TY - JOUR
T1 - Femoral stem insertion generates high bone cement pressurization
AU - Churchill, David L.
AU - Incavo, Stephen J.
AU - Uroskie, Jonathan A.
AU - Beynnon, Bruce D.
PY - 2001/1/1
Y1 - 2001/1/1
N2 - Adequate bone cement pressurization is critical in obtaining optimal femoral cement mantles during total hip arthroplasty. Pressurization can be generated during insertion of the femoral stem into the cement-filled canal. This may be clinically useful in augmenting conventional cement gun pressurization. Two factors, which were expected to influence the amount of insertioninduced pressurization, are the cement's cure state (viscosity) at the time of insertion and the femoral stem profile. This study evaluated the effect of these factors on cement pressurization during stem insertion. Femoral stems were inserted at a controlled rate into a reusable, simulated femoral canal. Intramedullary pressures were monitored at four locations along the canal's medial midline. The intrusion factor quantity, which accounts for pressure magnitude, duration of pressurization, and cement viscosity, was developed to quantify pressurization. Stem insertion into late cure stage (high viscosity) cement resulted in significantly higher intramedullary pressures (as much as 187% higher) and intrusion factors (as much as 43% higher) as compared with early stage (low viscosity) cement. The highest pressures and intrusion factors were found in the distal canal. A tapered stem profile resulted in significantly higher pressures (as much as 65%) and higher intrusion factors (as much as 63%) than a straight stem.
AB - Adequate bone cement pressurization is critical in obtaining optimal femoral cement mantles during total hip arthroplasty. Pressurization can be generated during insertion of the femoral stem into the cement-filled canal. This may be clinically useful in augmenting conventional cement gun pressurization. Two factors, which were expected to influence the amount of insertioninduced pressurization, are the cement's cure state (viscosity) at the time of insertion and the femoral stem profile. This study evaluated the effect of these factors on cement pressurization during stem insertion. Femoral stems were inserted at a controlled rate into a reusable, simulated femoral canal. Intramedullary pressures were monitored at four locations along the canal's medial midline. The intrusion factor quantity, which accounts for pressure magnitude, duration of pressurization, and cement viscosity, was developed to quantify pressurization. Stem insertion into late cure stage (high viscosity) cement resulted in significantly higher intramedullary pressures (as much as 187% higher) and intrusion factors (as much as 43% higher) as compared with early stage (low viscosity) cement. The highest pressures and intrusion factors were found in the distal canal. A tapered stem profile resulted in significantly higher pressures (as much as 65%) and higher intrusion factors (as much as 63%) than a straight stem.
UR - http://www.scopus.com/inward/record.url?scp=0035186250&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035186250&partnerID=8YFLogxK
U2 - 10.1097/00003086-200112000-00039
DO - 10.1097/00003086-200112000-00039
M3 - Article
C2 - 11764367
AN - SCOPUS:0035186250
SP - 335
EP - 344
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
SN - 0009-921X
IS - 393
ER -