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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 1, 107-113.
doi: 10.1302/0301-620X.90B1.19430  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Quantification of stem-cement interfacial gaps

IN VITRO CT ANALYSIS OF CHARNLEY-KERBOUL AND LUBINUS SPII FEMORAL HIP IMPLANTS

T. Scheerlinck, MD, Orthopaedic Surgeon, Chief of Clinic1; P. Vandenbussche, MD, Junior Registrar1; and P. C. Noble, BE, MEng, Sci, PhD, John S Dunn Professor of Orthopaedic Research2

1 Department of Orthopaedic and Trauma Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.
2 Institute of Orthopaedic Research and Education, Baylor College of Medicine, 6550 Fannin, Suite 2512, Houston, Texas 77030, USA.

Correspondence should be sent to Dr T. Scheerlinck; e-mail: Thierry.Scheerlinck{at}uzbrussel.be

Interfacial defects between the cement mantle and a hip implant may arise from constrained shrinkage of the cement or from air introduced during insertion of the stem. Shrinkage-induced interfacial porosity consists of small pores randomly located around the stem, whereas introduced interfacial gaps are large, individual and less uniformly distributed areas of stem-cement separation. Using a validated CT-based technique, we investigated the extent, morphology and distribution of interfacial gaps for two types of stem, the Charnley-Kerboul and the Lubinus SPII, and for two techniques of implantation, line-to-line and undersized.

The interfacial gaps were variable and involved a mean of 6.43% (SD 8.99) of the surface of the stem. Neither the type of implant nor the technique of implantation had a significant effect on the regions of the gaps, which occurred more often over the flat areas of the implant than along the corners of the stems, and were more common proximally than distally for Charnley-Kerboul stems cemented line-to-line. Interfacial defects could have a major effect on the stability and survival of the implant.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General