Measures of micromotion in cementless femoral stems-review of current methodologies

Abstract

Stability and loosening of implanted femoral stems in Total Hip Replacement have been well established as barriers to the primary concerns of osseointegration and long term implant survival. In-vitro experiments and finite element modeling have for years been used as a primary tool to assess the bone stem interface with variable methodologies leading to a wide range of micromotion, interference fit and stress shielding values in the literature. The current study aims to provide a comprehensive review of currently utilized methodologies for in-vitro mechanical testing as well as finite element modeling of both micromotion and interference of implanted femoral stems. A total of 12 studies detailed in 33 articles were selected for inclusion. Experimental values of micromotion ranged from 12 to <TEX>$182{\mu}m$</TEX> while finite element analysis reported a wider range from 2.74 to <TEX>$1,277{\mu}m$</TEX>. Only two studies were found that modeled bone/implant contact with consideration for interference fit. In studies evaluating stem micromotion in THA, the reference surface at the bone/stem interface should be well defined. Additionally, the amount of penetration considered should be disclosed and associated with bone density and roughness.