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...
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The British Editorial Society of Bone & Joint Surgery
2025-07-01
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| Series: | Bone & Joint Research |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.147.BJR-2024-0408.R1 |
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| 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 |
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| 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 |
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