Alterations in femoral and acetabular bone strains immediately following cementless total hip arthroplasty: an in vitro canine study.
Alterations in strain patterns in both the femur and acetabulum of the dog, due to cementless total hip arthroplasty (THA), were evaluated by monitoring cortical bone strains before and immediately following implantation of components, using an accurate in vitro jig, simulating the loading of the canine hip in vivo. Femoral arthroplasty with straight stem, canal-filling, femoral components, made of titanium-based alloy, led to a statistically significant reduction of proximal femoral bone strains, with proximal medical compressive strains reduced, on average, to only 22% of intact strain magnitude (p less than 0.01), even though the prostheses contained collars and were not fixed with cement. Strain alterations on the acetabulum, following cementless THA, were more complex and variable. Laterally, a significant decrease (p less than 0.01) in periacetabular strains to between 20 and 60% of the intact state was observed, while medial wall strains varied inconsistently after arthroplasty. These strain alterations reflect major changes in mechanical loading of both the femur and acetabulum immediately following cementless THA, using components similar to those used clinically in humans. Major reductions in strains on the proximal femur occurred with cementless femoral components, while the change in strains on the acetabulum were variable, and could be a result of variations in fit and placement of components inherent even in well-controlled implantation techniques. The physiologic in vitro loading of the canine femur with the pelvis, used to obtain these data, can be applied to future investigations exploring stress transfer around uncemented components and the relationship of stress transfer to morphological changes of bone, in the canine model.
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Orthopaedic Biomechanics Laboratory, Massachusetts General Hospital, Boston 02114.
Jasty
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Bragdon
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Ito
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Harris
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D000077:Acetabulum / Q000502:physiology*; D000818:Animals; D004285:Dogs; D005269:Femur / Q000502:physiology*; D006622:Hip Prosthesis; D008297:Male; D013718:Tensile Strength