The relationship between femoral periprosthetic cortical bone geometry and porosity after total hip arthroplasty

Abstract

Stress shielding from the presence of a femoral component can cause adverse changes to cortical bone geometry and porosity leading to increased fracture risk in the periprosthetic cortical bone. The objectives of this study were to determine if porosity increased after total hip arthroplasty along the principal axes, and to determine if a relationship existed between cortical bone porosity and geometry. Ten postmortem donors allowed comparisons of implanted femurs to the contralateral nonimplanted femurs. Transverse cross-sections of the femur were taken at 25, 45, 65, and 85% along the length of the femoral component. The cortical bone principal axes' location (degrees) and rigidity values (mm(4)) were based on cortical bone geometry by using digitized images of the cortical bone cross-sections. Percent porosity was measured along the principal axes using backscatter electron imaging. Cortical bone porosity increased in the more distal sections of the implanted femurs by approximately 3%, but did not preferentially increase along a particular principal axis. No correlation was found between changes in porosity and rigidity values. In conclusion, the porosity increases in the implanted femurs may have regionally reduced cortical bone strength. The locations of higher porosity did not appear related to the cortical bone geometry.