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PRIMARY STABILITY OF SHORT-STEM DESIGNS COMPARED TO CONVENTIONAL AND SHORTENED CONVENTIONAL STEMS IN TOTAL HIP ARTHROPLASTY

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Introduction: Aim of the study was to investigate the fixation patterns of cementless short-stem designs compared to the fixation patterns of well-known conventional stems artificially shortened in several steps.

Method: Primary rotational stability and tilting were measured in a standardized and validated simulator set-up. The tested short-stem designs included the Mayo (Zimmer), the CFP (Link), and the CUT (Eska). The “conventional” group consisted of the ABG (Stryker), the S-Rom (DePuy), and the G2 (DePuy). Additionally, these systems were tested when gradually shortened in several steps.

Results: The Mayo stem showed a 2/3 fixation pattern with 11.5 mdeg/Nm relative movement at the level of the lesser trochanter. The CFP showed a more distal fixation with 6.8 mdeg/Nm, and the CUT a proximal fixation with 7.6 mdeg/Nm. The Mayo and the CFP adapted to the femoral canal during ventro-dorsal tilting. The CUT tilted like a rigid body. This pattern of tilting was also shown by the ABG after it was shortened from 12.5 cm to 8.5 cm, by the G2 after a reduction from 15 to 6 cm, and the S-Rom after shortening from 18 to 6.9 cm.

Discussion: The shortened conventional stems showed a similar fixation pattern compared to the short-stem designs, the rotational stability was even better than with the Mayo and CFP stem. The CUT design acts like an extensively shortened conventional stem and seems to tilt in the femoral canal like a rigid body with a pressure increase at the lateral cortex of the femur.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.