Femoral Component Using the Impact Modular Total Hip Implant

  • Leo A. Whiteside


Revision of the femoral component in total hip replacement is a time-consuming and complicated procedure that requires an array of instrumentation and techniques. In some cases the cancellous bone and a cylindrical cortical structure remain intact and require no special grafting, fixation, or exposure techniques, whereas other cases require all three. Radiographic appearance is unreliable for preoperative planning in any case, and an elaborate array of instruments and an extensive implant selection should be available at the outset. Even cases that appear relatively simple often have angular deformity, complete loss of cancellous bone, peripheral defects, deficient cortical bone, patulous proximal femur, and fragile diaphyseal cortical bone. To deal with these challenges, proximal and distal fixation of the femoral component generally is considered necessary,1-4 but proximal stress relief and subsequent osteoporosis are long-term issues that must be addressed when using these techniques.5-9


Proximal Femur Femoral Component Metaphyseal Bone Deep Femoral Artery Diaphyseal Bone 
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  1. 1.
    Ohl MD, Whiteside LA, McCarthy DS, White SE. Torsional fixation of a modular femoral hip component. Clin Orthop. 1993;287:135–141.PubMedGoogle Scholar
  2. 2.
    Sugiyama H, Whiteside LA, Engh CA. Torsional fixation of the femoral component in total hip arthroplasty. Effect of surgical press-fit technique. Clin Orthop. 1992;275:187–193.PubMedGoogle Scholar
  3. 3.
    Whiteside LA, Easley JC. The effect of collar and distal stem fixation on micromotion of the femoral stem in un-cemented total hip arthroplasty. Clin Orthop. 1989;239: 145–153.PubMedGoogle Scholar
  4. 4.
    Whiteside LA, Arima J, White SE, Branam L, McCarthy DS. Fixation of the modular total hip femoral component in cementless total hip arthroplasty. Clin Orthop. 1994;298: 184–190.PubMedGoogle Scholar
  5. 5.
    Cook SD, Kalwitter JJ, Weinstein AM. The influence of design parameters on calcar stresses following femoral head arthroplasty. J Biomed Mater Res. 1980;14:133–144.PubMedCrossRefGoogle Scholar
  6. 6.
    Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987; 69:45–55.PubMedGoogle Scholar
  7. 7.
    Engh CA, Bobyn JD. The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop. 1988;231:7–28.PubMedGoogle Scholar
  8. 8.
    Engh CA, Glassman AH, Griffin WL, Mayer JG. Results of cementless revision for failed cemented total hip arthroplasty. Clin Orthop. 1988;235:91–110.PubMedGoogle Scholar
  9. 9.
    Engh CA, Massin P. Cementless total hip arthroplasty using the anatomic medullary locking stem. Clin Orthop. 1989;249:141–158.PubMedGoogle Scholar
  10. 10.
    Khalily C, Whiteside LA. Early radiographic comparison of the femoral component in three cementless total hip replacement designs. Presented at the Congress of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT), Barcelona, Spain. April 27,1997.Google Scholar
  11. 11.
    Khalily C, Whiteside LA. Predictive value of early radiographic findings in cementless total hip arthroplasty femoral components: an eight-to-twelve year followup. J Arthroplasty, in process, 1998.Google Scholar
  12. 12.
    Whiteside LA. Comparison of two cementless fixation techniques in complex revision total hip arthroplasty. Abstract submitted for 1998 Annual Meeting of the American Academy of Orthopaedic Surgeons.Google Scholar
  13. 13.
    Crowninshield RD, Johnston RC, Andrews JG, Brand RA. A biomechanical investigation of the human hip. J Biomech. 1978;11:75–85.PubMedCrossRefGoogle Scholar
  14. 14.
    Davy DT, Kotzar GM, Brown RH, Heiple KG, Goldberg VM, Heiple KG Jr., et al. Telemetric force measurements across the hip after total arthroplasty. J Bone Joint Surg Am. 1988;70:45–50.PubMedGoogle Scholar
  15. 15.
    Mjoberg B, Hansson LI, Selvik G. Instability of total hip prostheses at rotational stress. Acta Orthop Scand. 1984;55: 504–506.PubMedCrossRefGoogle Scholar
  16. 16.
    Wroblewski BM. The mechanism of fracture of the femoral prosthesis in total hip replacement. Int Orthop. 1979;3: 137–139.PubMedGoogle Scholar
  17. 17.
    Cameron HU, Jung Y, Noiles DG, McTighe T. Design features and early clinical results with a modular proximally fixed low bending stiffness uncemented total hip replacement. Scientific exhibit at the annual meeting of the American Academy of Orthopaedic Surgeons, Atlanta, Georgia, Feb. 4–9, 1988.Google Scholar

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© Springer Science+Business Media New York 1999

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  • Leo A. Whiteside

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