Technical Brief

The Effect of Stem Circumferential Grooves on the Stability at the Implant-Cement Interface

[+] Author and Article Information
Yara K. Hosein

Biomedical Engineering Graduate Program,
Western University,
London, ON N6A 5B9, Canada

Graham J. W. King

Department of Surgery,
Western University,
London, ON N6A 5B9, Canada

Cynthia E. Dunning

Biomedical Engineering Graduate Program,
Department of Surgery, and
Department of Materials & Mechanical Engineering,
Western University,
London, ON N6A 5B9, Canada
e-mail: cdunning@uwo.ca

1Corresponding author.

Manuscript received March 5, 2013; final manuscript received September 16, 2013; published online December 6, 2013. Assoc. Editor: Venketesh N. Dubey.

J. Med. Devices 8(1), 014504 (Dec 06, 2013) (5 pages) Paper No: MED-13-1022; doi: 10.1115/1.4025468 History: Received March 05, 2013; Revised September 16, 2013

The application of stem surface treatments and finishes are common methods for improving stem-cement interface stability in joint replacement systems; however, success of these surfaces has been variable. As opposed to applying a treatment or finish, altering stem design through changing the surface topography of the base stem material may offer some advantages. This study compared the effect of stem circumferential grooving on the torsional and axial stability of cemented stems. Fifteen metal stems were machined from cobalt chrome to have smooth (n = 5) or circumferential-grooved surfaces, where groove depth and spacing was either 0.6 mm (n = 5) or 1.1 mm (n = 5). Stems were potted in aluminum tubes using bone cement, left 24 h to cure, and placed in a materials testing machine for testing using a cyclic staircase loading protocol at 1.5 Hz. All stems were tested independently in compression and torsion on separate testing days, using the same stems repotted with new cement. Motion of the stem was tracked, and failure was defined either as rapid increase in stem motion, or completion of the loading protocol. Statistical analysis was used to compare interface strength and stem motion prior to failure. Grooved stems demonstrated increased interface strength (p < 0.001) and reduced motion (p < 0.01) compared to smooth stems under compression. In torsion, no significant difference was found in strength among the grooved and smooth stems (p = 0.10); however, grooved 1.1 mm demonstrated greatest interface motion prior to catastrophic failure (p < 0.01). Overall, circumferential-grooved stems offered improved stability under compression, and comparable stability in torsion, relative to the smooth stems.

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New Zealand Orthopaedic Association, 2010, “Eleven Year Report—January 1999 to December 2009,” www.cdhb.govt.nz/njr/reports/A2D65CA3.pdf
Australian Orthopaedic Association, 2010, “National Joint Registry, Hip and Knee Arthroplasty Annual Report 2010,” https://aoanjrr.dmac.adelaide.edu.au/annual-reports-2010
Mohler, C.G., Callaghan, J.J., Collis, D.K., and Johnston, R.C., 1995, “Early Loosening of the Femoral Component at the Cement-Prosthesis Interface After Total Hip Replacement,” J. Bone Joint Surg., Am. Vol., 77(9), pp. 1315–1322.
Kim, J.M., Mudgal, C.S., Konopka, J.F., and Jupiter, J. B., 2011, “Complications of Total Elbow Arthroplasty,” J. Am. Acad. Orthop. Surg., 19(6), pp. 328–339. [PubMed]
Amis, A. A., Dowson, D., and Wright, V., 1980, “Elbow Joint Force Predictions for Some Strenuous Isometric Actions,” J. Biomech., 13(9), pp. 765–775. [CrossRef] [PubMed]
Johnson, J. A., and King, G. J. W., 2005, Shoulder and Elbow Arthroplasty, Lippincott, New York, pp. 279–296.
Bergmann, G., Deuretzbacher, G., Heller, M., Graichen, F., Rohlmann, A., Strauss, J., and Duda, G. N., 2001, “Hip Contact Forces and Gait Patterns From Routine Activities,” J. Biomech., 34(7), pp. 859–871. [CrossRef] [PubMed]
Bergmann, G., Graichen, F., Bender, A., Kaab, M., Rohlmann, A., and Westerhoff, P., 2007, “In Vivo Glenohumeral Contact Forces—Measurements in the First Patient 7 Months Postoperatively,” J. Biomech., 40(10), pp. 2139–2149. [CrossRef] [PubMed]
Barrack, R. L., 2000, “Early Failure of Modern Cemented Stems,” J. Arthroplasty, 15(8), pp. 1036–1050. [CrossRef] [PubMed]
Evans, B. G., Daniels, A. U., Serbousek, J. C., and Mann, R. J., 1988, “A Comparison of the Mechanical Designs of Articulating Total Elbow Prostheses,” Clin. Mater., 3(3), pp. 235–248. [CrossRef]
Jeon, I. H., Morrey, B. F., and Sanchez-Sotelo, J., 2012, “Ulnar Component Surface Finish Influenced the Outcome of Primary Coonrad-Morrey Total Elbow Arthroplasty,” J. Shoulder Elbow Surg., 21(9), pp. 1229–1235. [CrossRef] [PubMed]
van der Lugt, J. C., and Rozing, P. M., 2004, “Systematic Review of Primary Total Elbow Prostheses Used for the Rheumatoid Elbow,” Clin. Rheumatol., 23(4), pp. 291–298. [CrossRef] [PubMed]
Crowninshield, R. D., Jennings, J. D., Laurent, M. L., and Maloney, W. J., 1998, “Cemented Femoral Component Surface Finish Mechanics.,” Clin. Orthop. Relat. Res., 355, pp. 90–102. [CrossRef] [PubMed]
Scheerlinck, T., and Casteleyn, P. P., 2006, “The Design Features of Cemented Femoral Hip Implants,” J. Bone Joint Surg. Br., 88(11), pp. 1409–1418. [CrossRef] [PubMed]
Hosein, Y. K., King, G. J. W., and Dunning, C. E., 2013, “The Effect of Stem Surface Treatment and Material on Pistoning of Ulnar Components in Linked Cemented Elbow Prostheses,” J. Shoulder Elbow Surg., 22(9), pp. 1248–1255. [CrossRef] [PubMed]
Athwal, G. S., and Morrey, B. F., 2006, “Revision Total Elbow Arthroplasty for Prosthetic Fractures,” J. Bone Jt. Surg., Am. Vol., 88(9), pp. 2017–2026. [CrossRef]
Cheung, E. V., and O'Driscoll, S. W., 2007, “Total Elbow Prosthesis Loosening Caused by Ulnar Component Pistoning,” J. Bone Jt. Surg., Am. Vol., 89(6), pp. 1269–1274. [CrossRef]
Verdonschot, N., 2005, “Philosophies of Stem Designs in Cemented Total Hip Replacement,” Orthopedics, 28(8), pp. s833–s840. [PubMed]
Lewis, G., 2011, “Viscoelastic Properties of Injectable Bone Cements for Orthopaedic Applications: State-of-the-Art Review,” J. Biomed. Mater. Res., Part B: Appl. Biomater., 98(1), pp. 171–191. [CrossRef]
Kedgley, A. E., Takaki, S. E., Lang, P., and Dunning, C. E., 2007, “The Effect of Cross-Sectional Stem Shape on the Torsional Stability of Cemented Implant Components,” J. Biomech. Eng., 129(3), pp. 310–314. [CrossRef] [PubMed]
Callaghan, J. J., Fulghum, C. S., Glisson, R. R., and Stranne, S. K., 1992, “The Effect of Femoral Stem Geometry on Interface Motion in Uncemented Porous-Coated Total Hip Prostheses. Comparison of Straight-Stem and Curved-Stem Designs,” J. Bone Jt. Surg., Am. Vol., 74(6), pp. 839–848.
Faber, K. J., Cordy, M. E., Milne, A. D., Chess, D. G., King, G. J., and Johnson, J. A., 1997, “Advanced Cement Technique Improves Fixation in Elbow Arthroplasty,” Clin. Ortho. Relat. Res., 334, pp. 150–156. [CrossRef]
Iesaka, K., Jaffe, W. L., and Kummer, F. J., 2003, “Effects of Preheating of Hip Prostheses on the Stem-Cement Interface,” J. Bone Jt. Surg., Am. Vol., 85(3), pp. 421–427.
Kwong, F. N. K., and Power, R. A., 2006, “A Comparison of the Shrinkage of Commercial Bone Cements When Mixed Under Vacuum.,” J. Bone Jt. Surg. Br., 88(1), pp. 120–122. [CrossRef]
Lewis, G., 1997, “Properties of Acrylic Bone Cement: State of the Art Review,” J. Biomed. Mater. Res., 38(2), pp. 155–182. [CrossRef] [PubMed]
Orr, J. F., Dunne, N. J., and Quinn, J. C., 2003, “Shrinkage Stresses in Bone Cement,” Biomaterials, 24(17), pp. 2933–2940. [CrossRef] [PubMed]
Eveleigh, R., 2001, “Mixing Systems and the Effects of Vacuum Mixing on Bone Cement,” British J. Perioper. Nursing, 11(3), pp. 132–140.
Lennon, A. B., and Prendergast, P. J., 2002, “Residual Stress Due to Curing Can Initiate Damage in Porous Bone Cement: Experimental and Theoretical Evidence,” J. Biomech., 35(3), pp. 311–321. [CrossRef] [PubMed]
Bishop, N. E., Ferguson, S., and Tepic, S., 1996, “Porosity Reduction in Bone Cement at the Cement-Stem Interface,” J. Bone Jt. Surg. Br., 78(3), pp. 349–356.
Draenert, K., and Draenert, Y., 2005, The Well-Cemented Total Hip Arthroplasty, Springer, New York, pp. 93–102.
Crowninshield, R. D., Brand, R. A., Johnston, R. C., and Milroy, J. C., 1980, “An Analysis of Femoral Component Stem Design in Total Hip Arthroplasty,” J. Bone Joint Surg., Am. Vol., 62(1), pp. 68–78.


Grahic Jump Location
Fig. 1

Stem surface designs tested in both compression and torsion: (a) smooth, (b) 1.1 mm grooved, and (c) 0.6 mm grooved. All stems were cemented to fixed 20 mm depth, as indicated by the region highlighted by the double arrows.

Grahic Jump Location
Fig. 2

Representative graphs of stem motion for smooth, grooved 0.6 mm and grooved 1.1 mm. (a) Relative stem motion under compression, and (b) relative stem rotation in torsion, was used to determine interface toggle prior to failure. (c) Global stem motion was used to determine the change in stem motion with increased number of cycles at the maximum load, as indicated by the starred region.

Grahic Jump Location
Fig. 3

Interface stability offered by the smooth, grooved 0.6 mm, and grooved 1.1 mm stems under compression, as measured by (a) loads required to cause failure and, (b) interface toggle prior to failure. All stems failed at consistent loads, resulting in zero standard deviation for the measures of load at failure, as seen in part (a). Smooth stems showed the least stability (p < 0.01**) compared to the grooved surfaces.

Grahic Jump Location
Fig. 4

Interface stability offered by the smooth, grooved 0.6 mm and grooved 1.1 mm stems under torsional loading, as measured by (a) torque required to cause failure and, (b) interface toggle prior to failure. No differences were found in the torque to failure among all stems (p = 0.1), however, grooved 1.1 mm stems showed greatest interface toggle prior to failure (p < 0.01*).

Grahic Jump Location
Fig. 5

Stem motion with increased number of cycles at maximum compression load, for grooved 0.6 mm and grooved 1.1 mm stems. Grooved 1.1 mm stems showed increased stem motion compared to the grooved 0.6 mm (p = 0.03).



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