Reaming versus broaching in cemented hip arthroplasty: mechanical stability in cadaver femora.
BACKGROUND
We used an experimental hip model to assess the mechanical stability of a hip prosthesis, and compared the femoral medullary canal preparation techniques of reaming and broaching.


METHODS
15 pairs of cadaveric femora had a simulated replacement, the right femur with a reaming technique and the left with a broaching technique. Both femurs were radiographed to assess component positioning and cement mantle. The femurs were osteotomized 30 days after the procedure. The shear strength of the interface was studied at 4 different levels along an aluminum rod during push-out tests.


RESULTS
The overall mean value of the interface failure load was 15% lower with the reaming technique (6.5 kN for the reaming technique versus 7.7 kN for the broaching technique; p = 0.02).


CONCLUSIONS
Broaching was superior to reaming for the preparation of the femoral canal, and should be used in order to increase primary stability. Further in vivo studies are required to account for factors such as intramedullary pressure, bleeding and surgical variations, which could not be accounted for in our study.
Ioannidis
Theologos T
TT
University Department of Orthopaedic Surgery, KAT Hospital, 2 Nikis Street, Kifissia, Athens, Greece.
Apostolou
Constantinos D
CD
Korres
Dimitrios S
DS
Papaletsos
Ioannis
I
Gandaifis
Nikolaos D
ND
Panagopoulos
Christos N
CN
Agathocleous
Panagiotis E
PE
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001696:Biomechanical Phenomena; D001843:Bone Cements; D005269:Femur / Q000503:physiopathology / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008954:Models, Biological; D010027:Osteotomy; D011475:Prosthesis Failure
D001843:Bone Cements