Published online by Cambridge University Press: 22 February 2011
A stemmed bone ingrowth hip resurfacing arthroplasty designed for use with bone deficient femoral heads raises concerns of stress shielding and is investigated in this study. Ten CoCr bone ingrowth hip resurfacing devices were implanted in five adult canines. Design consisted of a 6mm deep cylindrical cavity with porous beaded surface of 150um pore size and Imm nominal depth. A 3mm diameter smooth CoCr stem was eccentrically fixed to the component for additional fixation with threaded nut at the lateral cortex. Femoral head was reamed for interference fit with hole for the stem placed superiorly. Acrylic fixed polyethylene cups were used for acetabular components. Animals were followed with serial radiographs to sacrifice at 73 to 267 days. After sacrifice microradiographs of ground sections and histologic specimens were evaluated for bone ingrowth, remodeling, and femoral neck attenuation. All specimens showed well ingrown bone at the porous layer. Bone remodeling showed preservation of proximal femoral neck cancellous trabecular pattern and medial cortical support. Resorption of bone at the implant rim and femoral neck thinning were, however, present. Two specimens had neck thinning of 10% or less, four of 10 to 25%, three of 25 to 50%, and one greater than 50%. There was no correlation with time to sacrifice for parameters evaluated. Results indicate preservation of the compressive stresses through the femoral head. Resorption of bone at the rim and femoral neck attenuation, however, indicates load sharing between the implant and bone. Though a lower modulus material such as titanium would decrease load sharing, the geometrical design insures the presence of stress distribution anomalies.