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Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora

INTRODUCTION: Femoral centralizers in total hip arthroplasty (THA) are designed to improve the neutral implant position and ensure a homogeneous cement mantle without implant-bone impingement. To date there are no data about the cement mantle configuration and implant position after malinsertion, as...

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Autores principales: Kusserow, Andreas, Ficklscherer, Andreas, Kreuz, Peter Cornelius, Finze, Susanne, Mittelmeier, Wolfram, Jansson, Volkmar, Milz, Stefan, Wegener, Bernd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697065/
https://www.ncbi.nlm.nih.gov/pubmed/26788098
http://dx.doi.org/10.5114/aoms.2015.56361
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author Kusserow, Andreas
Ficklscherer, Andreas
Kreuz, Peter Cornelius
Finze, Susanne
Mittelmeier, Wolfram
Jansson, Volkmar
Milz, Stefan
Wegener, Bernd
author_facet Kusserow, Andreas
Ficklscherer, Andreas
Kreuz, Peter Cornelius
Finze, Susanne
Mittelmeier, Wolfram
Jansson, Volkmar
Milz, Stefan
Wegener, Bernd
author_sort Kusserow, Andreas
collection PubMed
description INTRODUCTION: Femoral centralizers in total hip arthroplasty (THA) are designed to improve the neutral implant position and ensure a homogeneous cement mantle without implant-bone impingement. To date there are no data about the cement mantle configuration and implant position after malinsertion, as seen in mini-open approaches or adipose patients with a limited view. The present biomechanical study was performed to investigate whether a distal centralizer may correct and optimize the position of a malinserted femoral stem. MATERIAL AND METHODS: Thirteen MS 30 stems with and without a distal centralizer each were implanted in paired fresh human femora. Malinsertion was performed using a 3D guiding device with 10° deviation to the femoral axis in the sagittal plane. The thickness of the cement mantle was measured on the anterior, posterior, medial and lateral side of the implanted stem at a distance of 1 cm each. For each side data were taken at 13 points. RESULTS: Digital evaluation of the cement mantle thickness revealed compareable values in frontal plane when a centralizer was used (p > 0.4). In contrast the cement mantle thicknesses without a centralizing device varied in the distal region between 3.38 mm and 5.09 mm (p ≤ 0.001) and in the central region between 3.52 mm and 4.19 mm (p ≤ 0.009). CONCLUSIONS: A distal centralizer allows a more uniform cement mantle and neutral alignment even with a malinsertion of the femoral stem. This could reduce the failure rate and early loosening in complex THA.
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spelling pubmed-46970652016-01-19 Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora Kusserow, Andreas Ficklscherer, Andreas Kreuz, Peter Cornelius Finze, Susanne Mittelmeier, Wolfram Jansson, Volkmar Milz, Stefan Wegener, Bernd Arch Med Sci Basic Research INTRODUCTION: Femoral centralizers in total hip arthroplasty (THA) are designed to improve the neutral implant position and ensure a homogeneous cement mantle without implant-bone impingement. To date there are no data about the cement mantle configuration and implant position after malinsertion, as seen in mini-open approaches or adipose patients with a limited view. The present biomechanical study was performed to investigate whether a distal centralizer may correct and optimize the position of a malinserted femoral stem. MATERIAL AND METHODS: Thirteen MS 30 stems with and without a distal centralizer each were implanted in paired fresh human femora. Malinsertion was performed using a 3D guiding device with 10° deviation to the femoral axis in the sagittal plane. The thickness of the cement mantle was measured on the anterior, posterior, medial and lateral side of the implanted stem at a distance of 1 cm each. For each side data were taken at 13 points. RESULTS: Digital evaluation of the cement mantle thickness revealed compareable values in frontal plane when a centralizer was used (p > 0.4). In contrast the cement mantle thicknesses without a centralizing device varied in the distal region between 3.38 mm and 5.09 mm (p ≤ 0.001) and in the central region between 3.52 mm and 4.19 mm (p ≤ 0.009). CONCLUSIONS: A distal centralizer allows a more uniform cement mantle and neutral alignment even with a malinsertion of the femoral stem. This could reduce the failure rate and early loosening in complex THA. Termedia Publishing House 2015-12-11 2015-12-10 /pmc/articles/PMC4697065/ /pubmed/26788098 http://dx.doi.org/10.5114/aoms.2015.56361 Text en Copyright © 2015 Termedia & Banach http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Basic Research
Kusserow, Andreas
Ficklscherer, Andreas
Kreuz, Peter Cornelius
Finze, Susanne
Mittelmeier, Wolfram
Jansson, Volkmar
Milz, Stefan
Wegener, Bernd
Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora
title Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora
title_full Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora
title_fullStr Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora
title_full_unstemmed Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora
title_short Importance of a distal centralizer in experimental malpositioning of cemented stems. A biomechanical study on human femora
title_sort importance of a distal centralizer in experimental malpositioning of cemented stems. a biomechanical study on human femora
topic Basic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697065/
https://www.ncbi.nlm.nih.gov/pubmed/26788098
http://dx.doi.org/10.5114/aoms.2015.56361
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