Author(s): Gruen TA, McNeice GM, Amstutz HC
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Abstract In view of the increasing incidence of stem-type femoral component loosening, a detailed retrospective radiographic zonal analysis of 389 total hip replacements indicated a 19.5\% incidence (76 hips) of radiological evidences of mechanical looseness, i.e., fractured acrylic cement and/or a radiolucent gap at the stem-cement or cement-bone interfaces. Detailed serial radiographic examination demonstrated progressive loosening in 56 of the 76 hips and these were categorized into mechanical modes of failure. The 4 modes of failure characterizing stem-type component progressive loosening mechanisms consisted of stem pistoning within the acrylic (3.3\%), cement-embedded stem pistoning with the femur (5.1\%), medial midstem pivot (2.5\%), calcar pivot (0.7\%) and bending (fatigue) cantilever (3.3\%).
This article was published in Clin Orthop Relat Res
and referenced in Orthopedic & Muscular System: Current Research