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The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model

Received: 28 June 2017     Accepted: 17 July 2017     Published: 23 October 2017
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Abstract

The Preserve stem is a modified Zweymüller femoral stem that omits the trochanteric wing. Omission of the trochanteric wing of the prosthesis might influence its rotational stability, but, there are no reports about the rotational stability of a modified Zweymüller femoral stem. The purpose of this study was to investigate the effect of the trochanteric wing on rotational stability by comparing the modified Zweymüller femoral stem and the original Zweymüller femoral stem. Computed tomography of the right femur was used to construct a resin model of the proximal femur. Three types of uncemented stems were used in this study: Preserve α, β, and exemplary Zweymüller stem. Preserve β is a modified Zweymüller-type of stem with a reduced trochanteric wing. Preserve α is also a Zweymüller-type of stem with a further reduced trochanteric wing. The resin bone model was mounted on a universal testing machine. The stem was inserted into the bone model manually and loaded vertically up to 600 N. Then the stem was rotated posteriorly by 1°/sec until angular rotation was achieved to 5°. The torque at 5° was compared among the three stems. Vertical displacement of the stem during rotation testing was also recorded as a correlative measure for prosthetic subsidence. The results showed that the mean torque at 5° was not significantly different among the Preserve α, β, and exemplary Zweymüller stem (Tukey-Kramer test). Furthermore, the mean vertical displacement amounts during rotation testing were not significantly different among the three stems (Tukey-Kramer test). This study indicate that the Preserve α and β, modified Zweymüller stems, are rotationally as stable as the exemplary Zweymüller stem.

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 3, Issue 5)
DOI 10.11648/j.ijcems.20170305.13
Page(s) 66-70
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Rotational Stability, Zweymüller Stem, Trochanteric Wing

References
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[2] Mahmoud AN, Kesteris U, Flivik G. (2017) Stable migration pattern of an ultra-short anatomical uncemented hip stem: a prospective study with 2 years radiostereometric analysis follow-up. Hip Int. 27 (3): 259-266.
[3] Koch CN, Mateo LS, Kayiaros S, Cassidy KA, Jerabek SA, Gonzalez Della Valle A. (2016) Spontaneous Fractures of a Modern Modular Uncemented Femoral Stem. HSS J. 12 (3): 250-254.
[4] Murphy CG, Bonnin MP, Desbiolles AH, Carrillon Y, Aїt Si Selmi T. (2016) Varus will have varus; a radiological study to assess and predict varus stem placement in uncemented femoral stems. Hip Int. 26 (6): 554-560.
[5] Veen EJ, Schrier JC, Van't Riet E, Breslau MJ, Barnaart AF. (2016) Outcome of the Cementless Zweymüller BICON-PLUS Cup and SL-PLUS Stem in the Very Elderly Individuals. Geriatr Orthop Surg Rehabil. 7 (2): 74-80.
[6] McLaughlin JR, Lee KR. (2016) Long-term results of uncemented total hip arthroplasty with the Taperloc femoral component in patients with Dorr type C proximal femoral morphology. Bone Joint J. 98-B (5): 595-600.
[7] Inaba Y, Kobayashi N, Oba M, Ike H, Kubota S, Saito T. (2016) Difference in Postoperative Periprosthetic Bone Mineral Density Changes Between 3 Major Designs of Uncemented Stems: A 3-Year Follow-Up Study. J Arthroplasty. 31 (8): 1836-41.
[8] Sueyoshi T, Meding JB, Berend ME, Brunsman MJ, Ritter MA. (2016) Short-term Outcomes with a Second-Generation Uncemented Stem in Total Hip Arthroplasty. Orthopedics. 39 (2): e215-8.
[9] Gastaud O, Cambas PM, Tabutin J. (2016) Femoral revision with a primary cementless stem. Orthop Traumatol Surg Res. 102 (2): 149-53.
[10] Enoksen CH, Gjerdet NR, Klaksvik J, Arthursson AJ, Schnell-Husby O, Wik TS. (2016) Deformation pattern and load transfer of an uncemented femoral stem with modular necks. An experimental study in human cadaver femurs. Clin Biomech (Bristol, Avon). 32: 28-33.
[11] McLaughlin JR, Lee KR. (2016) Total Hip Arthroplasty With an Uncemented Tapered Femoral Component in Patients Younger Than 50 Years of Age: A Minimum 20-Year Follow-Up Study. J Arthroplasty. 31 (6): 1275-8.
[12] Effenberger H, Heiland A, Ramsauer T, Plitz W, Dorn U. (2001) A model for assessing the rotational stability of uncemented femoral implants. Arch Orthop Trauma Surg. 121: p. 60-4.
[13] Zweymüller K, Semlitsch M. (1982) Concept and material properties of a cementless hip prosthesis system with Al2O3 ceramic ball heads and wrought Ti-6Al-4V stems. Arch Orthop Trauma Surg. 100: p. 229-36.
[14] Kolb A, Grübl A, Schneckener CD, et al. (2012) Cementless total hip arthroplasty with the rectangular titanium Zweymüller stem: a concise follow-up, at a minimum of twenty years, of previous reports. J Bone Joint Surg Am. 94: p. 1681-4.
[15] Suckel A, Geiger F, Kinzl L, et al. (2009) Long-term results for the uncemented Zweymuller/Alloclassic hip endoprosthesis. A 15-year minimum follow-up of 320 hip operations. J Arthroplasty. 24: p. 846-53.
[16] Ottink K, Barnaart L, Westerbeek R, et al. (2015) Survival, clinical and radiological outcome of the Zweymüller SL/Bicon-Plus total hip arthroplasty: a 15-year follow-up study. Hip Int. 25: p. 204-8.
[17] Garcia-Cimbrelo E, Cruz-Pardos A, Madero R, et al. (2003) Total hip arthroplasty with use of the cementless Zweymüller Alloclassic system. A ten to thirteen-year follow-up study. J Bone Joint Surg Am. 85: p. 296-303.
[18] Delaunay C. (2014) Effect of hydroxyapatite coating on the radio-clinical results of a grit-blasted titanium alloy femoral taper. A case-control study of 198 cementless primary total hip arthroplasty with the Alloclassic™ system. Orthop Traumatol Surg Res. 100: p. 739-44.
[19] Korovessis P, Repantis T, Zafiropoulos A. (2011) High medium-term survivorship and durability of Zweymüller-Plus total hip arthroplasty. Arch Orthop Trauma Surg. 131: p. 603-11.
[20] Reigstad O, Siewers P, Røkkum M, et al. (2008) Excellent long-term survival of an uncemented press-fit stem and screw cup in young patients: follow-up of 75 hips for 15-18 years. Acta Orthop. 79: p. 194-202.
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    Tomonori Shigemura, Takanori Omae, Shigeru Mitsuhashi, Yasuaki Murata, Yohei Yamamoto, et al. (2017). The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model. International Journal of Clinical and Experimental Medical Sciences, 3(5), 66-70. https://doi.org/10.11648/j.ijcems.20170305.13

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    ACS Style

    Tomonori Shigemura; Takanori Omae; Shigeru Mitsuhashi; Yasuaki Murata; Yohei Yamamoto, et al. The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model. Int. J. Clin. Exp. Med. Sci. 2017, 3(5), 66-70. doi: 10.11648/j.ijcems.20170305.13

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    AMA Style

    Tomonori Shigemura, Takanori Omae, Shigeru Mitsuhashi, Yasuaki Murata, Yohei Yamamoto, et al. The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model. Int J Clin Exp Med Sci. 2017;3(5):66-70. doi: 10.11648/j.ijcems.20170305.13

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  • @article{10.11648/j.ijcems.20170305.13,
      author = {Tomonori Shigemura and Takanori Omae and Shigeru Mitsuhashi and Yasuaki Murata and Yohei Yamamoto and Takashi Sato and Ryuto Tsuchiya and Yuichi Wada and Hiroyuki Takahashi and Michihiro Fujiwara},
      title = {The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {3},
      number = {5},
      pages = {66-70},
      doi = {10.11648/j.ijcems.20170305.13},
      url = {https://doi.org/10.11648/j.ijcems.20170305.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20170305.13},
      abstract = {The Preserve stem is a modified Zweymüller femoral stem that omits the trochanteric wing. Omission of the trochanteric wing of the prosthesis might influence its rotational stability, but, there are no reports about the rotational stability of a modified Zweymüller femoral stem. The purpose of this study was to investigate the effect of the trochanteric wing on rotational stability by comparing the modified Zweymüller femoral stem and the original Zweymüller femoral stem. Computed tomography of the right femur was used to construct a resin model of the proximal femur. Three types of uncemented stems were used in this study: Preserve α, β, and exemplary Zweymüller stem. Preserve β is a modified Zweymüller-type of stem with a reduced trochanteric wing. Preserve α is also a Zweymüller-type of stem with a further reduced trochanteric wing. The resin bone model was mounted on a universal testing machine. The stem was inserted into the bone model manually and loaded vertically up to 600 N. Then the stem was rotated posteriorly by 1°/sec until angular rotation was achieved to 5°. The torque at 5° was compared among the three stems. Vertical displacement of the stem during rotation testing was also recorded as a correlative measure for prosthetic subsidence. The results showed that the mean torque at 5° was not significantly different among the Preserve α, β, and exemplary Zweymüller stem (Tukey-Kramer test). Furthermore, the mean vertical displacement amounts during rotation testing were not significantly different among the three stems (Tukey-Kramer test). This study indicate that the Preserve α and β, modified Zweymüller stems, are rotationally as stable as the exemplary Zweymüller stem.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model
    AU  - Tomonori Shigemura
    AU  - Takanori Omae
    AU  - Shigeru Mitsuhashi
    AU  - Yasuaki Murata
    AU  - Yohei Yamamoto
    AU  - Takashi Sato
    AU  - Ryuto Tsuchiya
    AU  - Yuichi Wada
    AU  - Hiroyuki Takahashi
    AU  - Michihiro Fujiwara
    Y1  - 2017/10/23
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ijcems.20170305.13
    DO  - 10.11648/j.ijcems.20170305.13
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 66
    EP  - 70
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20170305.13
    AB  - The Preserve stem is a modified Zweymüller femoral stem that omits the trochanteric wing. Omission of the trochanteric wing of the prosthesis might influence its rotational stability, but, there are no reports about the rotational stability of a modified Zweymüller femoral stem. The purpose of this study was to investigate the effect of the trochanteric wing on rotational stability by comparing the modified Zweymüller femoral stem and the original Zweymüller femoral stem. Computed tomography of the right femur was used to construct a resin model of the proximal femur. Three types of uncemented stems were used in this study: Preserve α, β, and exemplary Zweymüller stem. Preserve β is a modified Zweymüller-type of stem with a reduced trochanteric wing. Preserve α is also a Zweymüller-type of stem with a further reduced trochanteric wing. The resin bone model was mounted on a universal testing machine. The stem was inserted into the bone model manually and loaded vertically up to 600 N. Then the stem was rotated posteriorly by 1°/sec until angular rotation was achieved to 5°. The torque at 5° was compared among the three stems. Vertical displacement of the stem during rotation testing was also recorded as a correlative measure for prosthetic subsidence. The results showed that the mean torque at 5° was not significantly different among the Preserve α, β, and exemplary Zweymüller stem (Tukey-Kramer test). Furthermore, the mean vertical displacement amounts during rotation testing were not significantly different among the three stems (Tukey-Kramer test). This study indicate that the Preserve α and β, modified Zweymüller stems, are rotationally as stable as the exemplary Zweymüller stem.
    VL  - 3
    IS  - 5
    ER  - 

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Author Information
  • Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara City, Japan

  • Department of Orthopaedic Surgery, Sanmu Medical Center, Sanmu City, Japan

  • Department of Orthopaedic Surgery, Narashino Dai-ichi Hospital, Narashino City, Japan

  • Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara City, Japan

  • Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara City, Japan

  • Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara City, Japan

  • Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara City, Japan

  • Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara City, Japan

  • Department of Engineering, Teijin Nakashima Medical Co., Ltd, Okayama City, Japan

  • Department of Engineering, Teijin Nakashima Medical Co., Ltd, Okayama City, Japan

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