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BMC Musculoskeletal Disorders

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Open Access 01-12-2015 | Research article

Can bone apposition predict the retention force of a femoral stem? An experimental weight-bearing hip-implant model in goats

Authors: Knut Harboe, Christian Lycke Ellingsen, Einar Sudmann, Nils Roar Gjerdet, Kjetil Søreide, Kari Indrekvam

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Abstract

Background

The increasing incidence of prosthesis revision surgery in the Western world has led to an increased focus on the capacity for stem removal. We previously reported on a femoral stem implanted in goats with an approximate 15% reduction in retention force by drilling longitudinally orientated grooves on the side of the stem. In this current study, we aimed to histologically evaluate the bony apposition towards this stem and correlate this apposition with the pullout force.

Methods

We analyzed the femora of 22 goats after stem removal. All stems remained in place for 6 months, and the goats were allowed regular loading of the hip during this time. For histological evaluation, all femora were immersed in EDTA and decalcified until sufficiently soft for standard technique preparation. We evaluated bone apposition, the presence of foreign particle debris and other factors. The apposition was evaluated with a scoring system based on semi-quantitative bone apposition in four quadrants. Kappa statistics were calculated for the score. We correlated the retention force with the amount of bone apposition.

Results

The stem drilling was the only significant factor influencing the retention force (p = 0.020). The bone apposition Kappa score comparing poor and good apposition scores was fair (κ = 0.4, 95% CI 0.00–0.88). Signs of foreign body reaction were noted in 5 of 22 goats.

Conclusions

Based on the current findings in an experimental goat model, it appears that the effect of drilling tissue/bone out of the longitudinal grooves has a more significant impact on the retention force required to remove the stem than the amount of bone apposition outside the stem grooves. This observation may be further explored in the research of stem designs that are potentially easier to remove.

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Title: Can bone apposition predict the retention force of a femoral stem? An experimental weight-bearing hip-implant model in goats
Authors: Knut Harboe
Christian Lycke Ellingsen
Einar Sudmann
Nils Roar Gjerdet
Kjetil Søreide
Kari Indrekvam
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-015-0560-z

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Can bone apposition predict the retention force of a femoral stem? An experimental weight-bearing hip-implant model in goats

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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