The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interface

Aims: Cemented polished taper fit (PTF) stems are the femoral implant of choice for total hip arthroplasty (THA) in many locations worldwide. There is increasing evidence that periprosthetic fracture may be the single major contributor to reoperation with these stems. The aim of this study was to de...

Full description

Saved in:
Bibliographic Details
Main Authors: Bernard H. van Duren, Mohamad Taufiqurrakhman, Alison Jones, Mark Higgins, Andrew R. Manktelow, Benjamin V. Bloch, Hemant Pandit
Format: Article
Language:English
Published: The British Editorial Society of Bone & Joint Surgery 2025-07-01
Series:Bone & Joint Research
Subjects:
Online Access:https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.147.BJR-2024-0408.R1
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849728585683697664
author Bernard H. van Duren
Mohamad Taufiqurrakhman
Alison Jones
Mark Higgins
Andrew R. Manktelow
Benjamin V. Bloch
Hemant Pandit
author_facet Bernard H. van Duren
Mohamad Taufiqurrakhman
Alison Jones
Mark Higgins
Andrew R. Manktelow
Benjamin V. Bloch
Hemant Pandit
author_sort Bernard H. van Duren
collection DOAJ
description Aims: Cemented polished taper fit (PTF) stems are the femoral implant of choice for total hip arthroplasty (THA) in many locations worldwide. There is increasing evidence that periprosthetic fracture may be the single major contributor to reoperation with these stems. The aim of this study was to demonstrate how mismatches at the implant-cement interface may occur and the subsequent effect of these incongruities on the contacting area and the forces transmitted to the cement mantle. Methods: A parametric equation-based model was developed to determine the contact mismatch relative to axial stem rotations. This model was also used to calculate the restoration of contact surface area with stem subsidence for both a dual-taper and triple-taper geometry. A finite element analysis (FEA) was used to compare the effects of reduced contact area due to the incongruent hip implant-cement interface. Results: The contact model showed a large decrease in surface contact area with even only a small rotation going from 100% at 0° to 50.00% at 2.5° for the dual-taper geometry, and from 100% at 0° to 50.20% at 2.5° for the triple-taper geometry. There was a gradual but small ongoing decrease in contact surface with increasing rotation for both the dual-taper and triple-taper geometries. For both taper designs, there was an increase in contact surface area with an increase in subsidence resulting in contact for up to a 5° mismatch being restored with 2 mm subsidence. FEA showed that with increasing mismatches and consequent contact area reduction, there was an increase in von Mises stress in the implant-cement interface of up to 235%. Conclusion: With increasing mismatch, there was an increase in maximum stresses, total strain, and subsidence in the cement mantle, highlighting the importance of achieving an optimal implant-cement interface at the time of implantation of cemented PTF femoral stems. Cite this article: Bone Joint Res 2025;14(7):642–655.
format Article
id doaj-art-df81e47f0f1b498e92a66c47dc89fd59
institution DOAJ
issn 2046-3758
language English
publishDate 2025-07-01
publisher The British Editorial Society of Bone & Joint Surgery
record_format Article
series Bone & Joint Research
spelling doaj-art-df81e47f0f1b498e92a66c47dc89fd592025-08-20T03:09:31ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582025-07-0114764265510.1302/2046-3758.147.BJR-2024-0408.R1The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interfaceBernard H. van Duren0Mohamad Taufiqurrakhman1Alison Jones2Mark Higgins3Andrew R. Manktelow4Benjamin V. Bloch5Hemant Pandit6Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UKLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UKSchool of Mechanical Engineering, University of Leeds, Leeds, UKNottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UKNottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UKNottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UKLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UKAims: Cemented polished taper fit (PTF) stems are the femoral implant of choice for total hip arthroplasty (THA) in many locations worldwide. There is increasing evidence that periprosthetic fracture may be the single major contributor to reoperation with these stems. The aim of this study was to demonstrate how mismatches at the implant-cement interface may occur and the subsequent effect of these incongruities on the contacting area and the forces transmitted to the cement mantle. Methods: A parametric equation-based model was developed to determine the contact mismatch relative to axial stem rotations. This model was also used to calculate the restoration of contact surface area with stem subsidence for both a dual-taper and triple-taper geometry. A finite element analysis (FEA) was used to compare the effects of reduced contact area due to the incongruent hip implant-cement interface. Results: The contact model showed a large decrease in surface contact area with even only a small rotation going from 100% at 0° to 50.00% at 2.5° for the dual-taper geometry, and from 100% at 0° to 50.20% at 2.5° for the triple-taper geometry. There was a gradual but small ongoing decrease in contact surface with increasing rotation for both the dual-taper and triple-taper geometries. For both taper designs, there was an increase in contact surface area with an increase in subsidence resulting in contact for up to a 5° mismatch being restored with 2 mm subsidence. FEA showed that with increasing mismatches and consequent contact area reduction, there was an increase in von Mises stress in the implant-cement interface of up to 235%. Conclusion: With increasing mismatch, there was an increase in maximum stresses, total strain, and subsidence in the cement mantle, highlighting the importance of achieving an optimal implant-cement interface at the time of implantation of cemented PTF femoral stems. Cite this article: Bone Joint Res 2025;14(7):642–655.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.147.BJR-2024-0408.R1polished taper stemcementing techniquefinite element analysiscementing techniquehip stemsstrainsperiprosthetic fracturehip implantsfemoral stemstotal hip arthroplasty (tha)femoral implantreoperation
spellingShingle Bernard H. van Duren
Mohamad Taufiqurrakhman
Alison Jones
Mark Higgins
Andrew R. Manktelow
Benjamin V. Bloch
Hemant Pandit
The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interface
Bone & Joint Research
polished taper stem
cementing technique
finite element analysis
cementing technique
hip stems
strains
periprosthetic fracture
hip implants
femoral stems
total hip arthroplasty (tha)
femoral implant
reoperation
title The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interface
title_full The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interface
title_fullStr The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interface
title_full_unstemmed The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interface
title_short The impact of cementing technique in polished taper fit hip stems: a modelling analysis of implant-cement interface
title_sort impact of cementing technique in polished taper fit hip stems a modelling analysis of implant cement interface
topic polished taper stem
cementing technique
finite element analysis
cementing technique
hip stems
strains
periprosthetic fracture
hip implants
femoral stems
total hip arthroplasty (tha)
femoral implant
reoperation
url https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.147.BJR-2024-0408.R1
work_keys_str_mv AT bernardhvanduren theimpactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT mohamadtaufiqurrakhman theimpactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT alisonjones theimpactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT markhiggins theimpactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT andrewrmanktelow theimpactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT benjaminvbloch theimpactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT hemantpandit theimpactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT bernardhvanduren impactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT mohamadtaufiqurrakhman impactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT alisonjones impactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT markhiggins impactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT andrewrmanktelow impactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT benjaminvbloch impactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface
AT hemantpandit impactofcementingtechniqueinpolishedtaperfithipstemsamodellinganalysisofimplantcementinterface