Lee


This chapter describes the primary rotational stability of cemented stems. The 6-DOF measurement system type Heidelberg-Göttingen, which can track the complex spatial movement of stems, has characterised the anchoring stability of more than 50 uncemented stem designs. Different polished cemented hip stems have shown an overall tight fixation and excellent torsional stability using this system. Measurements have been repeated after debonding of the stems.


Femoral Component Femoral Stem Rotational Stability Cement Mantle Torque Transfer 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aldinger PR, Breusch SJ, Lukoschek M, Mau H, Ewerbeck V, Thomsen M (2003) 10-15 Year Follow-up of the Cementless Spotorno Stem. J Bone Joint Surg Br Mar; 85(2):209–14Google Scholar
  2. 2.
    Alfaro-Adrian J, Gill HS, Marks B, Murray DW (1999) Cement migration after THR: A comparison of Charnley Elite and Exeter femoral stems using RSA. J Bone Joint Surg Br 81(1):130–4PubMedGoogle Scholar
  3. 3.
    Beatty MF (1966) Kinematics of Finite, Rigid-Body Displacements. Am J Phys 34:949–954CrossRefGoogle Scholar
  4. 4.
    Bergmann G, Graichen F, Rohlmann A (1993) Hip loading during walking and running measured in two patients. J Biomech 26:969–990CrossRefPubMedGoogle Scholar
  5. 5.
    Blaha JD, Spotorno L, Romagnoli S (1991) CLS press-fit total hip arthroplasty. Techniques Orthop 6:80–86Google Scholar
  6. 6.
    Bobyn JD, Dujovne AR, Krygier JJ, Young DL (1993) Surface Analysis of the Taper Junctions of Retrieved and in Vitro Tested Modular Hip Prostheses. In: Morrey BF (ed). Biological, Material and Mechanical Considerations of Joint Replacement. Raven Press Ltd., New YorkGoogle Scholar
  7. 7.
    Cristofolini L, Viceconti M, Cappello A, Toni A (1996) Mechanical validation of whole bone composite femur models. J Biomech 29:525–535CrossRefPubMedGoogle Scholar
  8. 8.
    Cristofolini L, Teutonico AS, Monti L, Cappello A, Toni A (2003) Comparative in vitro study on the long term performance of cemented hip stems: validation of a protocol to discriminate between ≫good≪ and ≫bad≪ designs. J Biomech Nov;36(11):1603–15CrossRefPubMedGoogle Scholar
  9. 9.
    Callaghan JJ, Fulghum CS, Glisson RR, Stranne SK (1992) The effect of femoral stem geometry on interface motion in uncemented porous-coated total hip prostheses. J Bone Joint Surg Am 74(6):839–848PubMedGoogle Scholar
  10. 10.
    Davy DT, Kotzar GM, Brown RH, et al (1976) Telemetric force measurement across the hip after total hip arthroplasty. J Bone Joint Surg 58A:618–623Google Scholar
  11. 11.
    Dohle J, Becker W, Braun M (2001) Radiological analysis of osseointegration after implantation of the Zweymuller-Alloclassic total hip system. Z Orthop 139: 517–24PubMedGoogle Scholar
  12. 12.
    Ducheyne P, De Meester P, Aernoudt E (1977) Influence of a functional dynamic loading on bone ingrowth into surface pores of orthopedic implants. J Biomed Mater Res 11(6):811–824CrossRefPubMedGoogle Scholar
  13. 13.
    Dürselen L, Claes L, Wilke HJ (1991) Non-contact measurement of small translations and rotations in all degrees of freedom. Biomed Tech 36: 248–252Google Scholar
  14. 14.
    Engh CA, O’Connor D, Jasty M, McGovern TF, Bobyn JD, Harris WH (1992) Quantification of implant micromotion, strain shielding, and bone resorption with porous-coated anatomic locking femoral prostheses. Clin Orthop 285:13–29PubMedGoogle Scholar
  15. 15.
    Ek ET, Choong PF (2005) Comparison between triple-tapered and double-tapered cemented femoral stems in total hip arthroplasty. J Arthroplasty 20(1):94–100CrossRefPubMedGoogle Scholar
  16. 16.
    Fischer KJ, Carter DR, Maloney WJ (1992) In vitro study of initial stability of a conical collared femoral component. J Arthroplasty 7:389–395PubMedGoogle Scholar
  17. 17.
    Fornasier VL, Cameron HU (1976) The femoral stem/cement interface in total hip replacement. Clin Orthop 116:248–52PubMedGoogle Scholar
  18. 18.
    Franklin J, Robertsson O, Gestsson J, Lohmander LS, Ingvarsson T (2003) Revision and complication rates in 654 Exeter total hip replacements, with a maximum follow-up of 20 years. BMC Musculoskelet Disord. Mar 25; 4(1):6Google Scholar
  19. 19.
    Gebauer D, Refior HJ, Haake M (1989) Micromotions in the primary fixation of cementless femoral stem prostheses. Arch Orthop Trauma Surg 108:300–307CrossRefPubMedGoogle Scholar
  20. 20.
    Gilbert JL, Bloomfield RS, Lautenschläger EP, Wixson RL (1992) A computer-based biomechanical analysis of three-dimensional motion of cementless hip prosthesis. J Biomech 25:329–340CrossRefPubMedGoogle Scholar
  21. 21.
    Görtz W, Nägerl UV, Nägerl H, Thomsen M (2002) Spatial micromovements of uncemented femoral components after torsional loads J Biomech Eng (ASME) 124:706–713Google Scholar
  22. 22.
    Howell JR Jr, Blunt LA, Doyle C, Hooper RM, Lee AJ, Ling RS (2004) In vivo surface wear mechanisms of femoral components of cemented total hip arthroplasties: the influence of wear mechanism on clinical outcome. J Arthroplasty 19(1):88–101CrossRefPubMedGoogle Scholar
  23. 23.
    Hua J, Walker PS (1994) Relative Motion of Hip Stems under Load. An in Vitro Study of Symmetrical, Asymmetrical, and Custom Asymmetrical Designs. J Bone Joint Surg 76-A: 95–103Google Scholar
  24. 24.
    Huiskes R, Verdonschot N, Nivbrant B (1998) Migration, stem shape, and surface finish in cemented total hip arthroplasty. Clin Orthop 355:103–12PubMedGoogle Scholar
  25. 25.
    Hung JP, Chen JH, Chiang HL, Wu JS (2004) Computer simulation on fatigue behavior of cemented hip prostheses: a physiological model. Comput Methods Programs Biomed 76(2):103–13CrossRefPubMedGoogle Scholar
  26. 26.
    Jasty M, Maloney WJ, Bragdon CR, O’Connor DO, Haire T, Harris WH (1991) The initiation of failure in cemented femoral components of hip arthroplasties. J Bone Joint Surg Br 73(4):551–8PubMedGoogle Scholar
  27. 27.
    Jones RE, Willie BM, Hayes H, Bloebaum RD (2005) Analysis of 16 retrieved proximally cemented femoral stems. J Arthroplasty 20(1):84–93CrossRefPubMedGoogle Scholar
  28. 28.
    Kärrholm J, Nivbrant B, Thanner J, Anderberg C, Börlin N, Herberts P, Malchau H (2000) Radiostereometric Evaluation of Hip Implant Design and Surface Finish. Scientific Exhibition presented at the 67th Annual Meeting of the American Academy of Orthopaedic Surgeons, March 15-19, Orlando, USA.Google Scholar
  29. 29.
    Kinzel GL, Hall AS, Hillberry BM (1972) Measurement of the total motion between the two body segments — I. Analytical development. J Biomech 5:93–105PubMedGoogle Scholar
  30. 30.
    Mjörberg B, Hansson LI, Selvik G (1984) Instability of total hip prostheses at rotational stress. Acta Orthop Scand 55:504–506Google Scholar
  31. 31.
    Nägerl H, Kubein-Meesenburg D, Schäfer W, Cotta H, Thomsen M, Strachwitz B, Fanghänel J (1996) Measuring spatial micro-movement of the femur shaft of endoprostheses in relation to the spatial force system. Z Orthop 134:99–110PubMedGoogle Scholar
  32. 32.
    Ohl MD, Whiteside LA, McCarthy DS, White SE (1993) Torsional fixation of a modular femoral hip component. Clin Orthop 287:135–141PubMedGoogle Scholar
  33. 33.
    Panjabi MM, Krag MH, Goel VK (1981) A technique for measurement and description of three-dimensional six degree-of-freedom motion of a body joint with an application to the human spine. J Biomech 14:447–460CrossRefPubMedGoogle Scholar
  34. 34.
    Pilliar RM, Lee JM, Maniatopoulos C (1986) Observation on the effect of movement on bone ingrowth into porous-surfaced implants. Clin Orthop 208:108–113PubMedGoogle Scholar
  35. 35.
    Rossi P, Sibelli P, Fumero S, Crua E (1995) Short-term results of hydroxyapatite-coated primary total hip arthroplasty. Clin Orthop 310:98–102PubMedGoogle Scholar
  36. 36.
    Schmidbauer U, Brendel T, Kunze KG, Nietert M, Ecke H (1993) Dynamic force measurement in implantation of total endoprostheses of the hip joint. Unfallchirurgie 19:11–15PubMedGoogle Scholar
  37. 37.
    Schneider E, Eulenberger J, Steiner W, Wyder D, Friedman RJ, Perren SM (1989) Experimental method for the in vitro testing of the initial stability of cementless hip prostheses. J Biomech 22:735–744PubMedGoogle Scholar
  38. 38.
    Sugiyama H, Whiteside LA, Engh CA (1992) Torsional fixation of the femoral component in total hip arthroplasty: The effect of surgical press-fit technique. Clin Orthop 275:187–193PubMedGoogle Scholar
  39. 39.
    Schenk RK, Wehrli U (1989) Zur Reaktion des Knochens auf eine zementfreie SL-Femur-revisionsprothese. Orthopäde 18:454–462PubMedGoogle Scholar
  40. 40.
    Thomsen M (2004) Robotically milled bone cavities in comparison with hand-broaching in total hip replacement. In: Stiehl JB, Konermann WH, Haaker RGA: Navigation and Robotics in Total Joint and Spine Surgery. Springer Verlag, BerlinGoogle Scholar
  41. 41.
    Thomsen M, Breusch SJ, Aldinger P, Görtz W, Lahmer A, Honl M, Birke A, Nägerl H (2002) Robotically milled bone cavities. A comparison with hand broaching in different types of cementless hip stems. Acta Orth Scand, 73(4):379–385Google Scholar
  42. 42.
    Tonino AJ, Romanini L, Rossi P et al. (1995) Hydroxyapatite-coated hip prostheses. Early results from an international study. Clin Orthop 312:211–225PubMedGoogle Scholar
  43. 43.
    Vanderby Jr R, Manley PA, Kohles SS, McBeath AA (1992) Fixation stability of femoral components in a canine hip replacement model. J Orthop Res 10:300–309CrossRefPubMedGoogle Scholar
  44. 44.
    Whiteside LA, Easley JC (1989) The effect of collar and distal stem fixation on micromotion of the femoral stem in uncemented total hip arthroplasty. Clin Orthop 239:145–153PubMedGoogle Scholar
  45. 45.
    Wheeler JP, Miles AW, Clift SE (1999) The influence of the time-dependent properties of bone cement on stress in the femoral cement mantle of total hip arthroplasty. J Mater Sci Mater Med Aug;10(8):497–501CrossRefPubMedGoogle Scholar
  46. 46.
    Williams HD, Browne G, Gie GA, Ling RS, Timperley AJ, Wendover NA (2002) The Exeter universal cemented femoral component at 8 to 12 years. J Bone Joint Surg Br Apr;84(3):324–34Google Scholar

Copyright information

© Springer Medizin Verlag Heidelberg 2005

Authors and Affiliations

  • Marc Thomsen
    • 1
  • Christoph Lee
    • 1
  1. 1.Stiftung Orthopädische Universitätsklinik HeidelbergHeidelbergGermany

Personalised recommendations