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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 11, 1522-1527.
doi: 10.1302/0301-620X.90B11.20068  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Femoral neck fracture following hip resurfacing

THE EFFECT OF ALIGNMENT OF THE FEMORAL COMPONENT

E. T. Davis, MB, ChB, MSc, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon1; M. Olsen, BSc, PhD, Candidate2; R. Zdero, PhD, Research Director2; J. P. Waddell, MD, FRCS(C), Professor3; and E. H. Schemitsch, MD, FRCS(C), Professor4

1 The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road, Northfield, Birmingham B31 2AP, UK.
2 Martin Orthopaedic Biomechanics Laboratory, Shuter Wing (Room 5-066)
3 Division of Orthopaedic Surgery, Department of Surgery St Michael’s Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
4 Division of Orthopaedic Surgery, Department of Surgery St Michael’s Hospital, 800-55 Queen Street East, Toronto, Ontario M5C 1R6, Canada.

Correspondence should be sent to Mr E. T. Davis; e-mail: eddavis{at}doctors.org.uk

A total of 20 pairs of fresh-frozen cadaver femurs were assigned to four alignment groups consisting of relative varus (10° and 20°) and relative valgus (10° and 20°), 75 composite femurs of two neck geometries were also used. In both the cadaver and the composite femurs, placing the component in 20° of valgus resulted in a significant increase in load to failure. Placing the component in 10° of valgus had no appreciable effect on increasing the load to failure except in the composite femurs with varus native femoral necks. Specimens in 10° of varus were significantly weaker than the neutrally-aligned specimens.

The results suggest that retention of the intact proximal femoral strength occurs at an implant angulation of ≥ 142°. However, the benefit of extreme valgus alignment may be outweighed in clinical practice by the risk of superior femoral neck notching, which was avoided in this study.




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