Initial stability of an implanted cement-canal prosthesis. Results in experimental studies on human cadaver femurs

Abstract

Upon implantation of a cement-canal prosthesis in the proximal femur in total hip replacement, the bone cement is injected through the prosthesis via a system of drill holes. A second system of drill holes is used in this endoprosthesis to drain the distal femoral space as well as the cavities within the cement layer which form when the cement is being injected. Since the cement pressure is sustained until the cement has cured, substantial penetration of the cement into the cancellous bone can be achieved by using low intra-medullary cement pressures. Using cadaveric human femurs, the initial stability in the trabecular intertrochanteric region was determined in pull-out experiments for three different curing cement pressures (0.5 bar, 1.0 bar and 1.5 bar). The results were compared to corresponding controls in which a conventional cementation technique was used. With respect to the contact area of the bone/bone-cement interface, the initial stability increased by the factor 2.8 (cement-curing pressure 0.5 bar), 3.7 (cement-curing pressure 1.0 bar) and 2.9 (cement-curing pressure 1.5 bar) compared to the control group.